- A spirochete
0.1µm X 5-15µm.
- Cannot be seen by Gram staining
but can be observed using darkfield microscopy.
- Microaerophilic (def).
- Humans are the only natural host.
- Typically transmitted sexually
by contact with infected lesions; may be transmitted congenitally.
- There were 32,000 cases of syphilis
reported in the U.S. during 2003.
- Primary syphilis. Primary syphilis
appears as a chancre (def),
a painless ulcer with a raised border at the site of spirochete inoculation.
The chancre is highly infectious. Regional painless lymphadenopathy (def)
appears typically develops 1-2 weeks after the chancre. The chancre is abundant
in spirochetes that subsequently disseminate via the lymphatics and blood.
The chancre heals spontaneously within 2 months.
- Secondary syphilis. Secondary
syphilis appears as flu-like symptoms with fever, headache, sore throat, anorexia
, myalgias (def)
, lymphadenopathy, and a highly infectious generalized mucocutaneous rash
that may resolve over a period of weeks to months.
- Late syphilis. A small percentage
of cases progress to tertiary syphilis characterized by a chronic inflammatory
response that can destroy pretty much any organ or tissue. This can result
in blindness, dementia (def),
and granulomatous lesions called gummas (def).
- Congenital syphilis. In utero
infection can result in latent infections, multiorgan malformations, or fetal
death. Typically the newborn is initially asymptomatic but subsequently develops
and a widespread macropapular rash (def).
Late bony destruction and cardiovascular syphilis are common if the child
is not treated with antibiotics.
by Peter Liu, MD, Staff Physician, Department of Emergency Medicine, Virginia
Hospital Center Arlington; Brian
Euerle, MD, Program Director, Assistant Professor, Department of Surgery, Division
of Emergency Medicine, University of Maryland Medical School; and Pranatharthi
Haran Chandrasekar, MD, Director of Infectious Disease Fellowship, Professor,
Department of Internal Medicine, Harper Hospital, Wayne State University School