Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features

Abstract

SUMMARY Syphilis is a chronic disease with a waxing and waning course, the manifestations of which have been described for centuries. It occurs worldwide, and the incidence varies significantly with geographic location. Transmission is mainly by sexual contact. The causative organism, Treponema pallidum, was first described in 1905, but because of the inability to culture the organism and the limitations of direct microscopy, serologic testing is the mainstay of laboratory diagnosis. The disease has been arbitrarily divided into several stages. The primary stage is defined by a chancre at the site of inoculation. The secondary stage is characterized by a polymorphic rash, lymphadenopathy, and other systemic manifestations. A variable asymptomatic latent period follows, which for epidemiologic purposes is divided into early (<1 year) and late (>1 year) stages. The early stages (primary, secondary, and early latent) are potentially infectious. The tertiary stage is the most destructive and is marked by cardiovascular and neurologic sequelae and gummatous involvement of any organ system. Congenital infection may result in protean early or late manifestations. Unlike many other bacteria causing infectious diseases, the organism remains sensitive to penicillin, and this remains the mainstay of therapy.

HIV, Sexually Transmitted Infections, and Sexual Risk Behavior Among Transgenders in Indonesia

“…Syphilis control needs to be emphasized as syphilis fuels the HIV epidemic by increasing susceptibility for HIV and by increasing HIV infectiousness among those already infected with HIV [8]. In addition, untreated syphilis results in short-term (e.g., genital lesions, lymphadenopathy, and alopecia) and long-term (cardiovascular complications such as aortic aneurysm and neurological complications such as meningitis) morbidity [9]. Although three quarters of waria reported to have visited an STI clinic in the last 3 months for routine check-ups, those visiting STI clinics did not have lower syphilis rates.…”

Aortitis Diagnosed by F–18–Fluorodeoxyglucose Positron Emission Tomography in a Patient with Syphilis and HIV Coinfection

“…Clinical presentation usually occurs 5 to 30 years after primary infection [6][7][8]. As for the other manifestations of tertiary syphilis, invasion of the cardiovascular system occurs early following primary infection.…”

Evaluation of the Determine Syphilis TP assay for the detection of antibodies against Treponema pallidum for the serodiagnosis of syphilis

“…These situations can be avoided if the laboratory results are obtained using a rapid treponemal test, such as the Determine TP assay, which can test whole blood samples immediately, regardless of the equipment or conditions at the testing site. Nontreponemal tests such as RPR or TRUST, which were initially established by Wassermann in 1906 [26], are widely used for syphilis screening in China. Considering the BFP phenomenon, positive results of nontreponemal tests should require confirmation with treponemal-specific tests, such as TPPA, TP-ELISA, or TP-CLIA, which detect T. pallidumspecific antibodies.…”