The Late Manifestations of Syphilis: Skeletal, Visceral and Cardiovascular

Kampmeier, R. H.

doi:10.1016/s0025-7125(16)33449-6

Cited by 45 publications

(18 citation statements)

References 12 publications

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“…Importantly, the osseous distribution in skeletons was indistinguishable from that reported in radiologic studies of affected individuals in life [55][56][57]. This further confirms the validity of the technique.…”

Section: Skeletal Criteriasupporting

confidence: 72%

Syphilis: Its History and World Impact

Rothschild¹

2005

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The history of syphilis is one of irresponsibility, mythology and more recently, scientific insight. Pseudo-Descartian (defined as 'I think, therefore I publish') mythology has until now precluded any cogent discussion of where the disease originated and who was responsible for its spread. Evidence-based research now allows clear separation of syphilis from others in its class of treponematosis. Examination of skeletons from populations with clinically diagnosed bejel and yaws revealed bone alterations distinctive to those diseases and clearly separating them from syphilis. These insights allowed confident identification, for the first time, of the New World origin of syphilis and indeed, the 'smoking gun' in the Dominican Republic. Thus, the role of Columbus' crew in transmitting syphilis from the New World to the Old is confirmed. Finally, the impact of syphilis on history is explored, ranging from character assassination to potential effect on artistic expression and on the madness that enveloped the third to fifth decades of the last century.

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Section: Skeletal Criteriasupporting

confidence: 72%

Syphilis: Its History and World Impact

Rothschild¹

2005

CRR

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“…Using PCR and infectivity testing, T. pallidum is routinely found in the CSF of individuals with early and latent syphilis (183,193). T. pallidum has been detected decades after initial infection in tertiary gummatous lesions of the skin by silver staining and immunofluorescence microscopy (122,160,301) and by PCR (338).…”

Section: Invasionmentioning

confidence: 99%

Biological Basis for Syphilis

2006

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SUMMARY Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp. pallidum. Clinical manifestations separate the disease into stages; late stages of disease are now uncommon compared to the preantibiotic era. T. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. Nonetheless, T. pallidum is highly infectious and survives for decades in the untreated host. Early syphilis lesions result from the host's immune response to the treponemes. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection. One factor contributing to T. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. T. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health.

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“…Criteria unique to syphilis were the frequency of osseous involvement in the population and the extent of remodeling of the characteristic sabre shin lesion [20,[83][84][85]. These frequencies and osseotype characteristics are independent of sex and ethnicity [4,26,32,50,51].…”

Section: Skeletal Criteriamentioning

confidence: 99%

History of Syphilis

Rothschild

2005

Clinical Infectious Diseases

137

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Evidence-based research now allows clear separation of syphilis from other diseases in its class of treponematoses. Examination of skeletons from populations with clinically diagnosed bejel and yaws revealed bone alterations distinctive to those diseases, clearly separating them from alterations due to syphilis, transcending the limitations of current DNA and immunologic technologies. These insights allowed confident identification of the New World origin of syphilis. Absence of skeletal evidence of any treponemal disease in continental Europe before the time of Columbus excludes it as site of origin of syphilis. Treponemal disease appears to have originated in East Africa with late transmission to England, perhaps as a complication of the slave trade. The original treponemal disease apparently spread from Africa through Asia, entering North America. Approximately 8 millennia later, it mutated to syphilis. Presence of skeletal evidence of syphilis at the site in the Dominican Republic where Columbus landed suggests the route by which it was transmitted to the Old World.

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The Late Manifestations of Syphilis: Skeletal, Visceral and Cardiovascular

Cited by 45 publications

References 12 publications

Syphilis: Its History and World Impact

Syphilis: Its History and World Impact

Biological Basis for Syphilis

History of Syphilis

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