Syphilis - Causes, Signs & Symptoms, Pathogenesis, Diagnosis, And Treatment

Video Transcript :-
Syphilis is a sexually transmitted infection caused by the spirochete treponema pallidum.
Depending on the mode of transmission, syphilis is divided into 2 types.
Acquired syphilis and congenital syphilis.
Acquired syphilis occurs mainly from sexual contact, including oral, anal, and vaginal sex.
In addition, it can also occur via blood product transfusion and using contaminated needles, and occasionally through breaks in the skin that encounter infectious lesions.
Congenital syphilis occurs when a fetus gets the infection from the mother through the placenta during pregnancy, or when the neonate gets the infection during birth.
Treponema pallidum is an obligate parasite, meaning that it cannot survive outside a living organism.
If left untreated, acquired syphilis progresses through 4 stages: Primary, secondary, latent, and tertiary.
In acquired syphilis, the organism enters the body through intact mucus membranes or defects in the mucosal barrier, and gains access to lymphatics and bloodstream.
Primary syphilis is characterized by the development of a painless lesion called chancre at the site of bacterial entry.
This usually occurs after an incubation period of 3 to 6 weeks.
The lesion is highly infectious and has a punched-out base and rolled edges.
Chancre usually heals without treatment leaving considerable residual fibrosis.
Secondary syphilis develops about 4-10 weeks after the appearance of the primary chancre.
During this stage, bacteria multiply and spread throughout the body.
Systemic manifestations of secondary syphilis include malaise, fever, muscle pain, joint pain, lymphadenopathy, and rash.
Patchy hair loss of the scalp and facial hair, including the eyebrows, can also be seen.
The immune reaction is at its peak during the secondary stage, and antibody titers are very high.
Latent syphilis is a stage at which the features of secondary syphilis have resolved, but the patients remain seroreactive.
Some patients experience recurrent infectious skin lesions of secondary syphilis during this period.
About one third of untreated latent syphilis patients develop tertiary syphilis, whereas the other two third remains asymptomatic.
Tertiary syphilis is a rare condition, which mainly affects the cardiovascular system and the central nervous system.
It involves gradual inflammatory damage to the tissues over months to years.
3 categories of tertiary syphilis have been identified.
Gummatous syphilis, cardiovascular syphilis, and neurosyphilis.
In gummatous syphilis, granulomatous lesions called gummas develop in various organs, including the liver, bones, and testis.
Cardiovascular syphilis occurs at least 10 years after the primary infection.
The commonest manifestation is aneurysm formation in the ascending aorta, caused by chronic inflammatory destruction of the vasa vasorum, the penetrating vessels that nourish the walls of large arteries.
This may ultimately lead to aortic insufficiency.
Neurosyphilis can cause syphilitic meningitis, paralysis, spinal cord lesions, impairment of memory and speech, personality changes, irritability, and dementia.
T pallidum cannot be cultivated in vitro and is too small to be seen under the light microscope.
Serologic testing is considered the standard method of detection for all stages of syphilis.
These include VDRL and RPR tests.
Penicillin is the drug of choice in the treatment of syphilis.
And doxycycline is the best alternative for treating early and late latent syphilis.
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