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Syphilis
Published in Scott M. Jackson, Skin Disease and the History of Dermatology, 2023
From the modern dermatologist's perspective, syphilis presents with mild-to-moderate skin lesions and is usually diagnosed in either the secondary stage—by clinical exam and blood test—or in the latent stage, by blood test as a screening for the disease. It is unusual for patients to present to the office with a chancre; the overwhelming majority of cases observed by the author have been patients with an erythematous scaly rash that involved the trunk and extremities, including the palms and soles. However, only in cases affecting the profoundly immunocompromised will some of these other features—such as pustules and ulcers—be seen. It is important to keep that fact in mind as we examine the historical syphilis, a condition that, based on the descriptions and depictions, was apparently much worse than what is seen today—so much worse that one has to at least question whether it was even the same disease.
Bacteria
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Syphilis is another bacterial disease which may be considered to be a disease of the urogenital tract although the disease is not limited to that organ system. Syphilis is sexually transmitted. It is caused by the spirochete, Treponema palladum. Transmission requires direct contact with a syphilitic lesion as the organisms cannot survive long in the environment. Treponema penetrate the skin or mucous membranes at the contact site where they produce a local ulcer-like lesion called a chancre. The organisms, however, soon spread throughout the body and may in later stages damage the skin, bones, joints, and nervous system. They can also cross the placenta and infect the fetus.
Syphilis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Important practices for prevention of syphilis are early diagnosis and treatment, partner notification and treatment, and screening to identify asymptomatic cases in high-risk populations.
Ophthalmologic Assesment of Patients with Syphilitic Optic Neuropathy
Published in Ocular Immunology and Inflammation, 2023
Syphilis is transmitted through sexual contact, from mother to foetus in utero and via blood transfusion. The incidence of syphilis has decreased with effective antibiotherapy. However, the worldwide incidence has increased recently due to human immunodeficiency virus (HIV) co-infection, socio-economic changes, and unprotected sexual behaviour.1–3 There has also been a corresponding increase in the reported ocular manifestation of syphilis.1 Ocular involvement occurs during all stages and can affect any structures of the eye.3 Keratitis, scleritis, episcleritis, anterior and posterior uveitis, and optic nerve involvement can be seen.4 Uveitis, especially the posterior, is the most commonly reported ophthalmic manifestation.5 Isolated optic neuropathy (ON) as a manifestation of syphilis in HIV-negative patients is uncommon.6 It has been reported in approximately 20–30% of patients with ocular syphilis.4,5
Ocular Syphilis as a Cause of Chronic Postoperative Uveitis Followed by a Localized Ocular Jarisch–Herxheimer-like Reaction
Published in Ocular Immunology and Inflammation, 2023
Parsha Forouzan, David Fell, Freddie R. Jones
According to the most recent report from the Centers for Disease Control and Prevention (CDC) in 2019, syphilis is on the rise with both acquired and congenital forms increasing 75% and 280%, respectively, since 2015,1 which is likely an underestimation given the omission of latent infections. Syphilis adopts variable clinical presentations, can be difficult to detect yet remains transmissible during its latent phase, and can have severe neurologic and ocular consequences if left untreated. Acquired syphilis is typically transmitted through direct sexual contact with infectious lesions and can be present in one of the four different stages. Primary syphilis develops within a few weeks of infectious contact and classically manifests as a painless chancre. Secondary syphilis presents weeks to months later after resolution of the chancre and hematogenous spread of spirochetes, usually resulting in cutaneous and lymph node involvement and less often liver, kidney, joint, and ocular involvement. After resolution of symptoms, untreated syphilis enters a latent stage. In the early latent stage within the first one to two years of initial infection, 25% of the infected persons may exhibit recurrent symptoms and can potentially transmit their infection.2 The late latent stage of untreated syphilis can last decades with most remaining asymptomatic, but 15–40% of the infected persons progress to tertiary syphilis.3 Tertiary syphilis is manifested by gummatous syphilis (15%), cardiovascular syphilis (10%), and neurosyphilis (6.5%).4
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
Syphilis can be diagnosed using dark field microscopy, serological tests or PCR since T. pallidum cannot be easily isolated or cultured in vitro. Serologic tests provide a presumptive diagnosis of syphilis. Both nontreponemal tests (NTT) and treponemal-specific tests (TT) can be used as an initial screening test. If positive, the test must be confirmed using the other type of serologic test. The use of only one serologic test is insufficient since serologic testing can be associated with false-positive results. False-positive results are predominantly seen when using a NTT and are associated with various forms of systemic disease, immunization, pregnancy, intravenous drug use, and increased age[7]. More than 10% of intravenous illicit drug users can have false-positive test results with titers of more than 8 [7].