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Syphilis
Published in Scott M. Jackson, Skin Disease and the History of Dermatology, 2023
Syphilis is another major historical disease with prominent dermatologic manifestations. Of the four maladies highlighted in this text, syphilis is uniquely important in the development of dermatology as a specialty of medicine, and it remains relevant today. Syphilis is an infection caused by the bacterium Treponema pallidum, a corkscrew-shaped spirochete with whip-like structures (flagella) at its poles. Syphilis is not the only treponemal disease; there are three others—pinta, yaws, and bejel—that are referred to as the non-venereal endemic treponematoses; all of these are also caused by T. pallidum. Known primarily as a sexually transmitted disease, syphilis can also be transmitted transplacentally. It is known to medical students as the “Great Imitator” because it mimics so many different diseases and can affect virtually every major organ system, including the central nervous and cardiovascular systems. As the renowned William Osler famously claimed, “He who knows syphilis, knows medicine.”
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
Treponema pallidum is easily transmitted by sexual contact, and an overwhelming majority of cases are transmitted by sexual intercourse. Endemic syphilis is transmitted non-venerally by close contact with an active lesion and occurs in communities living under poor hygiene conditions. Syphilis is rarely transmitted during transfusion of blood or blood products or through needle sharing by intravenous drug abusers. The organism generally enters the body through small breaches in epithelial surfaces of genital, anorectal, oropharyngeal, or other cutaneous sites; however; penetration of intact mucous membranes can occur. Once inside the body it rapidly disseminates. The incubation period for T. pallidum averages 3 weeks, but can range 10–90 days. During the incubation period infected patients have, by definition, neither clinical nor serologic evidence of disease but are potentially infectious. The period of greatest infectivity is early in the disease when a chancre, mucous patch, or condyloma latum is present. Infectivity decreases over time, and after 4 years it is very unlikely that an untreated individual will spread syphilis, even by sexual contact. The risk of infection during a single sexual encounter with an infected individual is up to 60% depending on the stage of disease, and approaches 100% after five sexual encounters [8].
CT findings in aggressive Takayasu arteritis
Published in Acta Cardiologica, 2022
Benjamín Roque Rodríguez, Luis Enrique Lezcano Gort, María Victoria Mogollón Jiménez, Ignacio Díaz Villalonga, Sergio Moyano Calvente, Zineb Kounka
A 52-year-old woman was referred to our hospital with grade-2 dyspnoea without intermittent claudication. She complained of self-limiting episodes of fever, asthenia, and myalgias since the adolescence. Physical examination revealed a loud panfocal systolic murmur (IV/VI), and large inter-arm blood pressure difference (180/80-120/70 mmHg in right and left arm respectively). Treponema pallidum serological-test and autoantibodies were negative, and acute phase reactants were normal. Doppler echocardiogram reveals doubtful patent ductus arteriosus. CT angiography with multiplanar (Figure 1, panels 1 and 4) and volumen-rendered reformatted images (Figure 1, panels 2 and 3) showed severe narrowing of the middle segment of the descending thoracic/abdominal aorta (a), and both iliac arteries, with intima-media thickening in all of them (b). Collaterals have been developed, like a huge and tortuous right internal mammary artery which anastomoses with branches of the epigastric arteries (c). We found severe stenosis in common carotid arteries (critical in left common carotid artery) (d) and in both subclavian arteries at the ostia of vertebral arteries(e). On the basis of clinical and angiographic abnormalities, the diagnosis of Takayasu arteritis (TA) was made. TA is a large-vessel granulomatous vasculitis that primarily affects the aorta and its primary branches, specially supraaortic trunk and subclavian artery. It principally affects young women. The patient refused to take any treatment or perform new tests. Actually, she remains asymptomatic.
Utility of Treponemal Testing from Aqueous Fluid in the Diagnosis of Ocular Syphilis in Patients with HIV/AIDS
Published in Ocular Immunology and Inflammation, 2022
Nivedita Nair, Sridharan Sudharshan, Appakkudal R. Anand, Jyotirmay Biswas, K. Lily Therese
Most infectious uveitic entities like tuberculosis (TB), toxoplasmosis, cytomegalovirus (CMV), and herpetic viral retinitis usually have characteristic presentations which aid in the diagnosis. On the other hand, due to their varied manifestations, a low threshold for considering the diagnosis of syphilis, especially in high-risk populations, has to be adopted. Conventional diagnostic methods use a combination of serological tests that include a nontreponemal test (NTT) like venereal disease research laboratory (VDRL) or rapid plasma reagin (RPR), and a treponemal test (TT) such as fluorescent treponemal antibody absorption test (FTA-ABS) or treponema pallidum hemagglutination assay (TPHA) using the patient’s serum sample.5 Diagnosis of ocular syphilis is presently based on a combination of clinical suspicion, serological tests titers and by exclusion of other OIs in HIV/AIDS patients with atypical presentations.
Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature
Published in Acta Clinica Belgica, 2021
Wei Wang, Xuzhou Fan, Xuelian Huang, Jingmei Yan, Jianfeng Luan
Syphilis, once epidemic only in low-income countries, is currently increasing at epidemic rates in high-income countries, mainly in men who have sex with men, women of reproductive age, and newborns [1]. As a chronic bacterial infection caused by Treponema Pallidum(TP), it is highly contagious and has a complicated pathogenic mechanism.Its transmission methods include sexual contact and vertical transmission [2]. Based on data from the World Health Organization (WHO), there are approximately 18 million syphilis patients worldwide in the year of 2012, and more than 5 million cases of syphilis are diagnosed all around the globe each year [3]. China, the most populous country in the world, has a high syphilis disease burden. It is estimated that there are approximately 3 million cases of syphilis in China, accounting for over 15% of the global estimate [4–6]. Syphilis has become a public health issue of close concern to the world.