The generaTreponema belong to the
Treponemes are relatively short, slender
spirochetes with fine spirals and pointed
Treponemes cause following diseases:-
Veneral syphilis – Tpallidum
Endemic syphilis –Tpallidum
Yaws - Tpertenue
Pinta - Tcarateum
Described in 1905 by Schaudinn and
sexual; maternal-fetal, blood transfusion and
rarely by other means of both transmitting
and getting infected with HIV.
It is a thin, delicate, actively motile
spirochete with tapering ends & about
10µm long & 0.1 – 0.2µm wide.
It can be seen on fresh primary or secondary
lesions by darkfield microscopy or fluorescent
Have axial filaments, which are otherwise similar
to bacterial flagella.
Filaments enable movement of bacterium by
rotating in place.
It can be stained by silver impregnation
methods. Fontana’s method is useful fir
staining films & Levaditis method for tissue
T. pallidum enters the body via skin and
mucous membranes through abrasions during
Also transmitted transplacentally.
Travels via the lymphatic system to regional
lymph nodes and then throughout the body
via the blood stream.
Invasion of the CNS can occur during any stage
The bacteria multiply at
the initial entry site
forming a chancre, which
is painless, avascular,
ulcerated lesion and
most frequently on the
external genitalia, but it
may occur on the cervix,
perianal area, in the
mouth or anal canal.
BY three means :-
Person to person via vaginal, anal, or oral
sex through direct contact with a syphilis
Person to person during foreplay, even
when there is no penetrative sex (much less
Pregnant mother with syphilis to fetus.
pallidum from the
infected mother to
the fetus in utero, but
neonates may also be
passage through the
infected birth canal at
The clinical manifestations falls into 3 stages:-
The primary lesion in
syphilis is formation of
chancre at site of entry
The chancre covered
by thick, glairy
exudate rich in
Regional lymph nodes
are swollen, discrete,
rubbery & non-tender. Pennile chancre
Chancre heals within 10 – 40 days without
treatment leaving a thin scar.
In highly infected persons multiple chancres
Patient is most infectious
during this stage.
It sets in 1-3 months after
chancers heals.in between
the patient is asymptomatic.
Secondary lesion due to wide
spread & multiplication of
spirochetes & their
dissemination through the
Roseolar & papular skin
rashes, mucuous patches in
oropharynx are characteristic
Symptoms includes :-
– Gummata: rubbery tumors
– Bone deformities
– Loss of coordination
After several years
Tertiary lesions contain few
spirochetes & may represent
In few cases , neurological manifestations
such as general paralysis develop several
decades after initial infection & known as
Quaternary (or) late syphilis.
Treponemes demonstrated under Dark
background microscopy, Direct flourescent
antibody staining(DFA-TP),in tissue by
Silver impregnation method & immuno
Used to detect antibodies in CSF or in
sample of blood.
In this test antigen used is cardiolipin
collected from beefs heart.
Serum+1 drop of freshly prepared
cardiolipin antigen observed under
microscope presence of clumps indicate +ve
test & uniformly distributed crystals shows
This test useful in detecting early syphilis.
It is almost similar toVDRL test but finely
divided carbon particles are added to
It is newer blood test that checks antibodies
towards the organism that cause syphilis.
Penicillin is the only antibiotic used in
treatment of syphilis.
In early cases 2.4 million units of benzathine
penicillin G used , for late syphilis this
repeated for 3 weeks.
Those patients allergic to penicillin are
Tetracycline These given to treat
Azithromycin early syphilis.