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SYPHILIS 
B Y: A L I H A S S A N 
? - ?
Syphilis…. 
is a contagious bacterial infection that 
is transmitted through contact with an 
chancre on an infected person, usually 
during intimate sexual contact
History 
Origins 
- origin of syphilis has not been agreed on by researchers 
1.Christopher Columbus and his crew or other explorers brought it back with them from the 
“new world”. 
2. Syphilis was always present in the “old world” but it wasn’t yet identified as a separate disease 
from leprosy. 
3.Syphilis developed from the related diseases bejel and yaws. 
The first reference to the “French sickness” is made 
during Charles VIII’s Italian campaign 
A complete description of the “French sickness” was 
given by Juan de Virgo 
1493 1526 
? 
1495 
1500 
Christopher Columbus and his 
crew returns from the “new world” 
possibly carrying syphilis 
Fernandez de Oviedo was the first person 
to mention the “American origin” 
of syphilis 
# of cases in Europe reach 
epidemic proportions 
Christopher Columbus 
http://www.latinamericanstudies.org/columbus/older-columbus.gif 
1514 
1530 
The disease recieves the name syphilis 
from a poem entitled “Syphilis Sive 
Morbus Gallicus” by Jerome Francastor
History 
so few cases that the medical and 
scientific community is prepared to 
consider it erradicated 
1996 
Sir Alexander Fleming discovers 
penicillin while working on the 
1964-1965 
of cases on the rise in western countries 
influenza virus. 
1928 
Sir Alexander Fleming 
http://nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-bio.html 
the rising occurrence of syphilis around 
2001 
the world causes hope of eradicating the disease 
to lessen after being raised by the success of penicillin 
1905 
Treponema Pallidum, the bacteria that 
causes syphilis is discovered on March 3 
in Berlin by Chauvinand Hoffmann
DISEASE - CAUSE/GENERAL INFO 
classified as an STI (sexually 
transmitted infection) 
caused by the bacterium Treponema 
Pallidum 
 spiral shaped 
 enters through open cuts or sores in the 
mucous membrane 
contracted through contact with a 
chancre during sexual contact or 
passed from mother to baby called 
congenital syphilis 
progresses through 4 stages; primary, 
secondary, latent and tertiary stages 
stages get progressively worse if left 
untreated 
highly contagious 
potentially fatal 
Treponema Pallidum 
http://www.uveitis.org/images/syphil1.jpg
Disease - Symptoms 
not all people show visible signs of the 
disease at the beginning 
Primary Stage 
a small painless ulcer like sore called a chancre appears at 
the site of initial infection 
chancre usually appears 2-3 weeks after the initial infection 
a rash near the chancre may also appear 
the chancre may go unnoticed because of the location in 
the mouth, anus, vagina or throat 
usually disappears in 4-6 weeks without treatment 
the bacteria is still multiplying in the body 
contagious 
chancre 
http://www.co.multnomah.or.us/man2manpdx/image 
s/primary_oral_syphilis.jpg 
http://www.homeomiracles.com/Index/Male/Male_article/STD/Sexually%20transmitted%20Diseases.html
Disease - Symptoms 
Secondary Stage 
begins a few weeks to months after the chancre heals 
• rash with flat and raised patches 
- frequently on palms, soles, can be anywhere on body 
• lesions in the mouth, vagina, penis, mucus patches; condyloma lata 
• fever 
• swollen glands 
• loss of appetite 
• fatigue 
• aches and pains in bones or joints 
• patchy hair loss 
• chancre still present in some cases 
bacteria has spread to the blood 
most contagious stage 
resolves in 2-6 weeks without 
treatment 
http://www.ratsteachmicro.com/Assets/Syphilis/syphilis/poem.jpg 
http://www.scielo.br/img/revistas/abd/v80n1/ia09f07.jpg 
http://www.worldsbest-sexual-health-site.com/images/Hand.jpg
Disease - Symptoms 
Latent Stage 
characterized by the lack of symptoms 
no symptoms may appear for months or years 
syphilis is still alive in the body 
bacteria starts to damage the internal organs; 
brain, heart, sexual organs 
damage can go unnoticed until the next stage 
http://services.epnet.com/GetImage.aspx/getImage.aspx?ImageIID=6227 
Congenital Syphilis 
• during the secondary stage the infection can be transferred to 
the baby 
• if the mother is not treated during pregnancy it can cause 
deformations, or possibly death 
• tested after birth; if the baby has syphilis it is treated right away 
http://www.neonatology.org/classics/hess1922/figures/fig168.gif
Disease - Symptoms 
Tertiary Stage 
• occurs many years later, 5 to 50 years after secondary stage symptoms disappear 
• characterized by paralysis, gradual blindness, deterioration of the brain, loss of co-ordination, 
shooting pains, and death 
• gummatous syphilis - destructive lesions of bones, skin or liver 
• cardiovascular syphilis - severe damage to heart and blood vessels, inflammation of 
the aorta, heart disease 
• neurosyphilis - nervous system disorders; brain, eye, spinal cord, auditory system; 
deafness 
• brain - can cause paralysis, blindness, dementia or insanity 
http://www.ynhh.org/cardiac/heart/exterior_heart_anatomy.jpg 
http://www.ipmc.cnrs.fr/~duprat/neurophysiology/images/brain2.jpg
NEUROSYPHILIS 
Divided into 5 groups, which may 
overlap: 
Asymptomatic neurosyphilis 
Syphilitic meningitis 
Meningovascular syphilis 
General paresis 
Tabes dorsalis
SYPHILITIC MENENGITIS 
‘OAseptic meningitis’ at any One year after primary stage. 
CSF shows: 
Lymphocytic pleocytosis 
Elevated protein and usually normal glucose 
concentrations 
VDRL test is usually reactive. 
It can mimic tuberculous or fungal meningitis or aseptic 
meningitis of various causes. 
Often involves the base of the brain and may result in 
unilateral or bilateral cranial nerve palsies. 
Without treatment, syphilitic meningitis usually 
resolves, like the other manifestations of early syphilis
CARDIOVASCULAR SYPHILIS 
Ma5-10 years after initial infection. 
Primarily aortic insufficiency and aortic aneurysm of the 
ascending aorta. Other large arteries may sometimes be 
involved, and rarely the coronary ostia may be involved. 
Caused by obliterative endarteritis of the vasa vasorum 
with resultant damage to the intima & media of the great 
vessels, causing dilatation of the ascending aorta and 
eventually results in stretching of the ring of the aortic 
valve, producing aortic insufficiency. The valve cusps 
remain normal. 
Asymptomatic aortitis is best diagnosed by visualizing 
linear calcifications in the wall of the ascending aorta. 
More common in men than in women and possibly in 
blacks than in whites.
hard to diagnose because the symptoms 
are similar to other diseases such as 
the flu 
different tests used for the different stages 
primary stage - physical examination, 
description of symptoms taken, fluid 
from chancre taken and examined 
secondary stage - blood tests 
tertiary stage - spinal tap may be required 
in case of neurosyphilis 
Diagnosis 
http://www.healthsystem.virginia.edu/internet/cstap/images/IMG_1457.jpg 
http://www.raisingkids.co.uk/images/editorial/preg_test02.jpg
TESTS FOR SYPHILIS 
Dark field Microscopy 
VDRL, RPR 
FTA-ABS, MHA-TP 
Direct Fluorescent Antibody (DFA)
TREPONEMAL TESTS 
FTA-ABS 
Used as a confirmatory tests. 
Sensitivity and specificity high. 
 85% of patients with primary syphilis are reactive 
 99% with secondary syphilis 
 > 95% with late syphilis (It may be the only test with a positive result for 
patients with cardiovascular or neurologic syphilis). 
Remains reactive for life in most, despite adequate therapy. Only 15-25 
% of those treated for primary syphilis may turn negative by 2-3 
yrs. 
False positive in other treponemal diseases (pinta, yaws..) and other 
spirochete diseases (Lyme, leptospirosis…) 
MHA-TP test (micro haemagglutination assay for T. pallidum; 
agglutination of RBCs to which T. pallidum antigens have been 
fixed is the basis).
antibiotics; usually penicillin was used but nowadays 
Flouroquinolones like levofloxacin are used 
doxycycline may also be used 
administered either intramuscularly or intravenously 
Treatment 
daily 
then asked to attend injections for two years monthly 
And then every three months for examination and 
blood test to ensure and check the success of the 
treatment 
http://www.volstate.edu/HSCenterofEmphasis/images/image2.jpg 
• regular check-ups are needed 
after the treatment to make sure 
the infection is gone 
• treatment can be done at any 
stage but any damage done is 
irreversible 
http://www.brooksidepress.org/Products/Injections/320SubQ.JPG
PREVENTION 
Abstinance is the most effective way to prevent the 
contraction of the disease 
practice safe sex 
be tested regularly for syphilis if married or sexually active 
• best way to detect syphilis early 
get treated if you have it, to prevent the spread 
avoid direct contact with blood, sores or bodily fluid 
learn about safe sex and injection practices 
get tested for syphilis if you are pregnant so you can be 
treated; won’t pass it on to your baby 
If you have it…. 
• Get yourself treated and avoid sexual contact 
• may need to be tested. 
http://www.avert.org/photo_library/images/normal_photo_no_240.gif
FUTURE OUTLOOK 
raise awareness of the effects of the disease 
inform people of safe sex practices in order to prevent the 
spread 
hope to be able to eradicate syphilis using the above tactics 
http://www.cdc.gov/std/syphilis/syphilis2.jpg 
http://www.thedaily.washington.edu/image/preview/158?x=225
REFERENCE PAGE 
Archaeological Institute of America Tours.Origins of Syphilis on the World Wide 
Web: < http://www.archaeology.org/9701/newsbriefs/syphilis.html > 
Canadian Association for Adolescent Health. Syphilis on the World Wide Web: 
< http://www.youngandhealthy.ca/caah/Informations/STI/t428c431s509x413/Syphilis.aspx > 
Endersbe, Julie K Sexually Transmitted Diseases. Manakato, Minnesota: Capstone Press. 
Health Canada. on the World Wide Web: 
< http://www.hc-sc.gc.ca/iyh-vsv/alt_formats/cmcd-dcmc/pdf/syphilis_e.pdf > 
Medline Plus. Medical Encyclopedia: Syphilis.on the World Wide Web: 
< http://nim.nih.gov/medlineplus/ency/article/001327.html > 
Nobel Foundation. Sir Alexander Fleming. on the World Wide Web: 
< http://nobelprize.org/cgi-bin/print?from=/nobel_prizes/medicine/laureates/1945/fleming-bio.html > 
Quetel, Claude.. History of Syphilis. Cambridge: Policy Press. 
Secrets of the Dead.. The Syphilis Enigmings on the World Wide Web: 
< http://www.pbs.org/wnet/secrets/case_syphilis/p_index.html > 
Syphilis. In Diseases (Vol 8, pp.32-34). United States (CT): Scientific Publishing, Inc. 
Syphilis. In Health Matters (Vol 3 pp 126-127). Danbury, CT: Grolier Educational.
Reference Page 
Syphilis.. In Encyclopedia pf Family Health (Vol 15 pp2153-2155). Tarrytown, NY: Marshall Cavendish, Crop. 
The Flying Walrus.. Health. on the World Wide Web: < 
http://www.yorku.ca/walrus/06-12/health02.html> 
The Society of Obstetricians and Gynaecologists of Canada. . Sex Facts in Canada on the World Wide Web: < 
www.sexualityandu.ca/media-room/pdf/Sex-Stats-Fact-Sheet_e.pdf > 
Pharmacology by k.d tripathi 
Pathalogy by Dr. Vithal kulkarni 
Biochemistry by Eugene C. Toy M.D
Syphilis: A Concise History and Overview of Causes, Symptoms, Diagnosis and Treatment

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Syphilis: A Concise History and Overview of Causes, Symptoms, Diagnosis and Treatment

  • 1.
  • 2. SYPHILIS B Y: A L I H A S S A N ? - ?
  • 3. Syphilis…. is a contagious bacterial infection that is transmitted through contact with an chancre on an infected person, usually during intimate sexual contact
  • 4. History Origins - origin of syphilis has not been agreed on by researchers 1.Christopher Columbus and his crew or other explorers brought it back with them from the “new world”. 2. Syphilis was always present in the “old world” but it wasn’t yet identified as a separate disease from leprosy. 3.Syphilis developed from the related diseases bejel and yaws. The first reference to the “French sickness” is made during Charles VIII’s Italian campaign A complete description of the “French sickness” was given by Juan de Virgo 1493 1526 ? 1495 1500 Christopher Columbus and his crew returns from the “new world” possibly carrying syphilis Fernandez de Oviedo was the first person to mention the “American origin” of syphilis # of cases in Europe reach epidemic proportions Christopher Columbus http://www.latinamericanstudies.org/columbus/older-columbus.gif 1514 1530 The disease recieves the name syphilis from a poem entitled “Syphilis Sive Morbus Gallicus” by Jerome Francastor
  • 5. History so few cases that the medical and scientific community is prepared to consider it erradicated 1996 Sir Alexander Fleming discovers penicillin while working on the 1964-1965 of cases on the rise in western countries influenza virus. 1928 Sir Alexander Fleming http://nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-bio.html the rising occurrence of syphilis around 2001 the world causes hope of eradicating the disease to lessen after being raised by the success of penicillin 1905 Treponema Pallidum, the bacteria that causes syphilis is discovered on March 3 in Berlin by Chauvinand Hoffmann
  • 6. DISEASE - CAUSE/GENERAL INFO classified as an STI (sexually transmitted infection) caused by the bacterium Treponema Pallidum  spiral shaped  enters through open cuts or sores in the mucous membrane contracted through contact with a chancre during sexual contact or passed from mother to baby called congenital syphilis progresses through 4 stages; primary, secondary, latent and tertiary stages stages get progressively worse if left untreated highly contagious potentially fatal Treponema Pallidum http://www.uveitis.org/images/syphil1.jpg
  • 7. Disease - Symptoms not all people show visible signs of the disease at the beginning Primary Stage a small painless ulcer like sore called a chancre appears at the site of initial infection chancre usually appears 2-3 weeks after the initial infection a rash near the chancre may also appear the chancre may go unnoticed because of the location in the mouth, anus, vagina or throat usually disappears in 4-6 weeks without treatment the bacteria is still multiplying in the body contagious chancre http://www.co.multnomah.or.us/man2manpdx/image s/primary_oral_syphilis.jpg http://www.homeomiracles.com/Index/Male/Male_article/STD/Sexually%20transmitted%20Diseases.html
  • 8. Disease - Symptoms Secondary Stage begins a few weeks to months after the chancre heals • rash with flat and raised patches - frequently on palms, soles, can be anywhere on body • lesions in the mouth, vagina, penis, mucus patches; condyloma lata • fever • swollen glands • loss of appetite • fatigue • aches and pains in bones or joints • patchy hair loss • chancre still present in some cases bacteria has spread to the blood most contagious stage resolves in 2-6 weeks without treatment http://www.ratsteachmicro.com/Assets/Syphilis/syphilis/poem.jpg http://www.scielo.br/img/revistas/abd/v80n1/ia09f07.jpg http://www.worldsbest-sexual-health-site.com/images/Hand.jpg
  • 9. Disease - Symptoms Latent Stage characterized by the lack of symptoms no symptoms may appear for months or years syphilis is still alive in the body bacteria starts to damage the internal organs; brain, heart, sexual organs damage can go unnoticed until the next stage http://services.epnet.com/GetImage.aspx/getImage.aspx?ImageIID=6227 Congenital Syphilis • during the secondary stage the infection can be transferred to the baby • if the mother is not treated during pregnancy it can cause deformations, or possibly death • tested after birth; if the baby has syphilis it is treated right away http://www.neonatology.org/classics/hess1922/figures/fig168.gif
  • 10. Disease - Symptoms Tertiary Stage • occurs many years later, 5 to 50 years after secondary stage symptoms disappear • characterized by paralysis, gradual blindness, deterioration of the brain, loss of co-ordination, shooting pains, and death • gummatous syphilis - destructive lesions of bones, skin or liver • cardiovascular syphilis - severe damage to heart and blood vessels, inflammation of the aorta, heart disease • neurosyphilis - nervous system disorders; brain, eye, spinal cord, auditory system; deafness • brain - can cause paralysis, blindness, dementia or insanity http://www.ynhh.org/cardiac/heart/exterior_heart_anatomy.jpg http://www.ipmc.cnrs.fr/~duprat/neurophysiology/images/brain2.jpg
  • 11. NEUROSYPHILIS Divided into 5 groups, which may overlap: Asymptomatic neurosyphilis Syphilitic meningitis Meningovascular syphilis General paresis Tabes dorsalis
  • 12. SYPHILITIC MENENGITIS ‘OAseptic meningitis’ at any One year after primary stage. CSF shows: Lymphocytic pleocytosis Elevated protein and usually normal glucose concentrations VDRL test is usually reactive. It can mimic tuberculous or fungal meningitis or aseptic meningitis of various causes. Often involves the base of the brain and may result in unilateral or bilateral cranial nerve palsies. Without treatment, syphilitic meningitis usually resolves, like the other manifestations of early syphilis
  • 13. CARDIOVASCULAR SYPHILIS Ma5-10 years after initial infection. Primarily aortic insufficiency and aortic aneurysm of the ascending aorta. Other large arteries may sometimes be involved, and rarely the coronary ostia may be involved. Caused by obliterative endarteritis of the vasa vasorum with resultant damage to the intima & media of the great vessels, causing dilatation of the ascending aorta and eventually results in stretching of the ring of the aortic valve, producing aortic insufficiency. The valve cusps remain normal. Asymptomatic aortitis is best diagnosed by visualizing linear calcifications in the wall of the ascending aorta. More common in men than in women and possibly in blacks than in whites.
  • 14. hard to diagnose because the symptoms are similar to other diseases such as the flu different tests used for the different stages primary stage - physical examination, description of symptoms taken, fluid from chancre taken and examined secondary stage - blood tests tertiary stage - spinal tap may be required in case of neurosyphilis Diagnosis http://www.healthsystem.virginia.edu/internet/cstap/images/IMG_1457.jpg http://www.raisingkids.co.uk/images/editorial/preg_test02.jpg
  • 15. TESTS FOR SYPHILIS Dark field Microscopy VDRL, RPR FTA-ABS, MHA-TP Direct Fluorescent Antibody (DFA)
  • 16. TREPONEMAL TESTS FTA-ABS Used as a confirmatory tests. Sensitivity and specificity high.  85% of patients with primary syphilis are reactive  99% with secondary syphilis  > 95% with late syphilis (It may be the only test with a positive result for patients with cardiovascular or neurologic syphilis). Remains reactive for life in most, despite adequate therapy. Only 15-25 % of those treated for primary syphilis may turn negative by 2-3 yrs. False positive in other treponemal diseases (pinta, yaws..) and other spirochete diseases (Lyme, leptospirosis…) MHA-TP test (micro haemagglutination assay for T. pallidum; agglutination of RBCs to which T. pallidum antigens have been fixed is the basis).
  • 17. antibiotics; usually penicillin was used but nowadays Flouroquinolones like levofloxacin are used doxycycline may also be used administered either intramuscularly or intravenously Treatment daily then asked to attend injections for two years monthly And then every three months for examination and blood test to ensure and check the success of the treatment http://www.volstate.edu/HSCenterofEmphasis/images/image2.jpg • regular check-ups are needed after the treatment to make sure the infection is gone • treatment can be done at any stage but any damage done is irreversible http://www.brooksidepress.org/Products/Injections/320SubQ.JPG
  • 18. PREVENTION Abstinance is the most effective way to prevent the contraction of the disease practice safe sex be tested regularly for syphilis if married or sexually active • best way to detect syphilis early get treated if you have it, to prevent the spread avoid direct contact with blood, sores or bodily fluid learn about safe sex and injection practices get tested for syphilis if you are pregnant so you can be treated; won’t pass it on to your baby If you have it…. • Get yourself treated and avoid sexual contact • may need to be tested. http://www.avert.org/photo_library/images/normal_photo_no_240.gif
  • 19. FUTURE OUTLOOK raise awareness of the effects of the disease inform people of safe sex practices in order to prevent the spread hope to be able to eradicate syphilis using the above tactics http://www.cdc.gov/std/syphilis/syphilis2.jpg http://www.thedaily.washington.edu/image/preview/158?x=225
  • 20. REFERENCE PAGE Archaeological Institute of America Tours.Origins of Syphilis on the World Wide Web: < http://www.archaeology.org/9701/newsbriefs/syphilis.html > Canadian Association for Adolescent Health. Syphilis on the World Wide Web: < http://www.youngandhealthy.ca/caah/Informations/STI/t428c431s509x413/Syphilis.aspx > Endersbe, Julie K Sexually Transmitted Diseases. Manakato, Minnesota: Capstone Press. Health Canada. on the World Wide Web: < http://www.hc-sc.gc.ca/iyh-vsv/alt_formats/cmcd-dcmc/pdf/syphilis_e.pdf > Medline Plus. Medical Encyclopedia: Syphilis.on the World Wide Web: < http://nim.nih.gov/medlineplus/ency/article/001327.html > Nobel Foundation. Sir Alexander Fleming. on the World Wide Web: < http://nobelprize.org/cgi-bin/print?from=/nobel_prizes/medicine/laureates/1945/fleming-bio.html > Quetel, Claude.. History of Syphilis. Cambridge: Policy Press. Secrets of the Dead.. The Syphilis Enigmings on the World Wide Web: < http://www.pbs.org/wnet/secrets/case_syphilis/p_index.html > Syphilis. In Diseases (Vol 8, pp.32-34). United States (CT): Scientific Publishing, Inc. Syphilis. In Health Matters (Vol 3 pp 126-127). Danbury, CT: Grolier Educational.
  • 21. Reference Page Syphilis.. In Encyclopedia pf Family Health (Vol 15 pp2153-2155). Tarrytown, NY: Marshall Cavendish, Crop. The Flying Walrus.. Health. on the World Wide Web: < http://www.yorku.ca/walrus/06-12/health02.html> The Society of Obstetricians and Gynaecologists of Canada. . Sex Facts in Canada on the World Wide Web: < www.sexualityandu.ca/media-room/pdf/Sex-Stats-Fact-Sheet_e.pdf > Pharmacology by k.d tripathi Pathalogy by Dr. Vithal kulkarni Biochemistry by Eugene C. Toy M.D