Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. It progresses through four stages - primary, secondary, latent, and tertiary - if left untreated. In the primary stage, a painless sore called a chancre appears at the site of infection. In the secondary stage, a rash may appear on the body along with fever and swollen lymph nodes. Without treatment, syphilis can spread and cause damage to internal organs in the latent and tertiary stages, potentially resulting in neurological or cardiovascular problems. Congenital syphilis can also occur if a pregnant woman passes the infection to her fetus.

1. SYPHILIS

2. SEXUALLY TRANSMITTED DISEASES
(STDs)
 Group of communicable diseases transmitted by sexual contact.
Caused by a wide range of bacterial, viral ,protozoal and fungal agents and
ectoparasites.
Previously known as veneral diseases.
Various STD’s:
1. Syphilis
2. Gonorrhea
3. HIV/AIDS.

3. SYPHILIS
Causative organism: caused by spirochetes- TREPONEMA PALLIDUM
Word derived from the name of the mythological handsome boy ,syphilus who was
cursed by Greek God Apollo with the disease.
T.pallidum- a coiled spiral filament 10 µm long that moves actively in fresh
preparations
 The organism is rapidly destroyed by heat, cold,& antiseptics.
 The organism cant be stained by the usual methods & can be seen in the exudates &
tissues by:
 Dark ground illumination in fresh preparations
 Fluorescent antibody technique
 PCR as a research method

4. Epidemiology
Infected 12 million people in 1999 .
90% of cases in the developing world.
 Affects 700,000 - 1.6 million pregnancies a year.
 Spontaneous abortions, stillbirths, and congenital syphilis.
Sub-Saharan Africa -20% of perinatal deaths.
 Since 2000, rates of syphilis have been increasing in the US, UK, Australia and Europe
primarily among men who have sex with men.
Due to unsafe sexual practices.
 Syphilis increases the risk of HIV transmission and co-infection is common.
 Untreated it has a mortality of 8% to 58% with a greater death rate in males.
 19th and 20th century-less severe symptoms, due to widespread availability of effective
treatment and decreasing virulence of the spirochete.
 With early treatment few complications

5. MODE OF TRANSMISSION
Sexual intercourse resulting in lesions on glans penis, vulvovaginal & cervix
Intimate person-to-person contact with lesions on lips, tongues or fingers
Transfusion of infected blood
 Materno-foetal transmission in congenital syphilis if mother is infected

6. PATHOPHYSIOLOGY OF SYPHILIS:
• Progresses through 4 stages: primary, secondary, latent and tertiary stages.
Stages get progressively worse if left untreated highly contagious potentially fatal not
all people show visible signs 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 mouth, anus, vagina, or throat.
 • Usually disappears in 4-6 weeks without treatment the bacteria is still multiplying
in the body contagiously.

7. • SECONDARY STAGE:
 Begins a few weeks to months after 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.
 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.
• 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; like brain, heart, sexual
organs and damage can go unnoticed until the next stage.

8. 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 health.
 Gummatous syphilis-destructive lesions of bones, skin or live
 Cardiovascular syphilis-severs damage to heart and blood vessels, inflammation of
the aorta, heart disease.
 Neuro syphilis-nervous system disorders; brain, eye, spinal cord, auditory system.
Brain- can cause paralysis, blindness, dementia or insanity.
• CONGENITAL SYPHILIS:
 During the secondary stage the infection can be transferred to the baby.
 If the mother is not treated during pregnancy it cause deformations, or possibly death.
Tested after birth; if the baby has syphilis it is treated right away

9. Neurosyphilis may manifest as:
 Meningovascular syphilis affecting chiefly the meninges.
 Tabes dorsalis affecting the spinal cord.
 General paresis affecting the brain.
Major morphological features are:
Saddle shaped nose deformity due to destruction of bridge of nose
The characteristic Hutchinson’s teeth which are small widely spaced, peg-shaped
permanent teeth.
Mucocutaneous lesions of acquired secondary syphilis
Bony lesions like epiphysitis and periostitis
Interstitial keratitis with corneal opacity
Diffuse fibrosis in liver and interstitial fibrosis of lungs
One of the most serious consequence of congenital syphilis –neurological damage
with mental retardation

10. Signs and symptoms
• Signs & symptoms of syphilis vary depending in which of the four
stages (primary, secondary, tertiary, latent) it is present:
• Common symptoms are:
 Fever, Malaise, Sore throat, Rashes, Head ache
 Lymphadenopathy
 Mucous patches, Perforation of palate.
 Alopecia, Weight loss
 In severe conditions it causes mental retardation, shuffle walk e.t.c.