Treponema pallidum - Clinical manifestation, Venereal Syphilis, Congenital Syphilis

Clinical manifestations

The clinical manifestations of Treponema pallidum include:

1. Venereal syphilis/Sexually Transmitted Infection

2. Non-venereal syphilis

Venereal syphilis

In cases of untreated venereal syphilis, caused byTreponema pallidum, characteristic stages include:

1. incubating

2. primary syphilis

3. secondary syphilis

4. early latent syphilis

5. latent syphilis

6. tertiary syphilis

Primary syphilis

• primary syphilis incubation period of about 3 weeks

• In this stage of the disease, the chancre is seen

• chancre occurs on the penis/scrotum of 75% of men

• chancre occurs on the vulva, cervix, or perineum of more than 50% of women

• chancre contains numerous Treponema pallidum and is highly infectious

• it heals within 3-6 weeks

Secondary Syphilis

• secondary syphilis occurs 2-10 weeks after primary chancre and is most florid 3-4 months after infection

• characterized by mucocutaneous lesions which are macular pink to red, discrete, and measure 3-10 mm in diameter

• cutaneous lesions may vary from macular to papular, pustular, and nodular type

• the lesions are found in the entire body including the palms, soles, and other sites (mostly skin)

• this stage is associated with mild symptoms of malaise, weight loss, headache, nausea, fever, pain in the bones, painless generalized lymphadenopathy (85% of patients), and aseptic meningitis may occur

• after the secondary phase, the disease caused by Treponema pallidum becomes subclinical but not necessarily dormant (inactive). During this latent phase, diagnosis can be made using serologic methods.

• relapses are common during early (<= 1 year) latent syphilis. Late latent syphilis (> 1 year) is usually asymptomatic and non-infectious.

Tertiary syphilis

• tertiary syphilis, caused by Treponema pallidum, develops within 3-10 years of infection

• gumma is a typical pathological lesion found in the skin, mouth, and the URT

• gummatous lesions may be multiple or diffuse but are usually single lesions that measure from 1cm to several cm in diameter

• cardiovascular syphilis, eye diseases, chronic granulomatous and meningovascular manifestations, and neurosyphilis are the other manifestations of syphilis, which occur several decades after the infection

Non-venereal syphilis

The types of non-veneral syphilis caused by Treponema pallidum include:

1. Congenital syphilis

2. Occupational syphilis

Congenital syphilis

• congenital syphilis occurs by vertical transmission from mother to fetus during pregnancy

• in 40% of untreated cases, Treponema pallidum causes late miscarriage, stillbirth, and death.

Occupational syphilis

• occupational syphilis, caused by Treponema pallidum, occurs in medical and paramedical workers handling cases of secondary syphilis

• the lesion usually develops on the palm and other exposed body parts