TAILIEUCHUNG - Chapter 162. Syphilis

Syphilis, a chronic systemic infection caused by Treponema pallidum subspecies pallidum, is usually sexually transmitted and is characterized by episodes of active disease interrupted by periods of latency. After an incubation period averaging 2–6 weeks, a primary lesion appears, often associated with regional lymphadenopathy. The secondary stage, associated with generalized mucocutaneous lesions and generalized lymphadenopathy, is followed by a latent period of subclinical infection lasting years or decades. In about one-third of untreated cases, the tertiary stage appears, characterized by progressive destructive mucocutaneous, musculoskeletal, or parenchymal lesions; aortitis; or symptomatic central nervous system (CNS) disease. . | Chapter 162. Syphilis Syphilis a chronic systemic infection caused by Treponema pallidum subspecies pallidum is usually sexually transmitted and is characterized by episodes of active disease interrupted by periods of latency. After an incubation period averaging 2-6 weeks a primary lesion appears often associated with regional lymphadenopathy. The secondary stage associated with generalized mucocutaneous lesions and generalized lymphadenopathy is followed by a latent period of subclinical infection lasting years or decades. In about one-third of untreated cases the tertiary stage appears characterized by progressive destructive mucocutaneous musculoskeletal or parenchymal lesions aortitis or symptomatic central nervous system CNS disease. Etiology The Spirochaetales include three genera that are pathogenic for humans and for a variety of other animals Leptospira which causes human leptospirosis Chap. 164 Borrelia which causes relapsing fever and Lyme disease Chaps. 165 and 166 and Treponema which causes the diseases known as treponematoses see also Chap. 163 . The genus Treponema includes T. pallidum subspecies pallidum which causes venereal syphilis T. pallidum subspecies pertenue which causes yaws T. pallidum subspecies endemicum which causes endemic syphilis or bejel and T. carateum which causes pinta. Until recently the subspecies were distinguished primarily by the clinical syndromes they produce. Researchers have now identified molecular signatures that can differentiate the three subspecies of T. pallidum by culture-independent polymerase chain reaction PCR -based methods. Other Treponema species found in the human mouth genital mucosa and gastrointestinal tract have been associated with disease . periodontitis but their role as primary etiologic agents is unclear. T. pallidum subspecies pallidum referred to hereafter simply as T. pallidum a thin spiral organism has a cell body surrounded by a trilaminar cytoplasmic membrane a delicate peptidoglycan .

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