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Syphilis is a bacterial infection caused by the bacteria Treponema pallidum (genus Treponema, species T pallidum). A gram-negative motile spirochete with endoflagella.

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Treponema pallidum penetrates dermal micro abrasions or intact mucous membranes via direct contact with infected lesion

Sexual transmission is the most common route of transmission

Congenital syphilis: mother to fetus (transplacental) or through vaginal birth

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Endoflagella

Provide motility, thus aiding in tissue invasion and dissemination

A few hours after entry via skin or mucosa, T. pallidum enters the lymphatics and blood to produce a systemic infection

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Syphilis presents a wide variety of symptoms which can sometimes complicate its diagnosis, especially in the later stages.

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Syphilis has three stages

Primary stage:

Sores that are typically painless appear in areas of infection called chancre. Chancre will heal on their own whether treatment is administered or not (early latent stage)

Secondary stage:

Condyloma Lata

Flu like symptoms

Patchy hair loss

Symptoms will heal on their own whether treatment is administered or not (late latent stage)

Tertiary stage (sequelae):

If left untreated can cause unrepairable neurological and cardiovascular complications including death

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Treponemal tests are used to detect antibodies that are specific for syphilis which are carried out through blood testing. This includes TP-PA, rapid treponemal assays, various EIAs, and many more.

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Syphilis is treated with antibiotics. Benzathine penicillin G is typically used to cure primary and secondary syphilis. Penicillin indirectly disrupts the cell wall by blocking the enzyme transpeptidase. Transpeptidase is required for cross-linking of the peptidoglycan in bacterial cell walls. Without it the bacteria are fragile and susceptible to lysis.

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Syphilis is typically seen in people between the ages of 15 to 49. In addition, a significant increase has been seen in Western Europe, China, and the USA despite of efforts to eliminate syphilis in high-income countries. Syphilis has remained endemic in low and middle-income countries. There are about 12 million new cases of syphilis globally each year.

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Syphilis was one of the first major pathogens to be identified but is still unable to be cultivated in vitro. This makes it very elusive and difficult to make a preventive vaccine for. The only known effective preventive measures are safe sex practices such as the proper use of condoms.

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Mercury was the go-to treatment for Syphilis in the 19th century

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Peeling, R. W., Mabey, D., Kamb, M. L., Chen, X. S., Radolf, J. D., & Benzaken, A. S. (2017). Syphilis. Nature reviews. Disease primers, 3, 17073. https://doi.org/10.1038/nrdp.2017.73

Britannica, T. Editors of Encyclopaedia (2023, November 7). sexually transmitted disease. Encyclopedia Britannica. https://www.britannica.com/science/sexually-transmitted-disease

De Lay, B. D., Cameron, T. A., De Lay, N. R., Norris, S. J., & Edmondson, D. G. (2021). Comparison of transcriptional profiles of Treponema pallidum during experimental infection of rabbits and in vitro culture: Highly similar, yet different. PLoS Pathogens, 17(9), e1009949. https://link-gale-com.tccd.idm.oclc.org/apps/doc/A677502988/SCIC?u=txshracd2560&sid=bookmark-SCIC&xid=a4486e2d