Syphilis

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  • Spirochetes
    • spirochete cell has a central protoplasmic cylinder bounded by a plasma membrane
    • it has a typical gram-negative cell wall.
    • Unlike in other bacilli, this cylinder is enveloped by an outer membrane composed of glycolipids and lipoproteins
    • Between the peptidoglycan and the outer sheath are located multiple periplasmic flagella that do not protrude from the cell but are oriented axially.
    • Axial periplasmic flagella rotate like the external flagella of other motile bacteria, propelling the cell in a corkscrew-like manner. (MCQ)
    • Spirochetes can move through highly viscous solutions with little impediment
  • Treponema pallidum
    • Syphilis is primarily a sexually transmitted infection
    • caused by the spirochete T. pallidum. . (MCQ)
    • extremely fastidious and fragile.
    • It cannot be cultured in cell-free systems . (MCQ)
    • sensitive to disinfectants, heat, and drying.
    • T. pallidum is so thin that it requires immunofluorescent or dark- field techniques
    • it can be stained by silver impregnation methods
      • Fontana’s method is useful for staining .films
      •  Levaditi’s method for tissue sections.
    • The outer surface of the spirochete is sparse in proteins, and the organism is only weakly antigenic
    • Reagin antibody
      • reacts in the standard or nonspecific tests for syphilis, such as Wassermann, Kahn and VDRL . (MCQ)
      • a hapten extracted from the beef heart is used as the antigen.
      • This lipid hapten is known as cardiolipin
      • It is chemically a diphosphatidyl glycerol. . (MCQ)
      • Cardiolipn has been detected in T. pallidum
      • it is not known whether the reagin antibody is in­duced by cardiolipin that is present in the spirochete or released from damaged host tissues. . (MCQ)
    • It secretes hyaluronidase, an enzyme that disrupts ground sub- stance and probably facilitates dissemination of the organism.
    • Unlike typical gram-negative bacteria, most spirochetes, including T. pallidum, do not have lipopolysaccharide (LPS), or endotoxin, in the outer leaflet of the outer membrane.
    • Antigenic variation of surface proteins plays an important role in immune evasion. . (MCQ)
    • Syphilis
      • Primary syphilis
        • The first symptom of primary syphilis is a hard, painless genital or oral ulcer (chancre) that develops at the site of inoculation. . (MCQ)
        • The average period between infection and the appearance of the chancre is about 3 weeks . (MCQ)
        • This primary lesion heals spontaneously
        • the organism continues to spread throughout the body via the lymph and blood.
        • An asymptomatic period ensues, lasting as long as 24 weeks, followed by the secondary stage.
      • Secondary syphilis
        • characterized by the appearance of a red, maculopapular rash
          • occur on almost any part of the body including the palms of the hands and soles of the feet. . (MCQ)
        • pale, moist, flat papules seen primarily in the
          • anogenital region (where they are called condylomata lata), . (MCQ)
          • armpits, and mouth.
        • Both primary and secondary lesions teem with T. pallidum and are extremely infectious. (MCQ)
        • The secondary stage may be accompanied by multiorgan involvement, causing hepatitis, meningitis, nephritis, or chorioretinitis. . (MCQ)
        • Upon healing of the secondary lesions, the disease enters a latent period that can last for many years.
      • Tertiary syphilis
        • In approximately 40 percent of infected individuals, the disease progresses to a tertiary stage
        • characterized by
          • degeneration of the nervous system
          • cardiovascular lesions, such as ascending aortic aneurysms. (MCQ)
          • granulomatous lesions (gummas) in the liver, skin, and bones. . (MCQ)
      • Congenital syphilis:
        • transmitted through the placenta to a fetus after the first 10 to 15 weeks of pregnancy. . (MCQ)
        • Infection can cause fetal or infant death or spontaneous abortion
        • Treatment of the pregnant mother with appropriate antibiotics prevents congenital syphilis.
    • Laboratory identification
      • treponemal spirochetes from primary and secondary lesions can be detected microscopically using immunofluorescent stain or dark-field illumination  . (MCQ)
      • syphilis is usually diagnosed serologically.
      • Two kinds of antibodies
        • Antitreponemal antibodies . (MCQ)
          • specific to the treponemal surface proteins . (MCQ)
          • more specific than reagin-based tests. (MCQ)
          • not useful for monitoring therapy. (MCQ)
            • They remain positive during and after successful treatment
          • They include
            • Treponema pallidum Immobilisation (TPI) test
            • Fluorescent Treponemal Antibody Absorption (FTA-ABS) test
            • Treponema pallidum Hemagglutination Assay (TPHA)
            • Treponema pallidum Enzyme Immunoassays (TP-EIA)
          • TPI . (MCQ)
            • most specific test availa­ble for diagnosis of syphilis considered the gold standard in syphilis serology
          • TPHA a standard confirmatory test. . (MCQ)
        • Nontreponemal antibodies (reagin),
          • directed against normal phospholipid components of mammalian membranes, such as cardiolipin
          • are less specific and liable to give more false positives. . (MCQ)
          • Their positivity need to be confirmed by a specific test (usually fluorescent treponemal antibody).
          • useful in screening. (MCQ)
            • detectable 7-10 days after the appearance of primary chancre
          • useful for monitoring therapy. (MCQ)
            • they become negative about 1 year after successful treatment.
          • Sensitivity
            • in the primary stage is 60-75 per cent with the titres being low. (MCQ)
            • In the secondary stage, the sensitivity  is 100 per cent . (MCQ)
              • Prozone phenomenon may be a problem in high titre sera and it is therefore essential to test sera in dilutions. . (MCQ)
            • Another stage of syphilis in which such high titres are seen is congenital syphilis.
            • about a third of patients with late syphilis are seronegative.
            • The titres may rise in patients developing cardiovascular, neurological or gummatous lesions.
            • In some cases of neurosyphilis, again tests may be negative with serum but positive with the CSF
          • They include
            • Wassermann CF reaction
            • Kahn flocculation test
            • Venereal Disease Research Laboratory (VDRL) test
            • Rapid Plasma Reagin (RPR) test
            • Automated RPR test
            • VDRL-ELISA test
        • BFP reactions
          • defined as positive reaction obtained in cardiolipin tests, with negative results specific treponemal tests, in the absence of past present treponemal infections – and not caused technical faults.
          • They represent nontreponemal cardiolipin antibody responses
          • occur in about one per cent normal sera.
          • BFP antibody is usually IgM, reagin antibody in syphilis is mainly IgG. (MCQ)
          • Acute BFP reactions
            • last only for a few weeks months
            • usually associated with acute infections, injuries or inflammatory conditions.
          • Chronic BFP reactions . (MCQ)
            • persist for longer than six months
            • are typically seen in SLE and other collagen diseases
          • conditions associated with BFP reactions.
            • Leprosy, malaria
            • relapsing fever, infectious mononucleosis,
            • hepatitis and tropical eosinophilia
      • Dark ground examination . (MCQ)
        • negative results do not exclude the diagnosis of syphilis
        • it has low sensitivity
        • A treponemal concen­tration of 10 per ml in the exudates is required for the test to be positive
      • Direct fluorescent antibody test for T. palli­dum (DFA-TP)
        • It is a better and safer method for micro­scopic diagnosis.
        • DFA-TP test is done using fluorescent tagged anti-T. pallidumantiserum. . (MCQ)
        • The use of specific monoclonal antibody has made the test more reliable.
    • Treatment and prevention
      • One single treatment with penicillin is curative for primary and secondary syphilis. (MCQ)
      • no antibiotic resistance has been reported.
      • In cases of patient sensitivity to penicillin, alternate therapy with ery- thromycin or tetracyclines may also be effective


Do I Have Syphilis? Signs and Symptoms of Syphilis
Learn the signs and symptoms of syphilis. See a doctor, get tested, and follow their instructions if you have symptoms of any sexually transmitted infection or think you may have been exposed to one.
Syphilis
This clip was made for mine and one of my friends Health Assignment. we chose to do it on youtube because it gives the world and insite on syphilis.
websites included:
Review of syphilis
Table of Contents:
All about the Syphilis
Symptoms you might have Syphilis
One or more painless ulcers (know as chancres) appear at the place where the syphilis bacteria entered the body. On average, this will be 21 days after sexual contact with an infected person. Chancres may be difficult to notice and are highly infectious. The usual locations for chancres are: On the vulva (outside the vagina) or on the cervix (neck of the womb) in women. On the penis in men. Around the anus and mouth (both sexes)
Syphilis,a venereal disease caught due to contact with infected genitals during s…HD Stock Footage
Syphilis,a venereal disease caught due to contact with infected genitals during sexual intercourse
Secrets Of The Dead – The Syphillis Enigma 1of 4New discoveries, challenge the established origin of Syphilis.
Do I Have Syphilis? Signs and Symptoms of Syphilis
Do I Have Syphilis? Signs and Symptoms of Syphilis
Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women. You usually get syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.
Learn About Syphilis
Syphilis is a chronic infectious disease caused by the bacteria Treponema pallidum. it’s an unpleasant looking bacterial infection that is obtained by sexual intercourse. Syphilis is widespread in the USA and usually occurs in sexually active adults ages 20 to 29.