syphilis (redirected from lues)

syphilis (sĭf`əlĭs), contagious sexually transmitted disease caused by the spirochete Treponema pallidum (described by Fritz Schaudinn and Erich Hoffmann in 1905). Although some medical historians believe that syphilis first appeared in Spain among sailors who had returned from the New World in 1493, others have concluded from archaeological evidence that syphilis probably originated in the Old World but may have been confused with leprosy. It was not widely recognized until an epidemic in Europe at the end of the 15th cent.

Transmission

The most prevalent mode of transmission is by sexual contact; infection by other means is possible, but its occurrence depends upon an open wound or lesion to permit invasion of the organisms. A person with syphilitic sores has an increased chance of contracting AIDS from an infected partner. An infected mother can transmit the disease to her fetus; 25% of such pregnancies end in stillbirth or death of the infant, and another 40% to 70% will result in a baby with congenital syphilis, which, if untreated, can progress to late-stage syphilis and cause serious damage to the brain and other organs.

Symptoms

The development of syphilis occurs in four stages. The primary stage is the appearance of a painless chancre at the site of infection (often internal) about 10 days to 3 months after contact. There are no other symptoms, and the chancre disappears with or without treatment.

The secondary stage usually begins 3 to 6 weeks after the chancre with a rash over all or part of the body. Active bacteria are present in the sores of the rash. Headache, fever, fatigue, sore throat, patchy hair loss, and enlarged lymph nodes may be present. The signs of the secondary stage will disappear with or without treatment, but may reappear over the next 1 to 2 years.

Untreated syphilis then goes into a noncontagious latent period. Some people will have no more symptoms, but about one third will progress to tertiary syphilis, with widespread damage to the heart, brain, eyes, nervous system, bones, and joints. Late syphilis can result in mental illness, blindness, severe damage to the heart and aorta, and death.

Neurosyphilis, infection of the nervous system, frequently occurs in the early stages in untreated patients. There may be no symptoms, mild headache, or severe consequences such as seizures and stroke. Its treatment and course are complicated by concomitant HIV infection.

Diagnosis and Treatment

Diagnosis is made by symptoms, blood tests (required by many states before issuing marriage licenses), and microscopic identification of the bacterium. Until the advent of penicillin in the 1940s, treatment for syphilis was with mercury, arsenic, and bismuth. Penicillin is the antibiotic of choice for all stages of syphilis treatment, but penicillin-resistant organisms have complicated treatment of the disease. Even late-stage syphilis can be cured, but damage that has already occurred cannot be reversed. Despite available treatment, the incidence of syphilis in the United States was on the rise until 1990. Since then it has declined sharply, from 20 to just 2.6 cases per 100,000 people from 1990 to 1998. Federal health experts have attributed the decline to prevention efforts, including those intended to curtail the spread of AIDS.

See also Ehrlich, Paul.

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syphilis

Sexually transmitted disease caused by the spirochete Treponema pallidum. Without treatment, it may progress through three stages: primary, characterized by a chancre and low fever; secondary (weeks to months later; only half of those infected display symptoms), with a skin and mucous-membrane rash, lymph node swelling, and bone, joint, eye, and nervous system involvement; and tertiary. The tertiary stage follows a latency period that can last years, and only one-fourth of those infected display tertiary symptoms. These can be benign or incapacitating and even fatal; almost any part of the body may be attacked. Syphilis can spread to a fetus from an infected mother. Other species of Treponema cause similar but milder, nonsexually transmitted forms of syphilis (see yaws). Several blood tests can detect syphilis, even during latency. Antibiotic treatment is effective.

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syphilis

a venereal disease caused by infection with the microorganism Treponema pallidum: characterized by an ulcerating chancre, usually on the genitals and progressing through the lymphatic system to nearly all tissues of the body, producing serious clinical manifestations

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syphilis [′sif·ə·ləs]

(medicine)

An infectious disease caused by the spirocheteTreponema pallidum,transmitted principally by sexual intercourse.

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Syphilis

A sexually transmitted infection of humans caused by Treponema pallidum ssp. pallidum, a corkscrew-shaped motile bacterium (spirochete). Due to its narrow width, T. pallidum cannot be seen by light microscopy but can be observed with staining procedures (silver stain or immunofluorescence) and with dark-field, phase-contrast, or electron microscopy. The organism is very sensitive to environmental conditions and to physical and chemical agents. The complete genome sequence of the T. pallidum Nichols strain has been determined. The nucleotide sequence of the small, circular treponemal chromosome indicates that T. pallidum lacks the genetic information for many of the metabolic activities found in other bacteria. Thus, this spirochete is dependent upon the host for most of its nutritional requirements. See Bacterial genetics, Immunofluorescence

Syphilis is usually transmitted through direct sexual contact with active lesions and can also be transmitted by contact with infected blood and tissues. If untreated, syphilis progresses through various stages (primary, secondary, latent, and tertiary). Infection begins as an ulcer (chancre) and may eventually involve the cardiovascular and central nervous systems, bones, and joints. Congenital syphilis results from maternal transmission of T. pallidum across the placenta to the fetus. See Sexually transmitted diseases

Treponema pallidum is an obligate parasite of humans and does not have a reservoir in animals or the environment. Syphilis has a worldwide distribution. Its incidence varies widely according to geographical location, socioeconomic status, and age group. Although syphilis is controlled in most developed countries, it remains a public health problem in many developing countries. Studies have shown that syphilis is a risk factor for infection with the human immunodeficiency virus (HIV) since syphilitic lesions may act as portals of entry for the virus. There is little natural immunity to syphilis infection or reinfection.

Parenteral penicillin G is the preferred antibiotic for treatment of all stages of syphilis. Alternative antibiotics for syphilis treatment include erythromycin and tetracycline. There is currently no vaccine to prevent syphilis. However, it is anticipated that information obtained from the T. pallidum genome sequence will lead to further improvements in diagnostic tests for syphilis and to the eventual development of a vaccine that would prevent infection. See Antibiotic

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Syphilis

Fracastoro’s epic concerning Syphilis, mythical first victim. [Ital. Lit.: RHD, 1443; Plumb, 342]

See : Disease