SYPHILIS

CAUSATIVE AGENT

Treponema Pallidum is a
microaerophilic
spirochete
To slender to be seen in
gram stain but can be
visualized in silver
stains,dark field
exam,and
immunoflorescence
Skin - BASAL CELL CARCINOMA

TYPES
Palisade pattern
STAGE PATHOLOGY
cleft

PRIMARY AbnormalChancre
tissue

SECONDARY Palmar rash, lymphoadenopathy,

condyloma latum

Neurosyphilis: Meningovascular
TERTIARY Tabes dorsalis
General Paresis
Aortitis: Aneurysms
Aortic regurgitation
Gummas: Hepar Lobatum,skin,
bone others
 Thyroid - THYROID PAPILLARY CARCINOMA

Late abortion or still

birth

CCONGENITAL
Finger-like projections
Infantile Rash
Osteochondritis
Periostitis
(papillae) Liver & lung fibrosis

Childhood Interstitial keratitis

Hutchinson teeth
Eighth nerve deafness
Skin - SQUAMOUS CELL CARCINOMA

PRIMARY SYPHILIS
Stratified squamous
Epithelium (keratinised)
Pathologic manifestation:- chancer
Occurrence:- 3 weeks after contact
Squamous cells
with infected individual
Heals in 3-6 weeks with or without
treatment
Spirochetes are plentiful within
chancer which can be viewed by
dark field microscopy or
immunoflourescent stains of serous
Onion-like
exudatesructures
Treponemes spread throughout the
body by hematologic & lymphatic
dissemination even before the
appearance of chancre
Lung - CARDIAC CELLS
SECONDARY SYPHILIS

Occurence: - 2-10 weeks after primary

Chancre and lasts for several weeks
Macrophages have hemosiderin
Cause:- spread & proliferation of the
spirochetes within skin &
mucocutaneous tissues

Lesions could be maculopapular, scaly

or pustular

Moist areas might hve Condylomata

lata

Silvery gray superficial lesions in

mucuos membranes esp mouth
pharynx & ext genitalia

Other symptoms,
fever,lymphadenopathy,weight loss
 TERTIARY SYPHILIS
Occurs in 1/3rd of untreated patients usually after a
latent period of 5 years or more divided into CV
syphilis,Neurosiphylis,benign tertiary syphilis

Cardiovascular syphilis :- in form of

siphilitic aortitis occurs in more than
80% of cases,it leads to dilation of
aortic valve insufficiency & aneurysms
of proximal aorta

Neurosyphilis:- could be
asymptomatic or symptomatic,
Symptomaticchronic
meningovascular disease,Tabes
dorsalis & general paresis
AsymptomaticCSF exhibits
pleocytosis,elevated protein
levels,decreased glucose,antiobodies
stimulated by spirochetes

Benign tertiary syphilis:- formation of

gummas in various sites i.e. nodular
lesions due to delayed hypersensitivity
Bladder - TRANSITIONAL
to the bacteria,occur mostly in CELL CARCINOMA (1st grade carcinoma)
bone,skin etc,
Liver - CIRRHOSIS
CONGENITAL SYPHILIS
Connective
Occurs when T.pallidum crosses
placenta frm infected mother to
tissue capsule
fetus

Most frequent during primary or

secondary stage when spirochetes
are abdundant

Manifestations are divided into

infantile (<2 years)& late syphilis

Infantile manifestation: nasal

discharge & snuffles sloughing of Nodule
the skin esp hands feet &a round
the mouth,Hepatomegaly & skeletal
abnormalities are common

Late manifestation:- Hutichisons

triad,notched central
incisors,interstiital keratitis with
blindness & deafness frm 8th cranial
nerve injury,skeletal neurological &
facial abnormalities
Lung - ANRACOSIS
Diagnosis & treatment

Dust deposits
Serologic testsmain way of
diagnosis

Include nontrepomonal
antibody tests & antitrepomonal
antibody tests

Nontrepomonal tests measure

antibody to cardiolipin,a
phosphilipid present both in
host cells & T pallidum,these
are positive 4-6 weeks after
infection

Treatmeant :-Benzathine
Penicillin G is effective in all
stages, this is used because its
released vry slowly from its
depot
presentation,erythromycin &
Tetracycline can be used but
takes longer to effect i.e. higher
threshold value,no resistance
to penicillin has been observed