3. Syphilis….
is a contagious bacterial infection that
is transmitted through contact with an
chancre on an infected person, usually
during intimate sexual contact
4. History
Origins
- origin of syphilis has not been agreed on by researchers
1.Christopher Columbus and his crew or other explorers brought it back with them from the
“new world”.
2. Syphilis was always present in the “old world” but it wasn’t yet identified as a separate disease
from leprosy.
3.Syphilis developed from the related diseases bejel and yaws.
The first reference to the “French sickness” is made
during Charles VIII’s Italian campaign
A complete description of the “French sickness” was
given by Juan de Virgo
1493 1526
?
1495
1500
Christopher Columbus and his
crew returns from the “new world”
possibly carrying syphilis
Fernandez de Oviedo was the first person
to mention the “American origin”
of syphilis
# of cases in Europe reach
epidemic proportions
Christopher Columbus
http://www.latinamericanstudies.org/columbus/older-columbus.gif
1514
1530
The disease recieves the name syphilis
from a poem entitled “Syphilis Sive
Morbus Gallicus” by Jerome Francastor
5. History
so few cases that the medical and
scientific community is prepared to
consider it erradicated
1996
Sir Alexander Fleming discovers
penicillin while working on the
1964-1965
of cases on the rise in western countries
influenza virus.
1928
Sir Alexander Fleming
http://nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-bio.html
the rising occurrence of syphilis around
2001
the world causes hope of eradicating the disease
to lessen after being raised by the success of penicillin
1905
Treponema Pallidum, the bacteria that
causes syphilis is discovered on March 3
in Berlin by Chauvinand Hoffmann
6. DISEASE - CAUSE/GENERAL INFO
classified as an STI (sexually
transmitted infection)
caused by the bacterium Treponema
Pallidum
spiral shaped
enters through open cuts or sores in the
mucous membrane
contracted through contact with a
chancre during sexual contact or
passed from mother to baby called
congenital syphilis
progresses through 4 stages; primary,
secondary, latent and tertiary stages
stages get progressively worse if left
untreated
highly contagious
potentially fatal
Treponema Pallidum
http://www.uveitis.org/images/syphil1.jpg
7. Disease - Symptoms
not all people show visible signs of the
disease at the beginning
Primary Stage
a small painless ulcer like sore called a chancre appears at
the site of initial infection
chancre usually appears 2-3 weeks after the initial infection
a rash near the chancre may also appear
the chancre may go unnoticed because of the location in
the mouth, anus, vagina or throat
usually disappears in 4-6 weeks without treatment
the bacteria is still multiplying in the body
contagious
chancre
http://www.co.multnomah.or.us/man2manpdx/image
s/primary_oral_syphilis.jpg
http://www.homeomiracles.com/Index/Male/Male_article/STD/Sexually%20transmitted%20Diseases.html
8. Disease - Symptoms
Secondary Stage
begins a few weeks to months after the chancre heals
• rash with flat and raised patches
- frequently on palms, soles, can be anywhere on body
• lesions in the mouth, vagina, penis, mucus patches; condyloma lata
• fever
• swollen glands
• loss of appetite
• fatigue
• aches and pains in bones or joints
• patchy hair loss
• chancre still present in some cases
bacteria has spread to the blood
most contagious stage
resolves in 2-6 weeks without
treatment
http://www.ratsteachmicro.com/Assets/Syphilis/syphilis/poem.jpg
http://www.scielo.br/img/revistas/abd/v80n1/ia09f07.jpg
http://www.worldsbest-sexual-health-site.com/images/Hand.jpg
9. Disease - Symptoms
Latent Stage
characterized by the lack of symptoms
no symptoms may appear for months or years
syphilis is still alive in the body
bacteria starts to damage the internal organs;
brain, heart, sexual organs
damage can go unnoticed until the next stage
http://services.epnet.com/GetImage.aspx/getImage.aspx?ImageIID=6227
Congenital Syphilis
• during the secondary stage the infection can be transferred to
the baby
• if the mother is not treated during pregnancy it can cause
deformations, or possibly death
• tested after birth; if the baby has syphilis it is treated right away
http://www.neonatology.org/classics/hess1922/figures/fig168.gif
10. Disease - Symptoms
Tertiary Stage
• occurs many years later, 5 to 50 years after secondary stage symptoms disappear
• characterized by paralysis, gradual blindness, deterioration of the brain, loss of co-ordination,
shooting pains, and death
• gummatous syphilis - destructive lesions of bones, skin or liver
• cardiovascular syphilis - severe damage to heart and blood vessels, inflammation of
the aorta, heart disease
• neurosyphilis - nervous system disorders; brain, eye, spinal cord, auditory system;
deafness
• brain - can cause paralysis, blindness, dementia or insanity
http://www.ynhh.org/cardiac/heart/exterior_heart_anatomy.jpg
http://www.ipmc.cnrs.fr/~duprat/neurophysiology/images/brain2.jpg
11. NEUROSYPHILIS
Divided into 5 groups, which may
overlap:
Asymptomatic neurosyphilis
Syphilitic meningitis
Meningovascular syphilis
General paresis
Tabes dorsalis
12. SYPHILITIC MENENGITIS
‘OAseptic meningitis’ at any One year after primary stage.
CSF shows:
Lymphocytic pleocytosis
Elevated protein and usually normal glucose
concentrations
VDRL test is usually reactive.
It can mimic tuberculous or fungal meningitis or aseptic
meningitis of various causes.
Often involves the base of the brain and may result in
unilateral or bilateral cranial nerve palsies.
Without treatment, syphilitic meningitis usually
resolves, like the other manifestations of early syphilis
13. CARDIOVASCULAR SYPHILIS
Ma5-10 years after initial infection.
Primarily aortic insufficiency and aortic aneurysm of the
ascending aorta. Other large arteries may sometimes be
involved, and rarely the coronary ostia may be involved.
Caused by obliterative endarteritis of the vasa vasorum
with resultant damage to the intima & media of the great
vessels, causing dilatation of the ascending aorta and
eventually results in stretching of the ring of the aortic
valve, producing aortic insufficiency. The valve cusps
remain normal.
Asymptomatic aortitis is best diagnosed by visualizing
linear calcifications in the wall of the ascending aorta.
More common in men than in women and possibly in
blacks than in whites.
14. hard to diagnose because the symptoms
are similar to other diseases such as
the flu
different tests used for the different stages
primary stage - physical examination,
description of symptoms taken, fluid
from chancre taken and examined
secondary stage - blood tests
tertiary stage - spinal tap may be required
in case of neurosyphilis
Diagnosis
http://www.healthsystem.virginia.edu/internet/cstap/images/IMG_1457.jpg
http://www.raisingkids.co.uk/images/editorial/preg_test02.jpg
15. TESTS FOR SYPHILIS
Dark field Microscopy
VDRL, RPR
FTA-ABS, MHA-TP
Direct Fluorescent Antibody (DFA)
16. TREPONEMAL TESTS
FTA-ABS
Used as a confirmatory tests.
Sensitivity and specificity high.
85% of patients with primary syphilis are reactive
99% with secondary syphilis
> 95% with late syphilis (It may be the only test with a positive result for
patients with cardiovascular or neurologic syphilis).
Remains reactive for life in most, despite adequate therapy. Only 15-25
% of those treated for primary syphilis may turn negative by 2-3
yrs.
False positive in other treponemal diseases (pinta, yaws..) and other
spirochete diseases (Lyme, leptospirosis…)
MHA-TP test (micro haemagglutination assay for T. pallidum;
agglutination of RBCs to which T. pallidum antigens have been
fixed is the basis).
17. antibiotics; usually penicillin was used but nowadays
Flouroquinolones like levofloxacin are used
doxycycline may also be used
administered either intramuscularly or intravenously
Treatment
daily
then asked to attend injections for two years monthly
And then every three months for examination and
blood test to ensure and check the success of the
treatment
http://www.volstate.edu/HSCenterofEmphasis/images/image2.jpg
• regular check-ups are needed
after the treatment to make sure
the infection is gone
• treatment can be done at any
stage but any damage done is
irreversible
http://www.brooksidepress.org/Products/Injections/320SubQ.JPG
18. PREVENTION
Abstinance is the most effective way to prevent the
contraction of the disease
practice safe sex
be tested regularly for syphilis if married or sexually active
• best way to detect syphilis early
get treated if you have it, to prevent the spread
avoid direct contact with blood, sores or bodily fluid
learn about safe sex and injection practices
get tested for syphilis if you are pregnant so you can be
treated; won’t pass it on to your baby
If you have it….
• Get yourself treated and avoid sexual contact
• may need to be tested.
http://www.avert.org/photo_library/images/normal_photo_no_240.gif
19. FUTURE OUTLOOK
raise awareness of the effects of the disease
inform people of safe sex practices in order to prevent the
spread
hope to be able to eradicate syphilis using the above tactics
http://www.cdc.gov/std/syphilis/syphilis2.jpg
http://www.thedaily.washington.edu/image/preview/158?x=225
20. REFERENCE PAGE
Archaeological Institute of America Tours.Origins of Syphilis on the World Wide
Web: < http://www.archaeology.org/9701/newsbriefs/syphilis.html >
Canadian Association for Adolescent Health. Syphilis on the World Wide Web:
< http://www.youngandhealthy.ca/caah/Informations/STI/t428c431s509x413/Syphilis.aspx >
Endersbe, Julie K Sexually Transmitted Diseases. Manakato, Minnesota: Capstone Press.
Health Canada. on the World Wide Web:
< http://www.hc-sc.gc.ca/iyh-vsv/alt_formats/cmcd-dcmc/pdf/syphilis_e.pdf >
Medline Plus. Medical Encyclopedia: Syphilis.on the World Wide Web:
< http://nim.nih.gov/medlineplus/ency/article/001327.html >
Nobel Foundation. Sir Alexander Fleming. on the World Wide Web:
< http://nobelprize.org/cgi-bin/print?from=/nobel_prizes/medicine/laureates/1945/fleming-bio.html >
Quetel, Claude.. History of Syphilis. Cambridge: Policy Press.
Secrets of the Dead.. The Syphilis Enigmings on the World Wide Web:
< http://www.pbs.org/wnet/secrets/case_syphilis/p_index.html >
Syphilis. In Diseases (Vol 8, pp.32-34). United States (CT): Scientific Publishing, Inc.
Syphilis. In Health Matters (Vol 3 pp 126-127). Danbury, CT: Grolier Educational.
21. Reference Page
Syphilis.. In Encyclopedia pf Family Health (Vol 15 pp2153-2155). Tarrytown, NY: Marshall Cavendish, Crop.
The Flying Walrus.. Health. on the World Wide Web: <
http://www.yorku.ca/walrus/06-12/health02.html>
The Society of Obstetricians and Gynaecologists of Canada. . Sex Facts in Canada on the World Wide Web: <
www.sexualityandu.ca/media-room/pdf/Sex-Stats-Fact-Sheet_e.pdf >
Pharmacology by k.d tripathi
Pathalogy by Dr. Vithal kulkarni
Biochemistry by Eugene C. Toy M.D
