Show Summary Details
Page of

Syphilis 

Syphilis
Chapter:
Syphilis
DOI:
10.1093/med/9780198729228.003.0116
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 26 June 2019

Syphilis is caused by the spirochaete bacterium Treponema pallidum. Syphilis is now an uncommon infection in developed countries but remains endemic in many resource-poor countries. Syphilis is primarily a sexually transmitted infection. Other modes of infection include: passage through the placenta (congenital syphilis), mother-to-baby transmission during delivery, other close contact with an active lesion, transfusion of contaminated blood, and direct inoculation. The various clinical syndromes of syphilis include early and late congenital syphilis and acquired syphilis, with the latter progressing through four stages—primary, secondary, latent, and tertiary. Early congenital syphilis clinical signs may include nasal discharge (‘snuffles’), rash, osteochondritis/periostitis, central nervous system involvement, and non-specific signs. Late congenital syphilis clinical signs may include the Hutchinson’s triad, osteochondritis, and periostitis. Acquired syphilis stages include primary disease (ulcer or chancre), secondary (fever, rash, and condylomata lata), latent, and tertiary syphilis (gummas, cardiovascular, and neurosyphilis). Diagnosis relies mainly on serology, but also on direct identification of bacteria on dark-field microscopy or immunofluorescence staining. There are two types of serological test: treponemal-specific (TPHA, TPPA, and FTA-ABS) and non-treponemal (RPR and VDRL) tests. Treponemal specific tests remain positive indefinitely. Non-treponemal tests are mainly used to monitor the response to treatment. Penicillin remains the drug of choice for treatment of syphilis. Duration of therapy varies, according to the stage of disease and clinical manifestations. Prevention methods include screening pregnant women, sexual education, and identification and treatment of infected individuals.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.