Syphilis is caused by Treponema pallidum, a spirochete and its characterized by episodes of active disease, interrupted by the period of latency. This gram positive, motile, microaerophilic spirochete is pathogenic to humans, which may be best demonstrated by the dark field microscope, since it stains poorly except by silver impregnation.
The route of transmission of syphilis is usually by sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero.
CONGENITAL SYPHILIS | Transmitted to offspring by infected mother |
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ACQUIRED SYPHILIS | ||
Primary stage | Chancre at site of inoculation ie, commonly occurs on penis and on the vulva | Oral chancre is usually painless but may become painful because of secondary infection. |
Secondary stage (Develops 6 weeks after primary lesion) |
“Mucous patches” on tongue, gingival and are highly infectious. Split papules, condyloma latum are other features. | Painless. The serological reaction is always positive. The mucous patches on the palate and tonsil are described as snail track ulcers. Circinate (coin like) lesions are also characteristic. |
Tertiary stage (CNS+ CVS are involved) |
Gumma commonly involves tongue, palate | More common than primary or secondary. Causes perforation of palate. |
DUBOIS SIGN | Congenital syphilis | Very short little finger |
OLLENDORF’S SIGN | Secondary syphilis | The papula is exquisitely tender to the touch of a blunt probe |
HIGOUMENAKI’S SIGN | Congentinal syphilis | Irregular thickening of sternoclavicular portion of clavicle |
WIMBEGER’S SIGN | Congenital syphilis | Loss of radio opacity in tibia in early congenital syphilis |
DIAGNOSIS:
Wassermann test and Hinton test (based on flocculation) were considered to be effective rest for the diagnosis of syphilis, but the disadvantage is false positive results. The diagnosis can be made by examining the exudates of the active lesion under a dark field microscope for spirochetes.
TREATMENT:
Pencillin is the drug of choice. Erythromycin or tetracycline is used if the patient is allergic to penicillin. Surgical correction of the facial defects gives good esthetic results.
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