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Nature Reviews. Disease Primers Oct 2017Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. T. pallidum is renowned for its... (Review)
Review
Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochaetes and often imitate those of other diseases. The spirochaete has a long latent period during which individuals have no signs or symptoms but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase in the prevalence of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement are needed to ensure that syphilis is given a high priority on the global health agenda. More investment is needed in research on the interaction between HIV and syphilis in MSM as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.
Topics: Algorithms; Humans; Syphilis
PubMed: 29022569
DOI: 10.1038/nrdp.2017.73 -
Enfermedades Infecciosas Y... 2019Syphilis is an infectious disease caused by the spirochaete Treponema pallidum subsp. pallidum which is transmitted by sexual contact or vertical transmission during...
Syphilis is an infectious disease caused by the spirochaete Treponema pallidum subsp. pallidum which is transmitted by sexual contact or vertical transmission during pregnancy. The incidence of syphilis has increased in the last years, mainly among men who have sex with men. Without treatment, the disease develops into different clinical stages, being able to present cardiovascular or irreversible neurological complications after a number of years. The disease is classified as early syphilis - primary, secondary and early latent syphilis (less than 12 months) - which is contagious, and as late syphilis - late latent and tertiary syphilis- which is rarely contagious. Diagnosis and management are often a challenge because of its diversity of manifestations and the difficulty of interpretation of serological tests. The treatment of syphilis is based on penicillin or doxycycline in allergic patients. Treatment failure because of resistance has been described with azithromycin. The follow up with a serological test is recommended in all patients with syphilis in order to ascertain cure after the treatment and to diagnose possible reinfections.
Topics: Humans; Syphilis
PubMed: 30738716
DOI: 10.1016/j.eimc.2018.12.009 -
Lancet (London, England) Jul 2023Syphilis is a sexually and vertically transmitted bacterial infection caused by the bacterium Treponema pallidum. Its prevalence is high in low-income and middle-income... (Review)
Review
Syphilis is a sexually and vertically transmitted bacterial infection caused by the bacterium Treponema pallidum. Its prevalence is high in low-income and middle-income countries, and its incidence has increased in high-income countries in the last few decades among men who have sex with men. Syphilis is a major cause of adverse pregnancy outcomes in low-income and middle-income countries. Clinical features include a primary chancre at the point of inoculation, followed weeks later by the rash of secondary syphilis, a latent period, and in some cases, involvement of the eyes, CNS, and cardiovascular systems. It is diagnosed serologically. A single intramuscular dose of long-acting benzathine penicillin is recommended for people who have had syphilis for less than 1 year and longer courses for people with late latent syphilis. Control strategies include screening and treatment of all pregnant women, and targeted interventions for groups at high risk. Vaccine development, research on antibiotic prophylaxis, and digital messaging as prevention strategies are ongoing.
Topics: Pregnancy; Male; Female; Humans; Syphilis; Homosexuality, Male; Sexual and Gender Minorities; Chancre; Treponema pallidum; Penicillins
PubMed: 37481272
DOI: 10.1016/S0140-6736(22)02348-0 -
Infectious Disease Clinics of North... Jun 2023Syphilis is an important public health problem in the U.S. and many high-income nations. The rates of syphilis continue to increase and there is an urgent need for... (Review)
Review
Syphilis is an important public health problem in the U.S. and many high-income nations. The rates of syphilis continue to increase and there is an urgent need for medical providers of a variety of backgrounds to recognize this disease. In this review, we cover the key clinical findings of syphilis and provide an overview of the diagnosis and management of this disease in adults.
Topics: Adult; Humans; Syphilis; Treponema pallidum
PubMed: 37005164
DOI: 10.1016/j.idc.2023.02.006 -
Lancet (London, England) Apr 2017Syphilis is a chronic bacterial infection caused by Treponema pallidum that is endemic in low-income countries and and occurs at lower rates in middle-income and... (Review)
Review
Syphilis is a chronic bacterial infection caused by Treponema pallidum that is endemic in low-income countries and and occurs at lower rates in middle-income and high-income countries. The disease is of both individual and public health importance and, in addition to its direct morbidity, increases risk of HIV infection and can cause lifelong morbidity in children born to infected mothers. Without treatment the disease can progress over years through a series of clinical stages and lead to irreversible neurological or cardiovascular complications. Although syphilis is an ancient disease and the principles of recommended management have been established for decades, diagnosis and management are often challenging because of its varied manifestations and difficulty in interpretation of serological tests used to confirm diagnosis and evaluate response to therapy. In North America and western Europe, incidence of syphilis has increased dramatically in the past decade among men who have sex with men, particularly those with coexistent HIV infection. Only one drug, penicillin, is recommended for syphilis treatment and response to therapy is assessed based on changes over months in serological test titres. Treatment for patients who cannot receive penicillin and management of patients who do not serologically respond to treatment are common clinical problems.
Topics: Child; Female; Humans; Male; Neurosyphilis; Syphilis
PubMed: 27993382
DOI: 10.1016/S0140-6736(16)32411-4 -
Journal of Medicine and Life Mar 2014Before the discovery of Treponema pallidum as the etiologic agent, the origins of syphilis have been the subject of several debates. Diverse therapeutic agents were... (Review)
Review
Before the discovery of Treponema pallidum as the etiologic agent, the origins of syphilis have been the subject of several debates. Diverse therapeutic agents were employed in an attempt to cure the disease. Examining the milestones in the history of syphilis, the present article reviews the existing theories that tried to explain the origins of the disease, the approach in art, the cultural and the evolution of the treatments from the empiric means to the discovery of penicillin.
Topics: Culture; History, 15th Century; History, 16th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Syphilis; Treponema pallidum
PubMed: 24653750
DOI: No ID Found -
The New England Journal of Medicine Jan 2024
Review
Topics: Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis, Congenital
PubMed: 38231625
DOI: 10.1056/NEJMra2202762 -
Actas Dermo-sifiliograficas 2015
Topics: Humans; Syphilis
PubMed: 25245171
DOI: 10.1016/j.ad.2014.06.007 -
Revista Brasileira de Enfermagem 2021to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention. (Review)
Review
OBJECTIVES
to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention.
METHODS
integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors "syphilis, congenital", "complications", and "signs and symptoms", leading to the selection of 27 researches.
RESULTS
the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost.
CONCLUSIONS
the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.
Topics: Female; Humans; Infant, Newborn; Parturition; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis, Congenital
PubMed: 34287560
DOI: 10.1590/0034-7167-2019-0318 -
Presse Medicale (Paris, France : 1983) Apr 2013Syphilis is back since 2000. Early syphilis comprises primary syphilis, secondary syphilis and early latent syphilis (less than 1 year duration). During early phases of... (Review)
Review
Syphilis is back since 2000. Early syphilis comprises primary syphilis, secondary syphilis and early latent syphilis (less than 1 year duration). During early phases of syphilis, patients are more contagious and neurologic complications are rare. Early neurosyphilis are mostly represented by uveitis or cranial nerves lesions. Treatment of non-neurologic syphilis are based on intramusculary injection of benzathine-penicilline G: one injection in case of early syphilis, three injections in case of late syphilis. The follow-up after treatment is based on clinical evolution and the titer of VDRL. Intravenously infusion of penicillin G is the only treatment recommended for neurosyphilis.
Topics: Adult; Cross-Cultural Comparison; Cross-Sectional Studies; Drug Administration Schedule; Early Diagnosis; Female; Humans; Incidence; Infant, Newborn; Infusions, Intravenous; Injections, Intramuscular; Male; Neurosyphilis; Penicillin G; Penicillin G Benzathine; Population Surveillance; Pregnancy; Syphilis; Syphilis, Cutaneous; Syphilis, Latent
PubMed: 23414811
DOI: 10.1016/j.lpm.2012.09.024