-flexible helically coiled walls

-6 thin axial filaments around the length

-found as commensal in subgingival plaque

-produces no toxins or tissue destructive enzymes

-cannot be grown in artificial media

-humans are the only natural hosts

-cause of veneral syphillis and Yaws (amoung others)

-sexually transmitted, as well as by kissing if there are mucous membrane lesions

-incubation period is 21 days, but person is still infective during this latent period

Majority of cases occur in the three 'SA' areas:

South America

Sub-Saharran Africa

South & South-East Asia

-painless

-occurs 3-6 weeks after initial contact

-occurs on genetalia or lips

-this chancre is highly infective

-get regional non-tender lymph node swelling

-self resolves in 4-6 weeks (w/o scarring)

-about 6 weeks after primary chancre has healed

-now, bacteria spreads throughout the body in the blood stream

Clinical features:

- maculopapulary rash,mucous patches, condyloma latum (found on genitalia), alopecia [STAN SITWELL!!!!]

Systemic CHRONIC symptoms:  Weight loss and fever

occurs when secondary syphillis has resolved, but tests remain positive.

-After 4 years of no relapses, disease is considered to be non-infectious (except in pregnant women)

-develops 6-40 years after infection

-causes damage to organs, small vessels and nerve cells.

Three types:

-gummatous

-cardiovascular

-neurosyphilis

type of tertiary syphilis

-presence of gummy bear like lesions ('Gummas')

-found in skin (painless) and bones (deep gnawing pain)
- Can also be found in heart, brain and liver

type of tertiary syphilis

-get all sort of problems with the aorta such as aortic valve occlusion and blockage of coronary arteries
-Due to destruction of small blood vessels, the vasa vasorum that supply the aorta- causes degeneration of this region, affects tunica media also.

rarer type of tertiary syphilis (8% of cases)

-asymptomatic, but CSF pos for syphilis

-due to damage to small vessels in the brain, subacute meningitis and meningovascular disease.

-also causes tabes dorsalis (related to DRG and posterior column of spinal chord- ataxia) and argyll robertson pupil

damage to the dorsal columns of the spinal cord

-results in ataxia, staggering gait, postural instability, etc, etc

Applies to treponema pallidum

-6 weeks of incubation

-6 weeks for ulcer to heal

-6 weeks after ulcer heals for secondary syphilis to start

-6 weeks for 2ndary syphilis to resolve

-66% of patients resolve (ie. no tertiary)

-6 years to develop tertiary

-treponema crosses the placental blood barrier

-can cause spontaneous abortions

-8th nerve deafness can result

-bone and teeth problems can also result
Treat before fetus has reached 4 months of age- disease will not manifest

Basically any eye disease you can think of....

keratitis, iris nodules, scleritis, vitritis, papillitis, retinal detachment, papillodema, etc, etc, ETC!

-Specific test: Indirect Immunofluorescent treponemal Antibody Absorption test VDRL
- Nonspecific test: VDRL antibody testing
-Since it is a spirochete, could also use darkfield microscopy as well

-heating, drying, soap and water

-antibiotic of choice:  pennicilin (erythromycin in case of allergies0

Mild worsening of symptoms after treatment of treponema with penicillin.

Worsening due to release of a pyrogen.