# Syphilis Syphilis is caused by *Treponema pallidum*, a **gram negative (-) spirochete** - Spirochete bacterium Can be transmitted through: - *DIrect contact* with syphilis sore - *Congenitally* (mother -> child) Penecillin can be used to clear out bacteria at any point during infection, however permanent damage cannot be reversed. > [!example] Stages > **Primary Stage** > - Initially, a *singular spore* is formed known as the **chancre** ("shang-kr") > - Appears between 10-90 days after exposure > > **Secondary Stage** > - System dissemination > - Symptoms may include rashes, fever, malaise > - Up to 40% can show neurological symptoms > > **Latent Stage** > - Patients are typically *asymptomatic* and *non-infectious* during this phase, however, they can still produce positive results in serological screening tests. > - *T. pallidum* is still present at this stage > - Onset of tertiary stage symptoms determines early/late classification: > - *Early*: Less than 1 year > - *Late*: Greater than 1 year > > **Tertiary Stage** > - 2/3rds of patients with secondary syphilis (not treaetd) will move to the tertiary stage > - This stage is often associated with damage to internal organs (brain, nerves, eyes, heart) > - Symptoms: > - Difficulty coordinating muscle movements > - Paralysis > - Numbness > - Gradual blindness > - Dementia ## Testing Methods There are two types of testing methods for syphilis: 1. Non-Treponemal Tests (Detects Reagin) - A non-specific *screening* test 2. Treponemal Tests - Typically used after non-treponemal tests to verify screening and lead to full diagnosis ### Non-Treponemal Antibody **Rapid plasma reagin (RPR)** is the primary technique used in non-treponemal tests that detects *reagin* (the unknown) which are antibodies produced from the reaction of treponemal microorganisms within body tissues (tunnel digging) The antigen is a mixture of: - **cardiolipin**, **cholesterol**, and **lecithin** Charcoal is only present for visualization of reaction --- **Pros:** - Inexpensive **Cons:** - Can produce *false negatives* in early (primary) stage of syphilis due to antibody levels being too low to detect (postzone) and in the secondary stage due to a high increase of antibodies (prozone) --- Other conditions/diseases are associated with anti-lipid antibodies and can lead to false positives: - SLE (lupus) - Infectious Mono - Hepatitis - Pregnancy - Chronic Infections - IV Drug Use - Advanced Age