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CURRENT Medical Diagnosis & Treatment 2013
Chapter 34. Spirochetal Infections
Sections: Syphilis, Non–Sexually Transmitted Treponematoses, Non-Sexually Transmitted Treponematoses: Introduction, Yaws (Frambesia), Pinta, Endemic Syphilis, Selected Spirochetal Diseases, Relapsing Fever, Rat-Bite Fever, Leptospirosis, Lyme Disease (Lyme Borreliosis).
Topics Discussed: spirochaetales infections.
Excerpt:"Syphilis is a complex infectious disease caused by Treponema pallidum, a spirochete capable of infecting almost any organ or tissue in the body and causing protean clinical manifestations (Table 34–1). Transmission occurs most frequently during sexual contact (including oral sex), through minor skin or mucosal lesions; sites of inoculation are usually genital but may be extragenital. The risk of acquiring syphilis
after unprotected sex with an individual with infectious syphilis
is approximately 30–50%. Rarely, it can also be
transmitted through nonsexual contact, blood transfusion, or via
the placenta from mother to fetus (congenital
syphilis). The
immunologic response to infection is complex, but it provides the
basis for most clinical diagnoses. The infection induces the synthesis
of a number of antibodies, some of which react specifically with
pathogenic treponemes and some with components of normal tissues
(see below). If the disease is untreated, in most cases these immune
reactions fail to eradicate existing infection and may contribute
to tissue degeneration in the late stages. Patients treated early
in the disease are fully susceptible to reinfection.This is the stage of invasion and may pass unrecognized. The..."
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