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  • Syphilis is caused by the spirochete Treponema pallidum.
  • Usually sexually transmitted
  • Causes a wide range of systemic manifestations that are characterized by episodes of active disease interrupted by periods of latency
  • Approximately 30% of asymptomatic contacts examined within 30 days of exposure have infection


  • Spirochetes penetrate intact mucous membranes or microscopic dermal abrasions.
  • Transmission through sexual contact with infectious lesions, infection in utero, blood transfusion, and organ transplantation
  • Blood from a patient with incubating or early syphilis is infectious.
  • Characterized by multiple stages separated by periods of latency: primary, secondary, latent and tertiary

Clinical Features

[[File:Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|thumbnail|Chancres on the penile shaft due to a primary syphilitic infection]

Primary Syphilis

  • Primary lesion appears after an incubation of 2-6 weeks
    • Single painless papule that becomes eroded and indurated, cartilaginous consistency on palpation
    • Minority of patients can have multiple lesions or atypical appearance
    • Occurs at point of contact: penis, rectum, mouth, external genitalia, cervix, or labia
    • Heals in 4-6 weeks
  • Regional lymphadenopathy that is painless and firm

Differential Diagnosis



  • Benzathine penicillin G 2.4 million units IM x 1 (for primary or secondary infection)


See Also


  • Emedicine