T pallidum is a labile organism that will not endure drying or exposure to disinfectants (CDC). It is primarily a human pathogen, and does not seem to occur naturally in other species. Soon after the early infection sets in, the pathogen enters the lymphatic system and the blood stream. It then spreads throughout the entire body. Nearly all of the organs can be invaded by the pathogen, including the central nervous system.
The primary symptoms associated with Syphilis are characterized by a painless chancre sore at the area of entry near the genital region (Wikipedia). This lesion does not always develop, and sometimes multiple sores appear. Lymphadenopathy often accompanies the chancre sores (Department of Health). Most of these initial sores heal within 3-6 weeks of the original infection. The emergence of secondary Syphilis, which usually begins as the first outbreak is healing, is associated with a scattered rash, condyloma lata, lymphadenopathy, and several other symptoms such as high fever (CDC). Because the active bacteria is present in the lesions any physical contact-sexual or otherwise-may spread the infection to another person during this stage. The symptoms of secondary syphilis can go away without treatment or come and go over the next two years of the disease. During the latent stage, the disease is no longer contagious and symptoms are no longer present. Left untreated, most patients at this stage will suffer no further signs or symptoms associated with the disease. Only about one third of the people who contract Syphilis go on to develop Tertiary Syphilis (Rose). During this stage, the bacteria can damage the heart, eyes, brain, nervous system, bones, joints, and many other parts of the body. The Tertiary stage can last years and even decades. If left untreated, it can result in mental illness, blindness, neurological disorders, and even death. It should be noted that neurosyphilis could develop during any stage of the disease. Syphilitic Meningitis and Meningovascular Syphilis generally occur within the first few months or years following infection. In conjunction with neurosyphilis, late syphilis can attack almost any organ with gummatous lesions and cardiovascular complications.
There are many tests available to aid in the diagnosis of Syphilis. In early Syphilis, dark field examinations of exudates from sores and fluorescent antibody tests are performed in order to definitely diagnose a patient with Syphilis (Department of Health). Non-specific serologic tests are also helpful in syphilis screening and monitoring the response to treatment. More specific serologic tests are usually used to confirm a diagnosis. These tests remain positive for life and cannot be used to monitor a response to treatment. A CSF (Cerebrospinal Fluid) examination is required for the diagnosis of neurosyphilis.
Currently, the standard treatment for early syphilis is benzathine penicillin G. Prospective studies to come up with the most effective medications and dosages have not yet been conducted. The CDC recommends a single dose of 2.4 million units of benzathine penicillin to treat the disease (CDC). For those allergic to penicillin, dioxycycline is often