Manifestations of Syphilis

Hospital Physician January 2009 43 S yphilis is a sexually transmitted disease (STD) caused by the Treponema pallidum spirochete, named because of its resemblance to a twisted thread (Treponema) and pale color (pallidum).1 The term syphilis originates from the poem “Syphilis, sive Morbus Gallicus” by Girolamo Fracastoro, an Italian physician and poet (1478−1553), in which the fictional shepherd in the poem, Syphilus, is a victim of the disease.2,3 T. pallidum is transmitted by direct sexual contact (oral, anal, vaginal) or vertically across the placenta from mother to fetus. Syphilis can manifest in several ways. In the pre-antibiotic era, syphilis was often called “the great imitator” because its signs and symptoms are similar to those of various other diseases.4,5 This article reviews the manifestations of syphilis in its various stages and briefly discusses laboratory evaluation and treatment.