What is the pathophysiology of neurosyphilis?

Updated: Jul 17, 2018
  • Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Syphilis is a sexually transmitted disease caused by Treponema pallidum. Human beings are the only host. It is of great chronicity, is systemic from the onset, and is distinguished by florid manifestations in every structure of the body on one hand and years of completely asymptomatic latency on the other.

Treponemes are spirochetes, which are thin, delicate, helically coiled organisms measuring 5-20 µm in length. [12] They are readily destroyed by soap and water, drying, or temperatures higher than 42°C.

This spiral bacterium can be seen with dark-field microscopy or immunofluorescence. The human pathogens of the family Spirochaetaceae include the genera Treponema, Borrelia, and Leptospira. Within the genus Treponema are included the species T pallidum (syphilis), Treponema pertenue (yaws), and Treponema carateum (pinta).

T pallidum gains access to the body by way of minute abrasions of the skin or mucous membranes. Its subsequent attachment to host cells involves the action of a mucopolysaccharidase. The pathogenesis is primarily obliterative endarteritis of terminal arterioles with resultant inflammatory and necrotic changes. Immunity to reinfection does develop.

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