Syphilis
From Encyclopedia of Sex and Sexuality
Syphilis was first recognized in the late fifteenth century in Europe, coinciding with the return of Christopher Columbus from the New World. Debate continues over the origin of syphilis: was it brought to Europe from the Americas, or did it arrive in Europe with West African slaves who were being imported by the Portuguese and Spanish at this time? At first, syphilis caused a massive European epidemic with a high fatality rate; the infection has become less virulent over the ensuing centuries.
Syphilis is caused by Treponema pallidum, a spiral-shaped, snake-like microscopic organism, and one of the few bacteria that cannot be artificially grown in a test tube. Syphilis is known as the “great imitator” because it can clinically resemble so many other diseases. It causes a disease that progresses over time by stages (primary, secondary, and tertiary), with each stage separated by intervals ranging from months to years, during which no signs of infection are evident.
The primary syphilitic lesion is the chancre, a circular, painless, and firm lesion that appears at the site of the invasion. A chancre may appear anywhere on the lips, mouth, tongue, nipples, rectum, or genitalia, from nine to ninety days after infection. Lymph nodes near the chancre are usually enlarged but not painful. The chancre heals spontaneously in six to ten weeks, and a quiescent period of time, lasting from six weeks to six months, passes before the symptoms and signs of secondary syphilis appear. These result from spread of the microbes by blood and the lymphatics from the infection site to every organ and tissue of the body. The most visible lesions are nonpainful skin rashes of various types: these often appear on the palms and the soles, do not itch, and heal without scars. Soon after secondary lesions heal, another quiescent period ensues. This period can last a lifetime, but late, tertiary lesions can also appear after a period of years. Late syphilitic lesions can destroy normal skin, bone, and joints by ulceration and scarification. Tertiary syphilis attacks the nervous system by interrupting the blood supply to the brain and nervous tissue or by replacing normal tissue with tumor-like masses. Treatment with a long-acting, injectable form of penicillin is curative when given to patients with primary, secondary, and latent syphilis. However, the nervous tissue, heart, skin, and bone damage of tertiary syphilis cannot be reversed by penicillin therapy.
