• See Also
  1. Spirochete
  2. Gram Negative Bacteria
  3. Syphilis
  • Pathophysiology
  1. See Spirochetes
  2. Treponema pallidum primarily causes Syphilis, a Sexually Transmitted Infection
    1. Treponema pallidum subspecies also cause non-venereal skin diseases in children (endemic regions)
  3. Treponema are highly fragile outside the human host
    1. Organisms are easily killed with heating, drying or soap and water
  4. Treponema induce disease via host immune mediated inflammation
    1. Treponema species lack their own toxins
  1. See Treponema pallidum (Syphilis)
  1. Background
    1. These organisms were previously classified as specific Treponema species
      1. Following DNA analysis, they were all reclassified as subspecies of Treponema pallidum
    2. Like Syphilis, all have multiple stages (primary, secondary, tertiary)
      1. However, unlike Syphilis, effects are limited to skin and bone
      2. These non-venereal diseases do NOT involve heart or CNS
    3. Syphilis labs will also be positive with these 3 organisms
    4. All 3 organisms are cured with Penicillin (Bicillin LA)
  2. Bejel or Endemic syphilis (Treponema Pallidum Subspecies Endemicum)
    1. Affects children living in desert regions of Africa and the Middle East
    2. Endemic syphilis is spread via shared cups and eating utensils
    3. Oral Mucosa lesions are similar to Condyloma Lata
    4. Late effects include gummas and bone involvement
  3. Yaws (Treponema Pallidum Subspecies Carateum)
    1. Spread via open ulcerative lesions in person to person contact (moist tropical regions)
    2. Starts with a single Papule developing over months into a wart-like lesion
    3. Similar, widely distributed secondary lesions develop over the course of years
    4. Tertiary gummas develop in skin and bone, often disfiguring the face (gangosa)
  4. Pinta (Trpeonema palldium subspecies pertenue)
    1. Spread via direct contact with infectious lesion (rural latin america)
    2. Slowly developing Papule at contact site
    3. Multiple secondary red lesions develop later (appear blue with Sun Exposure)
      1. Lesions depigment and whiten within the year
  • Labs
  1. See Syphilis Serology
  2. Syphilis Serology does not differentiate Treponema pallidum subspecies
    1. Positive Serology is typically due to Syphilis
    2. In endemic regions, positive Serology (esp. children) may be due to Bejel, Yaws or Pinta
  3. Microscopy
    1. Spirochetes are too small to be seen on standard light microscopy without specific techniques
    2. May be identified on dark microscopy, silver stains or with immunofluorescence
  • References
  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 128
  2. Paster (2000) J Mol Microbiol Biotechnol 2(4):341-4 +PMID: 11075904 [PubMed]