engleski

Syphilis: dermatology and venereology united

Syphilis is a chronic, infectious, mostly sexually transmitted disease caused by Treponema (T.) pallidum (Spirochaeta pallida). From the introduction of penicillin in therapy, the number of syphilis infected individuals was on a decrease until the 1990s, however, in the last decades of the 20th century the incidence of syphilis patients increased again, at first in the former Soviet Union countries, then also in West European countries. It has been recognized that syphilis is more common in city centers in younger and homosexual population groups. Coinfection with syphilis and HIV has been recorded in about 50% of patients. The increasing number of syphilis infected individuals has evoked interest in education of students of medicine and young doctors on the diversity of clinical pictures, different stages of the disease, and laboratory diagnostic tests for syphilis and their interpretation. Doubts and misunderstanding can cause different definitions of the duration of certain stages of the disease in different countries, absence of primary syphilis, stage I in about 50% of patients as well as various atypical localizations of lesions in this stage. Secondary syphilis, stage II, is known as a stage with different clinical lesions but a decreased number of infected persons has resulted in rarely considering the differential diagnosis of syphilis. In laboratory diagnosis of syphilis there is a problem because T. pallidum cannot be grown reliably on artificial culture media and culture is not appropriate for detecting the organism in practice. In primary and secondary syphilis, the causative organism can be directly identified by dark field microscopy. However, inadequate education of specialists poses a problem because of the insufficient number of infected persons and samples for interpretation of findings. That is why serodiagnosis of syphilis is of utmost importance. Specific and non-specific tests have to be done because using only one of the tests may yield a false-negative result. The possibility of false-positive non-specific test results should be considered in the presence of some connective tissue diseases, cirrhosis, and pregnancy. The possible coinfection with HIV and its particular clinical picture and laboratory findings also requires due consideration.

Syphilis; Treponema pallidum; specific and non-specific tests

nije evidentirano