Treponema pallidum is a group of four main microorganisms that cause infection such as yaws and syphilis. The group has four subspecies namely T. pallidum pallidum (causes syphilis), T. pallidum pertenue (yaws), T.pallidum endemic (endemic syphilis) and T. pallidum carateum (pinta). The T. pallidum pallidum is the most virulent of all the four and it is the most common. It causes venereal syphilis. The syphilis infection is slow characterized by short periods of signs or symptoms and asymptomatic ones as the disease multiplies and spreads in the body tissues. The main modes of transmission of syphilis are sexual intercourse, blood transfusion, mother's milk, saliva, infected needles and piercing objects. The main reason as for the choice of the micro-organism is because of its silent development in the body and the severe long term effects if it goes untreated. This essay discusses the Treponema pallidum, its signs and symptoms, treatment and chronic effects of the infection.
Introduction to T. pallidum pallidum
Treponema pallidum pallidum is spirochaete bacterial species that cause syphilis. The Treponema pallidum requires a PH range of 7.2 – 7.4 and temperatures ranging between 30 – 37 degrees Celsius. Outside the human body, the bacterium can survive for up two hours. They have an incubation period of 10 to 90 days after which clinical signs appear (Price & Frey, 2003). They also require a microaerophilic environment which has a lower concentration of oxygen than the normal atmospheric oxygen levels. A high oxygen concentration leads to the death of the T. pallidum. The bacterium cells have high lipid contents and a complex antigenic. It is difficult to determine the antigenic because it is difficult to grow the cells in vitro, in standard cultures. The bacterium can, however, be studied if it is directly transmitted from a human carrier to an animal such as the guinea pigs and rabbits. They are gram-negative bacteria with a length of about 6-15 micrometers and a width of 0.1 – 0.2 micrometers. They have two membranes; cytoplasmic and outer membranes. They are spiral in shape (Price & Frey, 2003).
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Definitions
Latency - the period when the T. pallidum pallidum microbes are reproducing in the body and there are no signs to show that one is infected.
Epidemiology – the study of disease characteristics such as transmission, incidence, and prevalence, etc., over a specified period of time.
Clinical signs – indications that can be proven by medical examination.
Microaerophilic environments - environments where there is oxygen but at a lower concentration compared to atmospheric values.
Epidemiology
The disease is transmitted in several ways as mentioned. According to Fantry & Tramont (n.d), the person who has the untreated disease becomes non-infectious after four years. The patients can, however, be re-infected of they are not careful in their day to day activities. According to the Centers for Disease Control (CDC) (2016), there were 23, 872 cases of primary and secondary syphilis in the US in 2015. There were more syphilis cases reported between 2014 and 2015 than gonorrhea and chlamydia. The rate of infection has been on the rise among young and gay men as well as bisexual people. Also, the numbers of the newborns who are affected have been on the rise in the recent years. The rates are on the increase in the general population although women accounted for less than 10% of new cases between 2014 and 2015.
Signs, symptoms, and Treatment of Syphilis
Syphilis develops over four major stages, each with a unique signs or symptoms. The stages are categorized into primary, secondary, latent and tertiary (Price & Frey, 2003). The primary stage involves a localized infection at the area of infection due to the multiplication of the bacteria at the site. A small hard ulcerous lesion (chancre) appears at the infection site within 10 to 60 days. The chancre appears on the genitalia, mouth or the anorectal area of the patient depending on the infection site. The lesion appears singly, sometimes in a red ring, and heals within three to six weeks. There is the swelling but painless lymph nodes that progress to the whole body if untreated. It then develops into latency which is characterized by the bacteria spreading to other body tissues and organs and then the second stage (Price & Frey, 2003). During the latency period, patients can rarely transmit the disease except for the pregnant mothers who pass it to the infants. The first signs of the second stage, pink rashes, appear on the feet soles, palms or the genital area within one to six months. They last between three to six months and produce infectious fluids. If untreated, the disease moves into the late or tertiary stage where the bacteria concentrate in tissues and cause serious damages. It affects the brain or nervous system tissues, the cardiovascular tissues and the bone tissues. At this time, the affected tissues may develop complications that affect the day to day activities of the patient. There is also fever, fatigue, loss of appetite and weight loss (Price & Frey, 2003; Fantry & Tramont, n.d).
Yaws (caused by T. pallidum pertenue) enter the body through inflammatory lesions. Once in the body, there appears raspberry like papules during the period of latency. They are painless and usually, a patient scratches them, spreading the disease. The later stage involves the development of internal and external lesions that destroy the bones, skin, and tissues. On the other hand, endemic syphilis affects children mostly. The main modes of transmission are contaminated water and directly contacting the lesions of infected persons. The symptoms are similar to venereal syphilis and the disease can be prevented by improved hygienic conditions. Finally, pinta is characterized by painless papules and secondary papules that appear on the feet, palms and the scalp. The infection can only be transmitted during the primary stages. The skin ulcerations in the second and third stages can lead to skin depigmentation. The long-term implications of the disease are mainly disfigurements (Price & Frey, 2003).
Syphilis can be diagnosed by two main tests (Mayo Clinic, 2016). Blood tests and the cerebral spinal fluid test can be used to determine the presence of syphilis-causing microbes in the body. For the blood tests, antibodies are used to determine past and present infections. On the other hand, the lumbar presence of proteins and lowered sugar level in cerebral spinal fluid can be used to diagnose syphilis (Mayo Clinic, 2016). Today, syphilis is treated by penicillin injection or by the use of a two-week tetracycline regimen (Fantry & Tramont, n.d).
Long Term Side Effects of Treponema pallidum pallidum Infection
Syphilis is a disease that develops silently and it may take years before a person realizes that they are infected. It is important for a person who engages in indiscriminate sexual activities to go for medical checks so as to establish the infection early enough. They should start medication as soon as possible. Untreated syphilis has a severe impact on the patient's body. Damage to the brain nervous system leads to chronic syphilitic encephalitis which may, in turn, lead to neurologic disorders such as dementia.it may also lead to deformed knees causing changes in gait. Syphilis can also lead to aortic problems resulting in a cardiovascular problem. Ruptures of valves can be fatal if not managed fast enough. Lastly, syphilis may lead to bone deformations problems leading to disfigurement. The nasal and palate bones could be affected necessitating facial reconstruction.
References;
Centers for Disease Control. (2016). 2015 STD Surveillance Report Press Release: Reported STDs at Unprecedented High in the U.S. Retrieved April 28, 2017 from: https://www.cdc.gov/nchhstp/newsroom/2016/std-surveillance-report-2015-press-release.html
Fantry, E. L. & Tramont C. E. (n.d). Treponema Pallidum (Syphilis). Antimicrobe . Retrieved April 28, 2017 from: http://www.antimicrobe.org/b242.asp
Mayo Clinic. (2016). Syphilis: Diagnosis . Retrieved April 28, 2017 from: http://www.mayoclinic.org/diseases-conditions/syphilis/diagnosis-treatment/diagnosis/dxc-20234462
Price, P. & Frey, K. (2003). Microbiology for surgical technologists . Cengage Learning. Print
