Tags: Syphilis

Leishmania

The genera Leishmania and Trypanosoma are members of the family Trypanosomatidae. These protozoans cause diseases with widely varied clinical presentations as well as geographic distributions, including leishmaniasis, American trypanosomiasis (Chagas’ disease), and African trypanosomiasis (sleeping sickness).

American Trypanosomiasis (Chagas’ Disease)

T cruzi is found only in the Western Hemisphere, where it ranges from the southern United States to Argentina. An estimated 16 million-18 million people in Latin America have chronic T cruzi infections and ~ 50,000 die of Chagas’ disease each year. In the United States, there has been concern about transmission of the organism via blood transfusion from unsuspected infected donors who are immigrants from endemic zones. Similar concerns arise for organ transplant recipients.

Dermatophytes

Dermatophytes are molds that infect keratinized tissues including skin, hair, and nails. Whereas 40 dermatophyte species are known to infect humans, only about 15 of these are common causes of disease. These organisms belong to three genera, Microsporum, Trichophyton, and Epidermophyton. Because these fungi have such similar infectivity, morphology, and pathogenicity, they are often categorized according to the clinical syndrome and the preferred anatomic site with which they are associated, such as tinea capitis, tinea pedis, etc.

Chromomycosis

Chromomycosis, also known as chromoblastomycosis, is a chronic subcutaneous infection caused by several different fungi. Although rarely seen in the United States, it is common worldwide. Chromomycosis occurs worldwide but is most frequently encountered in tropical and subtropical regions. The most common occurrence is in barefoot individuals, particularly among agricultural workers.

Treponema Pallidum

The term syphilis was first used in 1530 by the Italian physician Girolamo Fracastoro in his epic poem Syphilis Sive Morbus Gallicus. Much has been learned since then about this sexually transmitted disease caused by T pallidum.

Late (Tertiary) Syphilis

Tertiary disease, usually seen 5-20 years after initial infection, traditionally includes cardiovascular syphilis, late benign (or gummatous) syphilis, and neurosyphilis (see Box 1). Fewer organisms are found in lesions during this stage. The incidence of cardiovascular involvement is probably underestimated, although clinically significant disease eventually develops in ~ 10% of all untreated patients.

Secondary Syphilis

The secondary stage of syphilis occasionally overlaps with the primary phase but usually begins ~ 6 weeks after resolution of the chancre; however, it can develop as late as 6 months after infection (see Box  1). Most patients have some degree of skin or mucocutaneous involvement. A faint and evanescent macular rash of the trunk and abdomen known as roseola syphilitica is sometimes seen initially.

Cervicitis

Infectious cervicitis may be caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, ureaplasmas, Herpes simplex or Trichomonas vaginalis. Chronic cervicitis is characterized by inflammation of the cervix without an identified pathogen.