Syphilis in women

Infection with the spirochete Treponema pallidum causes syphilis. Transmission of syphilis occurs through sexual contact with persons who have infectious mucocutaneous lesions. Before the advent of penicillin, this infection was responsible for a large portion of the debilitated patients residing in mental institutions. Later during this century, the disease became somewhat uncommon, only to see a resurgence during the early part of this decade. Syphilis progresses through stages defined as primary, secondary, latent, and tertiary. Diagnosis of this infection is by clinical examination, dark-field microscopy, and serology. Penicillin is the treatment of choice for all stages of syphilis. Doxycycline and tetracycline are acceptable alternatives in some penicillin-allergic patients. If patients are pregnant or have central nervous system involvement, alternative regimens should not be used because of lack of efficacy and/or fetal toxicity. Therefore, these patients must be desensitized and treated with penicillin. No effective vaccine for this infection is currently available.