Pathology notes

Apr 16th, 2015
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SEXUALLY TRANSMITTEDDISEASES(SYPHILIS AND GONORRHOEA)BY ODHIALO FREDSYPHILLIS/LUESCausal organism:-Treponema pallidumSource of infection is an active cutaneous or mucosal lesion in a sexualpartnerOrganisms rapidly disseminated to distant sites by lymphatics and thebloodstream, even before the appearance of lesions at the primaryinoculation site.Between 9 and 90 days (a mean of 21 days) after the initialinfection, a primary lesion, termed a chancre, appears at the point ofentry.Two types of antibodies are formed: nontreponemal antibodies andantibodies to specific treponemal antigens.Detection of these antibodies plays an important part in the diagnosisof syphilis.Chancre resolves spontaneously over a period of 4 to 6 weeks and isfollowed by the development of secondary syphilis.MORPHOLOGYMicroscopic lesion is a proliferative endarteritis with inflammatoryinfiltrate rich in plasma cells.Treponemes cause endothelial hypertrophy and proliferation, followed byintimal fibrosis and narrowing of the vessel lumen.Local ischemia caused by the vascular changes undoubtedly accounts forsome of the local cell death and fibrosis seen in syphilis, although otherfactors, including delayed hypersensitivity, also appear to contribute toparenchymal injury.Large areas of parenchymal damage in tertiary syphilis result in theformation of a gumma, an irregular, firm mass of necrotic tissuesurrounded by resilient connective tissue.Microscopically the gumma contains

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