Many believe that syphilis was brought to Europe by Columbus and his sailors, although there is no objective proof of this theory ( 176). Speculation abounds, often with scant evidence, about famous persons who may have had syphilis-the implicated include political figures ( 165, 172, 210), musicians ( 87, 114, 254), and literary greats ( 113, 187, 258, 262). Since its recognition in 15th-century Europe as a new disease, syphilis has been the subject of great mystery and legend. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection.
Early syphilis lesions result from the host's immune response to the treponemes. pallidum is highly infectious and survives for decades in the untreated host.
The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. Clinical manifestations separate the disease into stages late stages of disease are now uncommon compared to the preantibiotic era.
Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp.
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