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Syphilis

Syphilis, a chronic systemic infection caused by Treponema pallidum subspecies pallidum, is usually sexually transmitted and is characterized by episodes of active disease interrupted by periods of latency. After an incubation period averaging 2 to 6 weeks, a primary lesion appears, often associated with regional lymphadenopathy. A secondary bacteremic stage, associated with generalized mucocutaneous lesions and generalized lymphadenopathy, is followed by a latent period of subclinical infection lasting many years. In about one-third of untreated cases, the tertiary stage is characterized by progressive destructive mucocutaneous, musculoskeletal, or parenchymal lesions; aortitis; or symptomatic central nervous system (CNS) disease.

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Rubella (German Measles)

DEFINITION

Rubella is an acute viral infection of children and adults that characteristically includes rash, fever, and lymphadenopathy and has a broad spectrum of other possible manifestations. However, a high percentage of rubella infections in both children and adults are subclinical. In addition, the illness can resemble a mild attack of measles (rubeola) and can cause arthritis, especially in adults. Rubella was formerly known as German measles because it was first described clinically as distinct from rubeola in Germany, where it generated much medical interest in the mid-eighteenth and early nineteenth centuries. Rubella during pregnancy can lead to fetal infection, with the production of a significant constellation of malformations (congenital rubella syndrome) in a high proportion of infected fetuses. Rubella virus was first isolated in cell culture just before the last pandemic of the disease began in 1962. Since the licensing of rubella vaccine in the United States in 1969, there have been no further epidemics in this country.

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Gonococcal Infections

DEFINITION

Gonorrhea is a sexually transmitted infection of epithelium and commonly manifests as cervicitis, urethritis, proctitis, and conjunctivitis. If untreated, infections at these sites can lead to local complications such as endometritis, salpingitis, tuboovarian abscess, bartholinitis, peritonitis, and perihepatitis in the female; periurethritis and epididymitis in the male; and ophthalmia neonatorum in the newborn. Disseminated gonococcemia is an uncommon event whose manifestations include skin lesions, tenosynovitis, arthritis, and (in rare cases) endocarditis or meningitis.Neisseria gonorrhoeae is a gram-negative, nonmotile, non-spore-forming organism that grows in pairs (diplococci). Each individual organism is shaped like a coffee bean, with adjacent concave sides seen on Gram's stain. Gonococci, like all other Neisseria spp., are oxidase positive. They are distinguished from other neisseriae by their ability to grow on selective media and to utilize glucose but not maltose, sucrose, or lactose.

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