It is only in the 20th century that effective tests and treatments for syphilis were developed. Microscopy of fluid from the primary or secondary lesion using darkfield illumination can diagnose treponemal disease with high accuracy. As there are other treponemes that may be confused with Treponema pallidum,' care must be taken in evaluating with microscopy to correlate symptoms with the correct disease.
Present-day syphilis screening tests, such as the Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests are cheap and fast but not completely specific, as many other conditions can cause a positive result. These tests are routinely used to screen blood donors. It can be noted that the spirochete that causes syphilis does not survive the conditions used to store blood, and the number of transfusion transmitted cases of syphilis is minuscule; but the test is used to identify donors that might have contracted HIV from high risk sexual activity. The requirement to test for syphilis has been challenged due to the vast improvements in HIV testing. False positives on the rapid tests can be seen in viral infections (Epstein-Barr, hepatitis, varicella, measles), lymphoma, tuberculosis, malaria, Chagas Disease, endocarditis, connective tissue disease, pregnancy, intravenous drug abuse, or contamination.
Other Treponematoses
Treponematoses are diseases caused by species of the spirochete Treponema. In addition to Syphilis, this group includes:
- Yaws is a tropical disease characterized by an infection of the skin, bones and joints; it is caused by ''Treponema pallidum'' subspecies ''pertenue''.
- Pinta - caused by ''Treponema pallidum'' subspecies ''carateum''.
- Bejel - caused by ''Treponema pallidum'' subspecies ''endemicum''.
Further Reading
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