Inflammatory / infectious

Topic Completed: 1 May 2015

Minor changes: 13 November 2020

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed Search: Syphilis [title] cervix

John K.S.S. Philip, M.D.
Ziyan T. Salih, M.D.
Page views in 2020: 521
Page views in 2021 to date: 272
Cite this page: Philip J, Salih Z. Syphilis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixsyphilis.html. Accessed June 19th, 2021.
Definition / general
  • Syphilis is a sexually transmitted infection caused by Treponema palladium
  • May form primary chancre at cervix or produce a mass suggestive of invasive carcinoma (Am J Clin Pathol 1995;104:643)
  • Once nearly eliminated in US, syphilis is increasing among gay and bisexual men
  • In US in 2013, there were 56,471 newly reported cases of primary and secondary syphilis
    • MSM (men who have sex with men) accounted for 75% of these cases
  • In US, Black, Hispanic and other ethnic minorities are disproportionately affected by syphilis
  • Black Americans account for most syphilis cases among individuals who are not MSM (CDC - STDs in Racial and Ethnic Minorities)
Clinical features
  • Primary stage:
    • Genital ulcer
    • Regional lymphadenopathy
  • Secondary stage:
    • Multiple rashes in skin (palms and soles) or mucosa (mouth, vagina, anus)
    • Generalized lymphadenopathy
    • May have fever, sore throat, myalgia and fatigue
  • Tertiary stages:
    • Cardiovascular: aortic regurgitation, aortic aneurysm
    • Neurosyphilis: tabes dorsalis, general paresis, meningovascular
    • Gummas in the skin, bones or any organ
  • Early syphilis involving cervix:
  • Microscopic examination: rarely performed currently but can be done in early syphilis
  • Dark field examination: use fresh exudate from lesion
  • Immunofluorescence: use dried smears of exudate
  • Nontreponemal antigen tests are VDRL (venereal disease research laboratory) and RPR (rapid plasma reagin test)
  • Treponemal antigen tests are T. pallidum hemagglutination test (TPHA), T. pallidum particle agglutination test (TPPA) and fluorescent treponemal antibody absorption test (FTA- ABS)
Prognostic factors
  • Treatment with antibiotic in early stages leads to complete recovery
Case reports
Microscopic (histologic) description
  • Nonspecific findings, including lymphocytes, plasma cells, histiocytes, debris and neutrophils with multinucleated histiocytes and amorphous debris
  • Difficult to visualize organisms without silver stain and immunostains
Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Dark field microscopy

Back to top
Image 01 Image 02