Cervix
Inflammatory / infectious
Syphilis
Authors: John K.S.S. Philip, M.D., Ziyan T. Salih
Topic Completed: 1 May 2015
Minor changes: 13 November 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: Syphilis [title] cervix
Table of Contents
Definition / general | Epidemiology | Clinical features | Laboratory | Prognostic factors | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Philip J, Salih Z. Syphilis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixsyphilis.html. Accessed March 9th, 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)
Epidemiology
- 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:
- Colposcopic examination may reveal mass with atypical vessels (Am J Clin Pathol 1995;104:643)
Laboratory
- 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
- 42 year old woman with cervical syphilitic lesions mimicking cervical cancer (Interna J Infect Dis 2015;31:1)
- 42 and 46 year old women with syphilitic cervicitis simulating stage II cervical cancer (Am J Clin Pathol 1995;104:643)
- Young woman with syphilitic cervicitis (Obstet Gynecol 1978;52:12S)
Treatment
- Benzathine penicillin (CDC - Syphilis)
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:
Dark field microscopy
