Syphilis - Knowledge

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Because they had never been exposed as children, they were not able to fend off serious illness. Spreading the disease via sexual contact also led to victims being infected with a massive bacterial load from open sores on the genitalia. Adults in higher socioeconomic groups then became very sick with painful and debilitating symptoms lasting for decades. Often, they died of the disease, as did their children who were infected with congenital syphilis. The difference between rural and urban populations was first noted by Ellis Herndon Hudson, a clinician who published extensively about the prevalence of treponematosis, including syphilis, in times past. The importance of bacterial load was first noted by the physician Ernest Grin in 1952 in his study of syphilis in Bosnia.

940: 1374: 1328: 1672: 497: 246: 7413: 1432: 1581:, until the 1980s and 1990s. Since 2000, rates of syphilis have been increasing in the US, Canada, the UK, Australia and Europe, primarily among men who have sex with men. Rates of syphilis among US women have remained stable during this time, while rates among UK women have increased, but at a rate less than that of men. Increased rates among heterosexuals have occurred in China and Russia since the 1990s. This has been attributed to unsafe sexual practices, such as sexual promiscuity, prostitution, and decreasing use of barrier protection. 1717:. The great variety of symptoms of treponematosis, the different ages at which the various diseases appear, and its widely divergent outcomes depending on climate and culture, would have added greatly to the confusion of medical practitioners, as indeed they did right down to the middle of the 20th century. In addition, evidence indicates that some writers on disease feared the political implications of discussing a condition more fatal to elites than to commoners. Historian Jon Arrizabalaga has investigated this question for 1614: 956: 2030:

After funding for treatment was lost, the study was continued without informing the men that they were only being studied and would not be treated. Facing insufficient participation, the Macon County Health Department nevertheless wrote to subjects to offer them a "last chance" to get a special "treatment", which was not a treatment at all, but a spinal tap administered exclusively for diagnostic purposes. None of the men infected were ever told that they had the disease, and none were treated with

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hold proof of pre-Columbian syphilis, but there is a possibility that they point to an endemic form of treponemal disease instead. As syphilis, bejel, and yaws vary considerably in mortality rates and the level of human disgust they elicit, it is important to know which one is under discussion in any given case, but it remains difficult for paleopathologists to distinguish among them. (The fourth of the treponemal diseases is

693:. Late symptomatic neurosyphilis can develop decades after the original infection and includes 2 types; general paresis and tabes dorsalis. General paresis presents with dementia, personality changes, delusions, seizures, psychosis and depression. Tabes dorsalis is characterized by gait instability, sharp pains in the trunk and limbs, impaired positional sensation of the limbs as well as having a positive 10790: 1693:

Precise dating to the medieval period is not yet possible but work by Kettu Majander et al. uncovering the presence of several different kinds of treponematosis at the beginning of the early modern period argues against its recent introduction from elsewhere. Therefore, they argue, treponematosis — possibly including syphilis — almost certainly existed in medieval Europe.

6486:"He who knows syphilis knows medicine" said Father of Modern Medicine, Sir William Osler, at the turn of the 20th Century. So common was syphilis in days gone by, all physicians were attuned to its myriad clinical presentations. Indeed, the 19th century saw the development of an entire medical subspecialty – syphilology – devoted to the study of the great imitator, 1225:, elemental mercury had been used to treat skin diseases in Europe as early as 1363. As syphilis spread, preparations of mercury were among the first medicines used to combat it. Mercury is in fact highly anti-microbial: by the 16th century it was sometimes found to be sufficient to halt development of the disease when applied to ulcers as an 1705:, especially among the men tormenting Christ in scenes of the crucifixion. The association of saddle nose with men perceived to be so evil they would kill the son of God indicates the artists were thinking of syphilis, which is typically transmitted through sexual intercourse with promiscuous partners, a mortal sin in medieval times. 1233:. It was also treated by ingestion of mercury compounds. Once the disease had gained a strong foothold, however, the amounts and forms of mercury necessary to control its development exceeded the human body's ability to tolerate it, and the treatment became worse and more lethal than the disease. Nevertheless, medically directed 1132:(CDC) states, "Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected. However, a syphilis sore outside of the area covered by a latex condom can still allow transmission, so caution should be exercised even when using a condom." 2123:

stated "Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health. We deeply regret that it happened, and we apologize to all the individuals who were affected by such abhorrent research practices." The

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When living conditions changed with urbanization, elite social groups began to practice basic hygiene and started to separate themselves from other social tiers. Consequently, treponematosis was driven out of the age group in which it had become endemic. It then began to appear in adults as syphilis.

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in the study. Of these men, 399 had contracted syphilis before the study began, and 201 did not have the disease. Medical care, hot meals and free burial insurance were given to those who participated. The men were told that the study would last six months, but in the end, it continued for 40 years.

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The most compelling evidence for the validity of the pre-Columbian hypothesis is the presence of syphilitic-like damage to bones and teeth in medieval skeletal remains. While the absolute number of cases is not large, new ones are continually discovered, most recently in 2015. At least fifteen cases

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accounted for almost half of all cases in 2010. As of 2014, syphilis infections continue to increase in the United States. In the United States as of 2020, rates of syphilis have increased by more than threefold; in 2018 approximately 86% of all cases of syphilis in the United States were in men. In

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at all, and the antenatal care others receive does not include screening. It still occasionally occurs in the developed world, as those most likely to acquire syphilis are least likely to receive care during pregnancy. Several measures to increase access to testing appear effective at reducing rates

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as less than 2 years after original infection. Early latent syphilis is infectious as up to 25% of people can develop a recurrent secondary infection (during which bacteria are actively replicating and are infectious). Two years after the original infection the person will enter late latent syphilis

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or the "great pox" by the French. Other historical names have included "button scurvy", sibbens, frenga and dichuchwa, among others. Since it was a disgraceful disease, the disease was known in several countries by the name of their neighbouring, often hostile country. The English, the Germans, and

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that are 99.8 percent identical with absolute accuracy. Progress on uncovering the historical extent of syndromes through aDNA remains slow, however, because the bacterium responsible for treponematosis is rare in skeletal remains and fragile, making it notoriously difficult to recover and analyze.

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of secondary syphilis skin lesions. (A/B) H&E stain of SS lesions. (C/D) IHC staining reveals abundant bacteria embedded within a mixed cellular inflammatory infiltrate (shown in the red box) in the papillary dermis. The blue arrow points to a tissue histiocyte and the read arrows to two dermal

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In 2020, a group of leading paleopathologists concluded that enough evidence had been collected to prove that treponemal disease, almost certainly including syphilis, had existed in Europe prior to the voyages of Columbus. There is an outstanding issue, however. Damaged teeth and bones may seem to

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Despite significant progress in tracing the presence of syphilis in past historic periods, definitive findings from paleopathology and aDNA studies are still lacking for the medieval period. Evidence from art is therefore helpful in settling the issue. Research by Marylynn Salmon has demonstrated

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In 2015, about 45.4 million people had syphilis infections, of which six million were new cases. During 2015, it caused about 107,000 deaths, down from 202,000 in 1990. After decreasing dramatically with the availability of penicillin in the 1940s, rates of infection have increased since the

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Early work includes Henneberg, M., & Henneberg, R. J. (1994), "Treponematosis in an ancient Greek colony of Metaponto, southern Italy, 580-250 BCE" and Roberts, C. A. (1994), "Treponematosis in Gloucester, England: A theoretical and practical approach to the Pre-Columbian theory". Both in O.

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attempted. Other late presentations may be treated with once-weekly intramuscular benzathine penicillin for three weeks. Treatment at this stage solely limits further progression of the disease and has a limited effect on damage which has already occurred. Serologic cure can be measured when the

600:. The acute symptoms usually resolve after three to six weeks; about 25% of people may present with a recurrence of secondary symptoms. Many people who present with secondary syphilis (40–85% of women, 20–65% of men) do not report previously having had the classical chancre of primary syphilis. 2141:

the Italians called it "the French disease", while the French referred to it as the "Neapolitan disease". The Dutch called it the "Spanish/Castilian disease". To the Turks it was known as the "Christian disease", whilst in India, the Hindus and Muslims named the disease after each other.

1295:, may be as effective as penicillin-based treatment. It is recommended that a treated person avoid sex until the sores are healed. In comparison to azithromycin for treatment in early infection, there is lack of strong evidence for superiority of azithromycin to benzathine penicillin G. 1138:

from intimate physical contact with an infected person is effective at reducing the transmission of syphilis. The CDC states, "The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or to be in a long-term mutually

6046:. With Contributions from Brian Ayers and Jayne Brown. East Anglian Archaeology 129. Dereham: Historic Environment, Norfolk Museums and Archaeology Service, 2009. Erdal, Y. S. (2006). "A pre-Columbian case of congenital syphilis from Anatolia (Nicaea, 13th century AD)". 1075:

from a chancre may be used to make an immediate diagnosis. Hospitals do not always have equipment or experienced staff members, and testing must be done within 10 minutes of acquiring the sample. Two other tests can be carried out on a sample from the chancre:

460:. Occasionally, multiple lesions may be present (~40%), with multiple lesions being more common when coinfected with HIV. Lesions may be painful or tender (30%), and they may occur in places other than the genitals (2–7%). The most common location in women is the 1584:

Left untreated, it has a mortality rate of 8% to 58%, with a greater death rate among males. The symptoms of syphilis have become less severe over the 19th and 20th centuries, in part due to widespread availability of effective treatment, and partly due to

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Meningovascular syphilis involves inflammation of the small and medium arteries of the central nervous system. It can present between 1–10 years after the initial infection. Meningovascular syphilis is characterized by stroke, cranial nerve palsies and

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The natural history of treponematosis in North America. Gainesville, FL: University Press of Florida. Williams, H. (1932) "The origin and antiquity of syphilis: The evidence from diseased bones, a review, with some new material from America".

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to the person's partners. Physicians may also encourage patients to send their partners to seek care. Several strategies have been found to improve follow-up for STI testing, including email and text messaging of reminders for appointments.

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with only 57 organisms has a 50% chance of being infected. Most new cases in the United States (60%) occur in men who have sex with men; and in this population 20% of syphilis cases were due to oral sex alone. Syphilis can be transmitted by

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It is not generally possible to contract syphilis through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing. This is mainly because the bacteria die very quickly outside of the body, making transmission by

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that deformities in medieval subjects can be identified by comparing them to those of modern victims of syphilis in medical drawings and photographs. One of the most typical deformities, for example, is a collapsed nasal bridge called

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of acquired treponematosis based on evidence from bones, and six examples of congenital treponematosis based on evidence from teeth, are now widely accepted. In several of the twenty-one cases the evidence may also indicate syphilis.

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Dutour, O., et al. (Eds.). (1994). L'origine de la syphilis in Europe: avant ou après 1493? Paris, France: Éditions Errance. Baker, B. J. et al. (2020) "Advancing the Understanding of Treponemal Disease in the Past and Present".

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It remains mysterious why the authors of medieval medical treatises so uniformly refrained from describing syphilis or commenting on its existence in the population. Many may have confused it with other diseases such as leprosy

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Walker, D., Powers, N., Connell, B., & Redfern, R. (2015). "Evidence of skeletal treponematosis from the Medieval burial ground of St. Mary Spital, London, and implications for the origins of the disease in Europe".

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Congenital syphilis is that which is transmitted during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms. Common symptoms that develop over the first couple of years of life include

5934: 5860:. Harper, K. N., Zuckerman, M. K., Harper, M. L., Kingston, J. D., Armelagos, G. J. (2011) "The origin and antiquity of syphilis revisited: An appraisal of Old World Pre-Columbian evidence of treponemal infections". 1644:

beginning as early as 1495. Contemporaries believed the disease sprang from American roots, and in the 16th century physicians wrote extensively about the new disease inflicted on them by the returning explorers.

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occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. Latent syphilis has no symptoms and can last years. In tertiary syphilis, there are

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and no truly effective treatments. Its damage was caused not so much by great sickness or death early in the course of the disease but rather by its gruesome effects decades after infection as it progressed to

6558: 673:. Involvement of the central nervous system in syphilis (either asymptomatic or symptomatic) can occur at any stage of the infection. It may occur early, being either asymptomatic or in the form of syphilitic 7174: 4852: 1736:

in 1497 and was recorded at St Bartholomew's Hospital as infected 10 out of the 20 patients. In 1530, the pastoral name "syphilis" (the name of a character) was first used by the Italian physician and poet

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In 2012, about 0.5% of adults were infected with syphilis, with 6 million new cases. In 1999, it is believed to have infected 12 million additional people, with greater than 90% of cases in the

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of the bacteria. With early treatment, few complications result. Syphilis increases the risk of HIV transmission by two to five times, and coinfection is common (30–60% in some urban centers). In 2015,

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Primary syphilis is typically acquired by direct sexual contact with the infectious lesions of another person. Approximately 2–6 weeks after contact (with a range of 10–90 days) a skin lesion, called a

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Secondary syphilis occurs approximately four to ten weeks after the primary infection. While secondary disease is known for the many different ways it can manifest, symptoms most commonly involve the

1048:(FTA-Abs). Treponemal antibody tests usually become positive two to five weeks after the initial infection and remain positive for many years. Neurosyphilis is diagnosed by finding high numbers of 2429:"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015" 6062:. Epub 2010 Aug 18. PMID 20721939. Roberts, C. A. (1994). "Treponematosis in Gloucester, England: A theoretical and practical approach to the Pre-Columbian theory". In O. Dutour, et al. (Eds.), 7233:

Conducted between 1946 and 1948, the experiments were led by John Cutler, a US health service physician who would later be part of the notorious Tuskegee syphilis study in Alabama in the 1960s.

1781:, made it an object of fear and revulsion and a taboo. The magnitude of its morbidity and mortality in those centuries reflected that, unlike today, there was no adequate understanding of its 6038:(pp. 92–98). Paris, France: Éditions Errance. Stirland, Ann. "Evidence for Pre-Columbian Treponematosis in Europe". In Dutour, O., Pálfi, G., Bérato, J., & Brun, J. -P. (Eds.). (1994). 617:

and is not as infectious as the early phase. The latent phase of syphilis can last many years after which, without treatment, approximately 15-40% of people can develop tertiary syphilis.

10835: 9133: 6140:, 5, e15713. doi.org/10.1371/journal.pone.0015713. Štaudová, B., Strouhal, M., Zobaníková, M., Čejková, D., Fulton, L. L., Chen, L., ... Šmajs, D. (2014). "Whole genome sequence of the 2767: 612:

proof of infection without symptoms of disease. It develops after secondary syphilis and is divided into early latent and late latent stages. Early latent syphilis is defined by the

1688:(aDNA) holds the answer, because just as only aDNA suffices to distinguish between syphilis and other diseases that produce similar symptoms in the body, it alone can differentiate 7284:

Tagarelli A, Lagonia P, Tagarelli G, Quattrone A, Piro A (April 2011). "The relation between the names and designations of syphilis in the 16th century and its clinical gravity".

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in those centuries. According to a 2020 study, more than 20% of individuals in the age range 15–34 years in late 18th-century London were treated for syphilis. At the time the

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They include Henneberg, M., & Henneberg, R. J. (1994). "Treponematosis in an ancient Greek colony of Metaponto, southern Italy, 580-250 BCE". In O. Dutour, et al. (Eds.),

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Hawkes S, Matin, N, Broutet, N, Low, N (15 June 2011). "Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis".

6473: 6705: 2115:. The experiment resulted in at least 83 deaths. In October 2010, the U.S. formally apologized to Guatemala for the ethical violations that took place. Secretary of State 5597: 1577:

found it universal among 19th-century Egyptian prostitutes. In the developed world during the early 20th century, infections declined rapidly with the widespread use of

9570: 7659: 3044: 1151: 641:(6.5%), and cardiovascular syphilis (10%). Without treatment, a third of infected people develop tertiary disease. People with tertiary syphilis are not infectious. 7184: 1171:. If they are positive, it is recommended their partners also be treated. Congenital syphilis is still common in the developing world, as many women do not receive 9772: 9126: 637:

Tertiary syphilis may occur approximately 3 to 15 years after the initial infection and may be divided into three different forms: gummatous syphilis (15%), late

5420: 652:, which are soft, tumor-like balls of inflammation which may vary considerably in size. They typically affect the skin, bone, and liver, but can occur anywhere. 7220: 2677:"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010" 10840: 10830: 2006:

of untreated syphilis; the African-American men in the study were told they were receiving free treatment for "bad blood" from the United States government.

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syphilis usually occurs 1 to 46 years after the initial infection, with an average of 15 years. This stage is characterized by the formation of chronic

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The CDC recommends that sexually active men who have sex with men be tested at least yearly. The USPSTF also recommends screening among those at high risk.

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to detect syphilis appeared to be reliable, although more research is needed to assess its effectiveness and into improving outcomes in mothers and babies.

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A healthy man and a diseased man torture Christ before his crucifixion. Books of Hours, c. 1375-1435 (detail). France. (Getty Museum Open Content Program).

1625:, circa 1665–67, oil on canvas. De Lairesse, himself a painter and art theorist, had congenital syphilis that deformed his face and eventually blinded him. 6438: 2615:"Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting" 444:

with a clean base and sharp borders approximately 0.3–3.0 cm in size. The lesion may take on almost any form. In the classic form, it evolves from a

9119: 7456:"Current standards for diagnosis and treatment of syphilis: Selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines" 2072: 1732:). Since it was claimed to have been spread by French troops, it was initially called the "French disease" by the people of Naples. The disease reached 4031:"Immune Evasion and Recognition of the Syphilis Spirochete in Blood and Skin of Secondary Syphilis Patients: Two Immunologically Distinct Compartments" 1941:

or "poison women" of the 19th century is believed to be partly derived from the devastation of syphilis, with classic examples in literature including

1256:. The bacterium is highly vulnerable to penicillin when treated early, and a treated individual is typically rendered non-infective in about 24 hours. 221:. The signs and symptoms depend on the stage it presents: primary, secondary, latent or tertiary. The primary stage classically presents with a single 4438: 1860:

among those people who could afford to pay for timely diagnosis and treatment. Penicillin was discovered in 1928, and effectiveness of treatment with

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advanced greatly, syphilis, like many other infectious diseases, became more of a manageable burden than a scary and disfiguring mystery, at least in

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Screening for Syphilis in Nonpregnant Adolescents and Adults: Systematic Review to Update the 2004 U.S. Preventive Services Task Force Recommendation

5935:"Manuscripts and art support archaeological evidence that syphilis was in Europe long before explorers could have brought it home from the Americas" 5021: 3658: 975:. Blood tests are more commonly used, as they are easier to perform. Diagnostic tests are unable to distinguish between the stages of the disease. 6736: 6017:

and Gaul, J.S., Grossschmidt, K., Budenbauer, C., & Kanz, Fabian (2015). "A probable case of congenital syphilis from pre-Columbian Austria".

10820: 5565:. U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. Agency for Healthcare Research and Quality (US). 1570:

2021, preliminary CDC data illustrated that 2,677 cases of congenital syphilis were found in the population of 332 million in the United States.

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Penicillin is an effective treatment for syphilis in pregnancy but there is no agreement on which dose or route of delivery is most effective.

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Majander, K., Pfrengle S., Kocher, A., ..., Kühnert, J. K., Schuenemann, V. J. (2020), "Ancient Bacterial Genomes Reveal a High Diversity of

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Fraser, C. M., Norris, S. J., Weinstock, G. M., White, O., Sutton, G. G., Dodson, R., ... Venter, J. C. (1998). "Complete genome sequence of

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has been murkier and caused considerable debate. According to the Columbian theory, syphilis was brought to Spain by the men who sailed with

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Grin, E. I. (1952) "Endemic Treponematosis in Bosnia: Clinical and epidemiological observations on a successful mass-treatment campaign".

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Farhi D, Dupin, N (September–October 2010). "Origins of syphilis and management in the immunocompetent patient: facts and controversies".

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from a mother to her baby; the bacterium is able to pass through intact mucous membranes or compromised skin. It is thus transmissible by

7262: 6868: 6674: 1765:, symptoms, and disability, although records of its true prevalence were generally not kept because of the fearsome and sordid status of 1159:

Congenital syphilis in the newborn can be prevented by screening mothers during early pregnancy and treating those who are infected. The

6229: 6104:. Čejková, D., Zobaníková, M., Chen, L., Pospíšilová, P., Strouhal, M., Qin, X., ... Šmajs, D. (2012). "Whole genome sequences of three 1773:

was unknown but it was well known that it was spread sexually and also often from mother to child. Its association with sex, especially

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Mullooly C, Higgins, SP (August 2010). "Secondary syphilis: the classical triad of skin rash, mucosal ulceration and lymphadenopathy".

1129: 440:, appears at the site and this contains infectious bacteria. This is classically (40% of the time) a single, firm, painless, non-itchy 316: 3516: 9852: 9556: 7118: 7084: 5480: 5450: 4995: 4725: 3906: 6461: 5643:

Kent ME, Romanelli, F (February 2008). "Reexamining syphilis: an update on epidemiology, clinical manifestations, and management".

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Alexander JM, Sheffield JS, Sanchez PJ, Mayfield J, Wendel GD J (January 1999). "Efficacy of treatment for syphilis in pregnancy".

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Viñals-Iglesias H, Chimenos-Küstner, E (1 September 2009). "The reappearance of a forgotten disease in the oral cavity: syphilis".

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Koss CA, Dunne EF, Warner L (July 2009). "A systematic review of epidemiologic studies assessing condom use and risk of syphilis".

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and because the subjects had been misled concerning the purposes of the study. The revelation in 1972 of these study failures by a

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Baker, B. J. and Armelagos, G. J., (1988) "The origin and antiquity of syphilis: Paleopathological diagnosis and interpretation".

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Kent ME, Romanelli F (February 2008). "Reexamining syphilis: an update on epidemiology, clinical manifestations, and management".

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Because of the possibility of false positives with nontreponemal tests, confirmation is required with a treponemal test, such as

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with the cooperation of some Guatemalan health ministries and officials. Doctors infected soldiers, prostitutes, prisoners and

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Franzen C (December 2008). "Syphilis in composers and musicians – Mozart, Beethoven, Paganini, Schubert, Schumann, Smetana".

2180: 2061:, led to major changes in U.S. law and regulation on the protection of participants in clinical studies. Now studies require 9729: 4012: 3036: 10255: 9817: 9710: 9601: 5574: 4508:"Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement" 2588: 2038:, the men were told they were being treated for "bad blood"—a colloquialism describing various conditions such as fatigue, 991: 1319:

non-treponemal titers decline by a factor of 4 or more in 6–12 months in early syphilis or 12–24 months in late syphilis.

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usually between 1 cm and 2 cm in diameter) though there may be multiple sores. In secondary syphilis, a diffuse

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Gao L, Zhang, L., Jin, Q (September 2009). "Meta-analysis: prevalence of HIV infection and syphilis among MSM in China".

5892: 4718:"Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis" 2402: 1237:

became widespread through the 17th, 18th, and 19th centuries in Europe, North America, and India. Mercury salts such as

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of greater than 30 hours. The bacterium is known for its ability to evade the immune system and its invasiveness.

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have known for decades that syphilis was present in the Americas before European contact. The situation in Europe and

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Cardiovascular syphilis usually occurs 10–30 years after the initial infection. The most common complication is

7210: 4431:"A young man, J. Kay, afflicted with a rodent disease which has eaten away part of his face. Oil painting, ca. 1820" 1092:, which attach to specific syphilis proteins, while PCR uses techniques to detect the presence of specific syphilis 10071: 10058: 9579: 9111: 8265: 6054:. Cole G. and T. Waldron, "Apple Down 152: a putative case of syphilis from sixth century AD Anglo-Saxon England". 5979: 1565:, and men who have sex with men. In the United States about 55,400 people are newly infected each year as of 2014. 984: 484:

frequently (80%) occurs around the area of infection, occurring seven to 10 days after chancre formation. The

6554:"Vorläufiger Bericht über das Vorkommen von Spirochaeten in syphilitischen Krankheitsprodukten und bei Papillomen" 10569: 10145: 7142:"Ethical Failures and History Lessons: The U.S. Public Health Service Research Studies in Tuskegee and Guatemala" 6148:

strain Bosnia A: The genome is related to yaws treponemes but contains few loci similar to syphilis treponemes".

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1936) acknowledges the social stigma of syphilis, while urging those who possibly have the disease to be tested.

10310: 10132: 10086: 9997: 9987: 8763: 8224: 7850: 6582: 4845:"Table 6.5. Infectious Diseases Designated as Notifiable at the National Level-United States, 2009 [a]" 2732: 2104: 1438: 203: 7085:"Fact Sheet on the 1946-1948 U.S. Public Health Service Sexually Transmitted Diseases (STD) Inoculation Study" 6506:"The pox in Boswell's London: an estimate of the extent of syphilis infection in the metropolis in the 1770s†" 3643:

Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS (2013). "Abortion".

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Most evidence supports the Columbian origin hypothesis. However, beginning in the 1960s, examples of probable

10414: 10334: 10280: 9286: 8417: 8108: 7945: 6422: 1977: 1750: 944: 9310: 4879:(12th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010. p. 2144. 10825: 10722: 10250: 10091: 9875: 9616: 9527: 9202: 8832: 8584: 8339: 8030: 7960: 7527: 4430: 1987: 1973: 1653: 1249:

The first-line treatment for uncomplicated syphilis (primary or secondary stages) remains a single dose of

831: 513: 296: 10815: 10742: 10363: 10275: 9596: 9058: 9012: 8334: 7865: 7820: 2035: 1718: 1253: 1241:

were still in prominent medical use as late as 1916, and considered effective and worthwhile treatments.

1077: 338: 9653: 1373: 1113:

effective for prevention. Several vaccines based on treponemal proteins reduce lesion development in an

939: 10780: 10762: 10564: 9674: 8687: 8407: 6728: 6075:

Baker, B.J. et al. (2020) "Advancing the Understanding of Treponemal Disease in the Past and Present".

5765: 5743: 2911:

Karp G, Schlaeffer, F., Jotkowitz, A., Riesenberg, K. (January 2009). "Syphilis and HIV co-infection".

2014: 2003: 1999: 1842: 1758:) describing the ravages of the disease in Italy. In Great Britain it was also called the "Great Pox". 1729: 1315: 1314:

for a minimum of 10 days. If a person is allergic to penicillin, ceftriaxone may be used or penicillin

1096:. These tests are not as time-sensitive, as they do not require living bacteria to make the diagnosis. 902:. Approximately 30% to 60% of those exposed to primary or secondary syphilis will get the disease. Its 866:) failing to encode the metabolic pathways necessary to make most of its macronutrients. It has a slow 6556:[Preliminary report on the occurrence of Spirochaetes in syphilitic chancres and papillomas]. 1549:, and congenital syphilis. During 2015, it caused about 107,000 deaths, down from 202,000 in 1990. In 10290: 10066: 9518: 9499: 9465: 9100: 8747: 8609: 7419: 7412: 5416: 1164: 1081: 1027: 613: 477: 238:(soft, non-cancerous growths), neurological problems, or heart symptoms. Syphilis has been known as " 7651: 6553: 887: 10559: 10265: 10232: 9942: 9857: 9808: 9472: 9421: 8796: 8452: 8098: 8035: 7930: 7571: 6117: 5260:"Jarisch–Herxheimer reaction in a patient with syphilis and human immunodeficiency virus infection" 1994:

The "Tuskegee Study of Untreated Syphilis in the Negro Male" was an infamous, unethical and racist

1946: 1368: 1327: 757: 733: 307:). These three diseases are not typically sexually transmitted. Diagnosis is usually made by using 741: 10690: 10490: 10227: 10202: 10122: 9606: 9511: 8813: 8717: 8412: 8131: 8103: 7733: 6545: 5780: 5161: 4747: 4587: 4400: 3098: 2223: 1838: 1671: 1250: 496: 6577: 6368:"Syphilis in renaissance Europe: rapid evolution of an introduced sexually transmitted disease?" 5127: 967:

Syphilis is difficult to diagnose clinically during early infection. Confirmation is either via

10270: 10222: 10212: 10207: 10096: 9781: 9504: 9345: 9146: 8861: 8692: 8604: 7920: 6022: 4874: 4791: 2947: 2171: 2166: 2096: 1904: 1702: 1304: 698: 670: 597: 404: 113: 7611: 7246: 6852: 6658: 6293:

Anthony Grafton (March 1995). "Drugs and Diseases: New World Biology and Old World Learning".

6198:

Arrizabalaga, Jon. "The Changing Identity of the French Pox in Early Renaissance Castile". In

3929: 630: 407:

in one of four different stages: primary, secondary, latent, and tertiary, and may also occur

10845: 10717: 10695: 10608: 9921: 9479: 9410: 9007: 8886: 8825: 8801: 8594: 8521: 8209: 7743: 7723: 7523: 7179: 6269: 6262: 6213: 6174: 4524: 4507: 3895:"Transmission of Primary and Secondary Syphilis by Oral Sex --- Chicago, Illinois, 1998–2002" 3135:

Campion EW, Ghanem KG, Ram S, Rice PA (27 February 2020). "The Modern Epidemic of Syphilis".

2022: 1761:

In the 16th through 19th centuries, syphilis was one of the largest public health burdens in

1558: 1269: 1238: 1177: 1155:

Portrait of a man affected with what is now believed to have been congenital syphilis c. 1820

1068: 972: 312: 258: 254: 105: 5473:"STD Trends in the United States: 2010 National Data for Gonorrhea, Chlamydia, and Syphilis" 2975: 1128:

use reduces the likelihood of transmission during sex, but does not eliminate the risk. The

999: 10752: 10421: 10410: 10037: 10027: 9827: 9458: 9451: 9401: 9281: 9249: 9000: 8966: 8856: 8740: 7940: 7738: 7713: 5043: 5022:"Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins" 3524: 2626: 2034:

even after the antibiotic had been proven to successfully treat syphilis. According to the

1637: 1542: 1204: 702: 7110: 7088: 5472: 4717: 1798:

compounds and isolation were commonly used, with treatments often worse than the disease.

8: 10634: 10629: 10539: 10465: 10455: 10429: 10425: 10300: 10106: 10017: 9789: 9636: 9227: 9142: 8808: 8792: 8785: 8662: 8599: 8574: 8548: 8402: 8380: 7975: 7935: 7855: 7845: 7556: 5442: 3894: 3077:(27th ed.). Elk Grove Village, IL: American Academy of Pediatrics. pp. 631–44. 2125: 2010: 1888: 1872: 1857: 1738: 1603: 1308: 1057: 995: 749: 718: 656: 457: 308: 262: 245: 101: 48: 8732: 7427: 6112:

strains: yaws and syphilis treponemes differ in less than 0.2% of the genome sequence".

5235: 5206: 4946: 4694: 4669: 2711: 2630: 2613:

Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. (2015).

10685: 10596: 10007: 9992: 9982: 9389: 9215: 9192: 8849: 8837: 8511: 8375: 8260: 8219: 8093: 8088: 8083: 7910: 7480: 7455: 7393: 7356: 7309: 6922: 6906: 6783: 6634: 6617: 6488: 6392: 6367: 6348: 5736:"WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba" 5712: 5687: 5668: 5536: 5503: 5389: 5364: 5108: 5095: 5070: 4987: 4750:, Grossman DC, Curry SJ, Davidson KW, Epling JW, García FA, et al. (7 June 2016). 4645: 4618: 4483: 4466: 4349: 4301: 4276: 4252: 4227: 4179:"Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features" 4155: 4116: 4089: 4065: 4030: 3868: 3843: 3819: 3790: 3747: 3722: 3698: 3673: 3652: 3625: 3572: 3547: 3493: 3468: 3395: 3336: 3311: 3292: 3242: 3160: 2890: 2839: 2814: 2792: 2724: 2649: 2614: 2507: 2482: 2453: 2428: 2365: 1880: 1774: 1746: 1622: 1618: 1550: 1192: 800: 725: 345: 291: 277: 239: 211: 72: 7023:"Code of Federal Regulations Title 45 Part 46 Protections of Human Subjects 46.1.1(i)" 7022: 5341: 5143: 4565: 3674:"Dental Stigmata of Congenital Syphilis: A Historic Review With Present Day Relevance" 3439: 3414: 2692: 2498: 2444: 2009:

The Public Health Service started working on this study in 1932 in collaboration with

1431: 1331:

Jarisch–Herxheimer reaction in a person with syphilis and human immunodeficiency virus

1230: 548:. All of these lesions harbor bacteria and are infectious. Other symptoms may include 10810: 10710: 10390: 10101: 9379: 8988: 8569: 8275: 8151: 8146: 8025: 7999: 7925: 7915: 7753: 7728: 7582: 7485: 7397: 7385: 7360: 7348: 7301: 7252: 7004: 6994: 6926: 6914: 6886: 6858: 6831: 6806: 6787: 6775: 6664: 6639: 6527: 6430: 6397: 6340: 6298: 6273: 6219: 6202:, edited by Florence Eliza Glaze and Brian K. Nance, 397–417. Florence: SISMEL, 2011. 6044:

Criminals and Paupers: The Graveyard of St. Margaret Fyebriggate in combusto, Norwich

5808: 5800: 5717: 5660: 5620: 5566: 5541: 5523: 5394: 5345: 5308: 5281: 5240: 5222: 5100: 4979: 4971: 4927: 4880: 4826: 4773: 4699: 4650: 4569: 4529: 4488: 4367: 4341: 4306: 4257: 4208: 4203: 4178: 4159: 4121: 4070: 4052: 4002: 3935: 3873: 3824: 3752: 3703: 3629: 3617: 3577: 3498: 3444: 3387: 3341: 3296: 3284: 3234: 3164: 3152: 3078: 3018: 2955: 2928: 2882: 2844: 2784: 2716: 2701: 2654: 2562: 2512: 2458: 2357: 2176: 2120: 2042:

and syphilis—which was a leading cause of death among southern African American men.

1892: 1884: 1795: 1234: 1167:(WHO) recommends all women be tested at their first antenatal visit and again in the 851: 760:(screwdriver-shaped incisors), Moon's molars or bud molars, and Fournier's molars or 694: 649: 416: 235: 96: 60: 9548: 9141: 7565: 7561: 7436: 7313: 7062: 6200:

Between Text and Patient: The Medical Enterprise in Medieval and Early Modern Europe

5672: 5112: 4353: 3246: 2894: 2480: 2369: 1918: 544:. It may form flat, broad, whitish, wart-like lesions on mucous membranes, known as 10747: 10668: 10482: 10450: 9305: 9299: 9293: 9271: 9266: 9255: 8667: 8516: 8422: 8370: 8240: 8015: 7950: 7622: 7475: 7467: 7377: 7340: 7293: 7153: 6898: 6767: 6629: 6517: 6387: 6379: 6352: 6332: 5792: 5707: 5699: 5652: 5531: 5515: 5384: 5376: 5337: 5271: 5230: 5218: 5214: 5139: 5090: 5082: 4961: 4917: 4763: 4689: 4685: 4681: 4640: 4630: 4561: 4519: 4478: 4333: 4296: 4288: 4247: 4239: 4198: 4190: 4151: 4111: 4101: 4060: 4042: 3863: 3855: 3814: 3806: 3742: 3734: 3693: 3685: 3609: 3567: 3559: 3488: 3480: 3434: 3426: 3399: 3379: 3331: 3323: 3276: 3226: 3144: 3010: 2920: 2874: 2834: 2826: 2813:

Coffin L, Newberry A, Hagan H, Cleland C, Des Jarlais D, Perlman D (January 2010).

2776: 2728: 2706: 2696: 2688: 2644: 2634: 2554: 2502: 2494: 2448: 2440: 2349: 2108: 2062: 1960:, a scene of a wealthy man receiving treatment for syphilis with the tropical wood 1724:

The first written records of an outbreak of syphilis in Europe occurred in 1495 in

1660:—in skeletal remains shifted the opinion of some towards a "pre-Columbian" origin. 1613: 1574: 1566: 1541:. It affects between 700,000 and 1.6 million pregnancies a year, resulting in 1538: 955: 525: 364: 170: 4991: 4243: 3430: 2796: 1876: 1163:(USPSTF) strongly recommends universal screening of all pregnant women, while the 10794: 10641: 10529: 10353: 10285: 10192: 10012: 9891: 9536: 9220: 9172: 8944: 8652: 8579: 8250: 7965: 7810: 7748: 7576: 7443: 4966: 4337: 4292: 4047: 4026: 3996: 3842:

Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS (12 October 2017).

3546:

Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS (12 October 2017).

3383: 3001:

White RM (13 March 2000). "Unraveling the Tuskegee Study of Untreated Syphilis".

2830: 2639: 2558: 2116: 2092: 1806: 1770: 1681: 1554: 1303:

For neurosyphilis, due to the poor penetration of benzathine penicillin into the

1199:, and the United States. This means health care providers are required to notify 1168: 920: 843: 761: 678: 660: 545: 536:

on the trunk and extremities, including the palms and soles. The rash may become

481: 441: 286: 226: 7625: 6124:, M., Pospíšilová, P., Norris, S. J., ... Šmajs, D. (2010). "Genome analysis of 5560: 5276: 5259: 2580: 1721:

with startling results revealing an effort to hide its association with elites.

1594:

became the first country to eliminate mother-to-child transmission of syphilis.

1143:

relationship with a partner who has been tested and is known to be uninfected."

500:

Typical presentation of secondary syphilis with a rash on the palms of the hands

10767: 10646: 10549: 10379: 10245: 10187: 10172: 10032: 9963: 9532: 9490: 9325: 9150: 8881: 8712: 8702: 8619: 8161: 7989: 7628: 7587: 7449:

Recommendations for Public Health Surveillance of Syphilis in the United States

6549: 6336: 6153: 6101: 6080: 6059: 5963: 5857: 5086: 3014: 2924: 2100: 2091:

from 1946 to 1948. It was done during the administration of American President

2046: 1995: 1923: 1868: 1818: 1810: 1791: 1649: 1629: 1435: 1196: 1172: 916: 859: 785: 682: 589: 7331:

Ghanem KG, Ram S, Rice PA (February 2020). "The Modern Epidemic of Syphilis".

6268:(Uncorrected page proof. ed.). New Haven: Yale University Press. p. 5703: 5380: 3689: 2780: 2394: 2128:

who also participated in the late stages of the Tuskegee syphilis experiment.

1684:, a skin disease and therefore unrecoverable through paleopathology.) Ancient 1226: 10804: 10727: 10544: 10440: 10396: 10081: 9880: 9838: 9721: 9658: 9646: 9626: 9350: 9163: 8954: 8949: 8697: 8672: 8627: 8589: 8457: 8324: 8184: 8136: 8068: 8040: 7206: 7008: 6531: 6418: 5804: 5527: 5226: 4975: 4635: 4228:"Current status of syphilis vaccine development: Need, challenges, prospects" 4056: 3280: 3230: 2910: 2054: 2018: 1982: 1909: 1864:

was confirmed in trials in 1943, at which time it became the main treatment.

1787: 1714: 1289: 1264:

are alternative choices for those allergic to penicillin; due to the risk of

1200: 912: 867: 815: 666: 638: 537: 357: 341: 7546: 7542: 7471: 7297: 6959: 6434: 5519: 2878: 10732: 10658: 10554: 10326: 10217: 10197: 10002: 9916: 9734: 9442: 9261: 9072: 9038: 8974: 8642: 8214: 8194: 8009: 8004: 7994: 7835: 7639: 7489: 7448: 7389: 7352: 7305: 7215: 6779: 6643: 6401: 6383: 6344: 6295:

New Worlds, Ancient Texts The Power of Tradition and the Shock of Discovery

5812: 5721: 5664: 5570: 5545: 5398: 5285: 5244: 5159: 4983: 4931: 4830: 4777: 4768: 4751: 4703: 4654: 4573: 4533: 4492: 4345: 4310: 4261: 4212: 4163: 4125: 4074: 3877: 3828: 3756: 3707: 3621: 3581: 3502: 3448: 3391: 3345: 3288: 3238: 3156: 3037:"Revisiting the Great Imitator, Part I: The Origin and History of Syphilis" 3022: 2932: 2886: 2848: 2788: 2720: 2658: 2566: 2516: 2462: 2361: 2175:. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 1983–1989. 2058: 1937: 1853: 1849: 1826: 1814: 1782: 1778: 1633: 1311: 1265: 1261: 1222: 1114: 1072: 1023: 1015: 793: 706: 412: 388: 353: 327: 7381: 7344: 5970:, 34 (1958), 22–23; "Historical approach to the terminology of syphilis". 5349: 5205:

Bai ZG, Wang B, Yang K, Tian JH, Ma B, Liu Y, et al. (13 June 2012).

5104: 4106: 4029:, Cruz AR, Ramirez LG, Zuluaga AV, Pillay A, Abreu C, et al. (2012). 3613: 3148: 818:, highly mobile bacterium. Two other human diseases are caused by related 504: 10737: 10445: 10339: 10305: 10295: 10127: 9937: 9907: 9750: 9705: 9689: 9679: 9611: 9394: 9369: 9077: 8983: 8959: 8677: 8502: 8204: 7870: 7606: 6918: 4194: 3859: 3810: 3738: 3563: 2426: 1928: 1698: 1689: 1348: 1340: 1285: 1281: 1257: 1089: 1053: 1002:

on the nontreponemal tests can occur with some viral infections, such as

968: 907: 903: 895: 753: 737: 729: 701:

which are pupils that constrict when the person focuses on near objects (

625: 585: 561: 553: 529: 465: 371:

is recommended. During treatment people may develop fever, headache, and

368: 361: 349: 334: 140: 7211:"US says sorry for "outrageous and abhorrent" Guatemalan syphilis tests" 6136:

strains: Most of the genetic differences are localized in six regions".

4752:"Screening for Syphilis Infection in Nonpregnant Adults and Adolescents" 3671: 3327: 781: 387:(HIV). This is believed to be partly due to unsafe drug use, increased 10625: 10620: 9948: 9898: 9871: 9335: 9096: 9053: 9024: 9019: 8906: 8898: 8637: 8478: 8355: 8073: 8045: 7815: 7634: 7158: 7141: 6910: 6857:( ed.). Tuscaloosa, AL: University of Alabama Press. p. 113. 6771: 5598:"Syphilis cases in babies skyrocket in Canada amid healthcare failures" 3217:

Eccleston K, Collins, L, Higgins, SP (March 2008). "Primary syphilis".

2112: 2050: 2031: 1942: 1861: 1834: 1762: 1578: 1573:

Syphilis was very common in Europe during the 18th and 19th centuries.

1546: 1292: 1277: 1140: 1135: 1085: 1049: 959: 745: 690: 674: 521: 469: 408: 249:

Treponema pallidum bacteria (syphilis) in colorized electron micrograph

215: 78: 6522: 6505: 5656: 3484: 2353: 322:

The risk of sexual transmission of syphilis can be reduced by using a

10615: 10460: 10384: 10330: 9798: 9684: 9416: 9182: 9091: 8820: 8780: 8682: 8632: 8396: 7983: 7955: 7860: 7695: 7681: 7617: 6014: 5865: 4945:

Desai M, Woodhall SC, Nardone A, Burns F, Mercey D, Gilson R (2015).

4467:"Economic and programmatic aspects of congenital syphilis prevention" 2481:

GBD 2015 Mortality and Causes of Death Collaborators (October 2016).

2088: 2080: 2066: 1953: 1932: 1830: 1586: 1344: 1273: 1031: 1003: 879: 863: 645: 581: 573: 565: 267: 207: 40: 7506: 6991:

Examining Tuskegee : the infamous syphilis study and its legacy

6902: 6462:""He who knows syphilis knows medicine"—the return of an old friend" 6250:

Hidden Killers of the Tudor Home: The Horrors of Tudor Dentistry etc

5688:"Syphilis: The Renaissance of an Old Disease with Oral Implications" 4947:"Active recall to increase HIV and STI testing: a systematic review" 4746: 2676: 2545:

Woods, CR (June 2009). "Congenital syphilis-persisting pestilence".

850:, they do not cause neurological disease. Humans are the only known 383:

turn of the millennium in many countries, often in combination with

10700: 10651: 10509: 10358: 9847: 9822: 9426: 9239: 8929: 8873: 8772: 8329: 8309: 8245: 8199: 8141: 8078: 7840: 7789: 7718: 7114: 7087:. U.S. Department of Health and Human Services. n.d. Archived from 6323:

Dayan L, Ooi, C (October 2005). "Syphilis treatment: old and new".

5974:, 84 (1961), 545–562; "Treponematosis and man's social evolution". 5893:"Revisiting the Great Imitator: The Origin and History of Syphilis" 5796: 4922: 4905: 3998:

Sexually transmitted diseases: a textbook of genitourinary medicine

3370:

Bhatti MT (2007). "Optic neuropathy from viruses and spirochetes".

3073:

Committee on Infectious Diseases (2006). Larry K. Pickering (ed.).

2768:

European Journal of Clinical Microbiology & Infectious Diseases

2612: 1961: 1913:

An early medical illustration of people with syphilis, Vienna, 1498

1011: 899: 891: 765: 609: 569: 130: 20: 7283: 6616:

Tampa M, Sarbu I, Matei C, Benea V, Georgescu SR (15 March 2014).

4816: 1829:. It was manufactured and marketed from 1910 under the trade name 1821:

in 1909, during a survey of hundreds of newly synthesized organic

10680: 10591: 10519: 10435: 10022: 8911: 8506: 8360: 8270: 8189: 8176: 8126: 8055: 7779: 7774: 7769: 6051: 5830: 5327: 3966:"Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet" 2026: 1822: 1710: 1110: 1019: 1007: 883: 752:

among others. Infection during pregnancy is also associated with

593: 557: 541: 509: 437: 372: 222: 7417:

Knowledge's health care articles can be viewed offline with the

6698:"Comment la syphilis emporta Maupassant | La Revue du Praticien" 5207:"Azithromycin versus penicillin G benzathine for early syphilis" 4094:

Canadian Journal of Infectious Diseases and Medical Microbiology

3072: 629:

Model of a head of a person with tertiary (gummatous) syphilis,

10675: 8995: 8118: 8063: 7830: 7825: 7799: 7708: 7537: 7518: 3672:

Nissanka-Jayasuriya EH, Odell EW, Phillips C (September 2016).

2039: 1917:

The earliest known depiction of an individual with syphilis is

1733: 1725: 1641: 1125: 928: 577: 485: 473: 461: 449: 445: 392: 330: 242:" because it may cause symptoms similar to many other diseases. 126: 7059:"Final Report of the Tuskegee Syphilis Study Legacy Committee" 6887:"Racism and Research: The Case of the Tuskegee Syphilis Study" 5877:

For an introduction to this literature see Quétel, C. (1990).

5257: 4551: 3216: 878:

Syphilis is transmitted primarily by sexual contact or during

10534: 8921: 7784: 6805:(1st Vintage Book ed.). New York: Vintage. p. 346. 6758:

Eisler CT (Winter 2009). "Who is Dürer's "Syphilitic Man"?".

4876:

Brunner & Suddarth's textbook of medical-surgical nursing

4505: 1742: 549: 323: 5958:

Hudson, E. H. (1946). "A unitarian view of treponematosis".

3075:

Red book 2006 Report of the Committee on Infectious Diseases

2017:

in Alabama. Researchers enrolled 600 poor, African American

10836:

Infections with a predominantly sexual mode of transmission

10603: 10524: 9207: 8365: 7884: 7703: 2815:"Syphilis in Drug Users in Low and Middle Income Countries" 1657: 1591: 1176:

of congenital syphilis in low- to middle-income countries.

1093: 823: 756:. The three main dental defects in congenital syphilis are 697:. Both tabes dorsalis and general paresis may present with 533: 272: 230: 185: 4668:

Shahrook S, Mori R, Ochirbat T, Gomi H (29 October 2014).

4025: 2812: 2427:

GBD 2015 Maternal Mortality Collaborators (October 2016).

2049:

because researchers had knowingly withheld treatment with

1813:, in 1905. The first effective treatment for syphilis was 1640:

in 1492 and spread from there, with a serious epidemic in

9739: 9621: 8934: 8762: 5739: 4944: 1685: 1562: 858:. It is unable to survive more than a few days without a 728:(70%), rash (70%), fever (40%), neurosyphilis (20%), and 384: 191: 179: 7437:

UCSF HIV InSite Knowledge Base Chapter: Syphilis and HIV

6064:

L'origine de la syphilis in Europe: avant ou après 1493?

6040:

L'origine de la syphilis in Europe: avant ou après 1493?

6036:

L'origine de la syphilis in Europe: Avant ou après 1493?

5921:

L'origine de la syphilis in Europe: avant ou après 1493?

5558: 4906:"Partner notification for sexually transmitted diseases" 4667: 4623:

Indian Journal of Sexually Transmitted Diseases and AIDS

838:), and one further caused by the very closely related 7175:"U.S. Apologizes For Syphilis Experiments in Guatemala" 6264:

The worst of evils: man's fight against pain: a history

4176: 3600:

Longo DL, Ropper AH (3 October 2019). "Neurosyphilis".

2002:. Whereas the purpose of this study was to observe the 319:(U.S.) recommends for all pregnant women to be tested. 5923:(pp. 92-98; 101–108). Paris, France: Éditions Errance. 1895:, but that diagnosis has recently come into question. 1335:

One of the potential side effects of treatment is the

677:; or late as meningovascular syphilis, manifesting as 532:. There may be a symmetrical, reddish-pink, non-itchy 488:

may persist for three to six weeks if left untreated.

10778: 9578: 7453: 5365:"Antibiotics for syphilis diagnosed during pregnancy" 5298: 5071:"Mercury as an Antisyphilitic Chemotherapeutic Agent" 4670:"Strategies of testing for syphilis during pregnancy" 3466: 705:) but do not constrict when exposed to bright light ( 194: 182: 176: 7496: 6615: 5881:. Baltimore, MD: The Johns Hopkins University Press. 5264:

Revista da Sociedade Brasileira de Medicina Tropical

3841: 3545: 3134: 2077:

Preparation and Use of Guayaco for Treating Syphilis

2045:

The 40-year study became a textbook example of poor

1958:

Preparation and Use of Guayaco for Treating Syphilis

764:(molars with abnormal occlusal anatomy resembling a 188: 6993:. Chapel Hill: University of North Carolina Press. 6830:( ed.). Oxford: Berg Publishers. p. 205. 6660:

Pox: Genius, Madness, and the Mysteries of Syphilis

5614: 3266: 1441:from syphilis per 100,000 inhabitants in 2004 990:Nontreponemal tests are used initially and include 173: 7061:. University of Virginia. May 1996. Archived from 6261: 3068: 3066: 3064: 3062: 2864: 1891:was long believed to have gone mad as a result of 7682:Diseases of the skin and appendages by morphology 6988: 6544: 6413: 6411: 5960:American Journal of Tropical Medicine and Hygiene 5501: 5160:Center for Disease Control and Prevention (CDC). 4938: 4395: 4393: 3595: 3593: 3591: 1967: 919:in many countries. The risk of transmission from 10802: 6611: 6609: 6607: 6605: 6187:See her Medieval Syphilis and Treponemal Disease 5685: 5642: 5559:Cantor A, Nelson HD, Daeges M, Pappas M (2016). 5495: 4794:. Public Health Agency of Canada. 5 April 2005. 1268:, these are not recommended for pregnant women. 415:. It was referred to as "the great imitator" by 7111:"Guatemalans "died" in 1940s US syphilis study" 6459: 6292: 6066:(pp. 101–108). Paris, France: Éditions Errance. 5204: 4323: 4225: 3720: 3059: 2111:of the subjects and treated most subjects with 1608: 1553:, syphilis contributes to approximately 20% of 1046:fluorescent treponemal antibody absorption test 516:over much of the body due to secondary syphilis 7077: 6538: 6417: 6408: 6297:. Harvard University Press. pp. 159–194. 5258:D'Eça Júnior A, Rodrigues L, Costa LC (2017). 5068: 4460: 4458: 4456: 4390: 3588: 3462: 3460: 3458: 2476: 2474: 2472: 2218: 2216: 2214: 2212: 1701:. Salmon discovered that it appeared often in 1322: 1060:in the setting of a known syphilis infection. 906:is exemplified by the fact that an individual 9766: 9564: 9127: 8748: 8167:Pityriasis lichenoides et varioliformis acuta 7667: 7330: 7205: 6602: 6559:Arbeiten aus dem Kaiserlichen Gesundheitsamte 4819:Medicina Oral, Patologia Oral y Cirugia Bucal 4506:US Preventive Services Task F (19 May 2009). 4177:Singh AE, Barbara Romanowski (1 April 1999). 4141: 3927: 3309: 3303: 2808: 2806: 2339: 2210: 2208: 2206: 2204: 2202: 2200: 2198: 2196: 2194: 2192: 2160: 2158: 2156: 2154: 1347:released by the immune system in response to 1203:authorities, which will then ideally provide 337:. The preferred antibiotic for most cases is 10841:Sexually transmitted diseases and infections 10831:Infectious diseases with eradication efforts 7821:Dermatofibroma (benign fibrous histiocytoma) 7103: 7030:U.S. Department of Health and Human Services 6954: 6952: 6950: 6948: 6503: 6154:https://doi.org/10.1371/journal.pntd.0003261 6102:https://doi.org/10.1371/journal.pntd.0001832 5964:https://doi.org/10.4269/ajtmh.1946.s1-26.135 3994: 3657:: CS1 maint: multiple names: authors list ( 3517:"Ward 86 Practice Recommendations: Syphilis" 3412: 2968: 2954:. Philadelphia, PA: Elsevier. p. 1452. 2422: 2420: 1377:Syphilis deaths per million persons in 2012 1161:United States Preventive Services Task Force 7368:Ropper AH (October 2019). "Neurosyphilis". 7238: 7166: 6322: 6189:(Leeds: Arc Humanities Press, 2022), 61-79. 6120:. 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In Goldman L, Schafer AI (eds.). 1244: 726:enlargement of the liver and spleen 13: 8299: 8256:Postinflammatory hyperpigmentation 7324: 7039:from the original on 28 March 2016 6476:from the original on 7 August 2020 6015:https://doi.org/10.1002/ajpa.22630 5866:https://doi.org/10.1002/ajpa.21613 5453:from the original on 7 August 2019 4798:from the original on 9 August 2011 4728:from the original on 4 August 2011 4588:"Prenatal Syphilis Screening Laws" 4368:"Condom Fact Sheet in Brief | CDC" 4156:10.1016/j.clindermatol.2010.03.011 4001:. 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DFA uses 987:and treponemal tests. 964: 952: 796: 699:Argyll Robertson pupil 671:central nervous system 659:, which may result in 634: 598:interstitial keratitis 517: 501: 482:Lymph node enlargement 432: 375:, a reaction known as 342:injected into a muscle 250: 158:107,000 (2015, global) 114:Differential diagnosis 10718:Elephantiasis nostras 10696:Necrotizing fasciitis 10609:Hospital furunculosis 10291:Brill–Zinsser disease 9922:Dermatitis gangrenosa 9480:Prevotella intermedia 9411:Chlamydia trachomatis 9008:Molluscum contagiosum 8887:Trichomonas vaginalis 8826:Neisseria gonorrhoeae 8802:Chlamydia trachomatis 8595:Loose anagen syndrome 8522:Necrobiosis lipoidica 8458:Actinic/solar purpura 8132:Insect bite reactions 7921:Seborrheic dermatitis 7744:Merkel-cell carcinoma 7724:Molluscum contagiosum 7420:Medical Knowledge app 7382:10.1056/NEJMra1906228 7345:10.1056/NEJMra1901593 7180:National Public Radio 7146:Public Health Reviews 6966:. CDC. 25 June 2008. 5840:Archives of Pathology 5835:The Myth of Syphilis: 5781:"History of Syphilis" 3995:G. W. Csonka (1990). 3614:10.1056/NEJMra1906228 3149:10.1056/NEJMra1901593 3105:. 23 September 2019. 2702:10536/DRO/DU:30050819 2075: 1985: 1912: 1841:was the first modern 1674: 1616: 1543:spontaneous abortions 1434: 1376: 1330: 1288:, a third-generation 1239:mercury (II) chloride 1229:or when inhaled as a 1178:Point-of-care testing 1154: 1069:Dark field microscopy 973:dark field microscopy 958: 942: 931:extremely difficult. 784: 758:Hutchinson's incisors 732:(20%). If untreated, 628: 507: 499: 430: 313:dark field microscopy 248: 106:dark field microscopy 10753:Chronic lymphangitis 10422:Hot tub folliculitis 10411:Pseudomonal pyoderma 10038:Miliary tuberculosis 10028:Lichen scrofulosorum 9828:Toxic shock syndrome 9459:Tannerella forsythia 9452:Bacteroides fragilis 9402:Chlamydia pneumoniae 9282:Borrelia recurrentis 9250:Borrelia burgdorferi 8968:Human papillomavirus 8857:Ureaplasma infection 8418:Annulare centrifugum 7941:Glucagonoma syndrome 7739:Basal-cell carcinoma 7714:Seborrheic keratosis 5827:Current Anthropology 4916:(Suppl 3): S160–74. 4855:on 13 September 2012 4724:. 22 November 2010. 4195:10.1128/CMR.12.2.187 3860:10.1038/nrdp.2017.73 3811:10.1128/aac.01095-09 3739:10.1128/CMR.00070-13 3564:10.1038/nrdp.2017.73 2493:(10053): 1459–1544. 2439:(10053): 1545–1602. 1741:as the title of his 1638:Christopher Columbus 1205:partner notification 846:. Unlike subspecies 814:is a spiral-shaped, 794:Steiner silver stain 703:accommodation reflex 10826:Infectious diseases 10642:Acute lymphadenitis 10635:Perianal cellulitis 10630:Pyogenic paronychia 10540:Chlamydia infection 10456:Granuloma inguinale 10430:Green nail syndrome 10426:Ecthyma gangrenosum 10301:Cat-scratch disease 10107:Tuberculoid leprosy 10018:Lepromatous leprosy 9865:Streptococcus iniae 9637:Congenital syphilis 9505:Lemierre's syndrome 9228:Treponema denticola 8786:Haemophilus ducreyi 8663:Aphthous stomatitis 8600:Lichen planopilaris 8575:Androgenic alopecia 8381:Fixed drug eruption 7956:Pemphigus foliaceus 7856:Granular cell tumor 7187:on 10 November 2014 7032:. 15 January 2009. 6378:(Suppl 4): S174–6. 6260:Dormandy T (2006). 5879:History of Syphilis 5746:on 4 September 2015 5449:. 27 October 2014. 5069:G J O'Shea (1990). 5048:Wellcome Collection 4435:wellcomelibrary.org 4107:10.1155/2005/597580 3905:. 21 October 2004. 3645:Williams Obstetrics 3372:Int Ophthalmol Clin 3328:10.1503/cmaj.060665 2631:2015PLoSO..1043304N 2230:. 2 November 2015. 2126:John Charles Cutler 2065:, communication of 2011:Tuskegee University 1952:The Flemish artist 1899:Arts and literature 1889:Friedrich Nietzsche 1873:Arthur Schopenhauer 1858:developed countries 1739:Girolamo Fracastoro 1604:History of syphilis 1058:cerebrospinal fluid 996:rapid plasma reagin 719:Congenital syphilis 657:syphilitic aortitis 263:congenital syphilis 118:Many other diseases 49:Electron micrograph 10816:Bacterial diseases 10686:Pitted keratolysis 10597:Periapical abscess 10008:Erythema induratum 9993:Borderline leprosy 9983:Aquarium granuloma 9390:Chlamydia psittaci 9216:Treponema carateum 9193:Treponema pallidum 9143:Bacterial diseases 8850:Treponema pallidum 8838:Mycoplasma hominis 8683:Pemphigus vulgaris 8512:Granuloma annulare 8376:Carcinoid syndrome 8261:Tuberous sclerosis 8220:Coccidioidomycosis 8094:Bullous pemphigoid 8089:Pemphigus vulgaris 8021:Secondary syphilis 7911:Contact dermatitis 7598:External resources 7245:Grauer AL (2011). 7209:(1 October 2010). 7159:10.1007/BF03391665 7117:. 29 August 2011. 6772:10.1353/pbm.0.0065 6489:Treponema pallidum 6212:Winters A (2006). 6167:Treponema pallidum 6142:Treponema pallidum 6126:Treponema pallidum 6106:Treponema pallidum 6094:Treponema pallidum 5978:, 67(4), 885–901. 5363:Walker GJ (2001). 5044:"Sex and syphilis" 3976:on 24 October 2014 3793:Treponema pallidum 3521:hivinsite.ucsf.edu 2687:(9859): 2095–128. 2085: 1992: 1935:. The myth of the 1915: 1881:Charles Baudelaire 1803:Treponema pallidum 1775:sexual promiscuity 1747:dactylic hexameter 1677: 1627: 1623:Rembrandt van Rijn 1619:Gerard de Lairesse 1551:sub-Saharan Africa 1534: 1429: 1343:. It is caused by 1333: 1284:is often present. 1193:notifiable disease 1157: 1147:Congenital disease 1040:Treponema pallidum 965: 953: 840:Treponema carateum 820:Treponema pallidum 808:Treponema pallidum 802:Treponema pallidum 797: 790:Treponema pallidum 742:Higouménakis' sign 635: 582:joint inflammation 574:liver inflammation 518: 502: 452:and finally to an 433: 399:Signs and symptoms 377:Jarisch–Herxheimer 346:penicillin allergy 251: 240:the great imitator 212:Treponema pallidum 89:Treponema pallidum 66:Infectious disease 53:Treponema pallidum 10776: 10775: 10711:Fournier gangrene 10578: 10577: 10477: 10476: 10418:hot-foot syndrome 10391:Vibrio vulnificus 10158: 10157: 10154: 10153: 10102:Tuberculous gumma 9958: 9957: 9748: 9747: 9546: 9545: 9437: 9436: 9364: 9363: 9360: 9359: 9320: 9319: 9109: 9108: 9001:HSV-1 & HSV-2 8989:Hepatitis B virus 8730: 8729: 8726: 8725: 8570:Telogen effluvium 8534: 8533: 8530: 8529: 8491: 8490: 8487: 8486: 8432: 8431: 8284: 8283: 8152:Lichen spinulosus 8147:Keratosis pilaris 8026:Mycosis fungoides 7926:Stasis dermatitis 7916:Atopic dermatitis 7879: 7878: 7754:Trichoepithelioma 7729:Actinic keratosis 7649: 7648: 7376:(14): 1358–1363. 6864:978-0-8173-5534-0 6837:978-1-85973-444-5 6812:978-0-307-38598-7 6801:Hughes R (2007). 6657:Hayden D (2008). 6523:10.1111/ehr.13000 6427:Men Against Death 5791:(10): 1454–1463. 5657:10.1345/aph.1K086 5447:www.niaid.nih.gov 5314:978-1-904455-10-3 4886:978-0-7817-8589-1 4748:Bibbins-Domingo K 4374:. 18 April 2019. 4238:(14): 1602–1609. 4008:978-0-7020-1258-7 3941:978-1-35118-825-8 3485:10.1136/bmj.l4159 3084:978-1-58110-207-9 2961:978-0-323-75571-9 2946:Ferri FF (2022). 2354:10.1345/aph.1K086 2182:978-0-323-55087-1 2121:Kathleen Sebelius 2097:Juan José Arévalo 1893:tertiary syphilis 1885:Guy de Maupassant 1825:compounds led by 1630:Paleopathologists 1567:African Americans 1531: 1530: 1235:mercury poisoning 1006:(chickenpox) and 852:natural reservoir 730:lung inflammation 417:Sir William Osler 271:bacteria include 257:. It may also be 162: 161: 108:of infected fluid 97:Diagnostic method 28:Medical condition 10853: 10793: 10792: 10791: 10784: 10748:Bullous impetigo 10669:Sycosis vulgaris 10483:Campylobacterota 10432: 10178: 10177: 10169: 10168: 9969: 9968: 9804: 9803: 9795: 9794: 9775: 9768: 9761: 9752: 9751: 9573: 9566: 9559: 9550: 9549: 9375: 9374: 9331: 9330: 9306:Borrelia parkeri 9300:Borrelia duttoni 9294:Borrelia hermsii 9272:Neuroborreliosis 9267:Erythema migrans 9256:Borrelia afzelii 9178: 9177: 9169: 9168: 9136: 9129: 9122: 9113: 9112: 9088: 9069: 9050: 8757: 8750: 8743: 8734: 8733: 8668:Oral candidiasis 8545: 8544: 8443: 8442: 8371:Erythema nodosum 8315: 8314: 8304: 8303: 8297: 8296: 8241:Tinea versicolor 8079:Bullous impetigo 8016:Pityriasis rosea 7951:Lichen sclerosus 7936:Darier's disease 7901: 7900: 7890: 7889: 7846:Kaposi's sarcoma 7692: 7691: 7676: 7669: 7662: 7653: 7652: 7498: 7497: 7493: 7483: 7415: 7401: 7364: 7318: 7317: 7281: 7275: 7274: 7272: 7270: 7242: 7236: 7235: 7230: 7228: 7203: 7197: 7196: 7194: 7192: 7183:. Archived from 7170: 7164: 7163: 7161: 7137: 7131: 7130: 7128: 7126: 7107: 7101: 7100: 7098: 7096: 7091:on 25 April 2013 7081: 7075: 7074: 7072: 7070: 7055: 7049: 7048: 7046: 7044: 7038: 7027: 7019: 7013: 7012: 6986: 6980: 6979: 6977: 6975: 6956: 6943: 6942: 6940: 6938: 6882: 6873: 6872: 6851:Reid BA (2009). 6848: 6842: 6841: 6823: 6817: 6816: 6798: 6792: 6791: 6755: 6749: 6748: 6746: 6744: 6724: 6718: 6717: 6715: 6713: 6693: 6687: 6686: 6684: 6682: 6654: 6648: 6647: 6637: 6613: 6600: 6599: 6597: 6595: 6574: 6568: 6567: 6542: 6536: 6535: 6525: 6501: 6495: 6494: 6483: 6481: 6457: 6451: 6450: 6448: 6446: 6415: 6406: 6405: 6395: 6363: 6357: 6356: 6320: 6309: 6308: 6290: 6284: 6283: 6267: 6257: 6251: 6248: 6242: 6241: 6239: 6237: 6209: 6203: 6196: 6190: 6184: 6178: 6163: 6157: 6152:, 8(11), e3261. 6090: 6084: 6073: 6067: 6032: 6026: 6006: 6000: 5993: 5987: 5956: 5950: 5949: 5947: 5945: 5939:The Conversation 5930: 5924: 5916: 5910: 5909: 5907: 5905: 5888: 5882: 5875: 5869: 5849: 5843: 5823: 5817: 5816: 5776: 5770: 5762: 5756: 5755: 5753: 5751: 5732: 5726: 5725: 5715: 5683: 5677: 5676: 5640: 5631: 5630: 5612: 5606: 5605: 5593: 5587: 5586: 5584: 5582: 5556: 5550: 5549: 5539: 5499: 5493: 5492: 5490: 5488: 5469: 5463: 5462: 5460: 5458: 5439: 5433: 5432: 5430: 5428: 5409: 5403: 5402: 5392: 5360: 5354: 5353: 5325: 5319: 5318: 5296: 5290: 5289: 5279: 5255: 5249: 5248: 5238: 5202: 5196: 5195: 5188: 5182: 5181: 5179: 5177: 5157: 5148: 5147: 5123: 5117: 5116: 5098: 5066: 5060: 5059: 5057: 5055: 5040: 5034: 5033: 5017: 5011: 5010: 5008: 5006: 5000: 4969: 4951: 4942: 4936: 4935: 4925: 4901: 4895: 4894: 4871: 4865: 4864: 4862: 4860: 4851:. Archived from 4841: 4835: 4834: 4814: 4808: 4807: 4805: 4803: 4788: 4782: 4781: 4771: 4744: 4738: 4737: 4735: 4733: 4714: 4708: 4707: 4697: 4680:(10): CD010385. 4665: 4659: 4658: 4648: 4638: 4614: 4608: 4607: 4605: 4603: 4594:. 8 April 2019. 4584: 4578: 4577: 4549: 4538: 4537: 4527: 4503: 4497: 4496: 4486: 4462: 4451: 4450: 4448: 4446: 4427: 4421: 4420: 4418: 4416: 4397: 4388: 4387: 4385: 4383: 4364: 4358: 4357: 4321: 4315: 4314: 4304: 4272: 4266: 4265: 4255: 4223: 4217: 4216: 4206: 4174: 4168: 4167: 4139: 4130: 4129: 4119: 4109: 4085: 4079: 4078: 4068: 4050: 4023: 4017: 4016: 3992: 3986: 3985: 3983: 3981: 3962: 3953: 3952: 3950: 3948: 3925: 3919: 3918: 3916: 3914: 3891: 3882: 3881: 3871: 3839: 3833: 3832: 3822: 3786: 3761: 3760: 3750: 3718: 3712: 3711: 3701: 3678:Head Neck Pathol 3669: 3663: 3662: 3656: 3648: 3640: 3634: 3633: 3597: 3586: 3585: 3575: 3543: 3537: 3536: 3534: 3532: 3527:on 29 April 2019 3523:. Archived from 3513: 3507: 3506: 3496: 3464: 3453: 3452: 3442: 3410: 3404: 3403: 3378:(4): 37–66, ix. 3367: 3350: 3349: 3339: 3307: 3301: 3300: 3264: 3251: 3250: 3214: 3169: 3168: 3132: 3119: 3118: 3116: 3114: 3095: 3089: 3088: 3070: 3057: 3056: 3054: 3052: 3033: 3027: 3026: 2998: 2992: 2991: 2989: 2987: 2972: 2966: 2965: 2943: 2937: 2936: 2908: 2899: 2898: 2862: 2853: 2852: 2842: 2810: 2801: 2800: 2762: 2745: 2744: 2742: 2740: 2714: 2704: 2672: 2663: 2662: 2652: 2642: 2625:(12): e0143304. 2610: 2601: 2600: 2598: 2596: 2577: 2571: 2570: 2542: 2521: 2520: 2510: 2478: 2467: 2466: 2456: 2424: 2415: 2414: 2412: 2410: 2391: 2374: 2373: 2337: 2244: 2243: 2241: 2239: 2220: 2187: 2186: 2162: 2109:informed consent 2063:informed consent 1817:, discovered by 1711:Hansen's disease 1555:perinatal deaths 1539:developing world 1524: 1518: 1512: 1506: 1500: 1494: 1486: 1480: 1474: 1468: 1462: 1456: 1450: 1444: 1436:Age-standardized 1424: 1418: 1412: 1406: 1400: 1394: 1388: 1382: 1245:Early infections 950: 750:Clutton's joints 707:pupillary reflex 631:Musée de l'Homme 526:mucous membranes 365:benzylpenicillin 201: 200: 197: 196: 193: 190: 187: 184: 181: 178: 175: 43: 31: 30: 10861: 10860: 10856: 10855: 10854: 10852: 10851: 10850: 10801: 10800: 10799: 10789: 10787: 10779: 10777: 10772: 10584: 10574: 10498: 10473: 10409: 10368: 10354:Meningococcemia 10315: 10286:Verruga peruana 10193:Epidemic typhus 10150: 10111: 10013:Histoid leprosy 9974: 9954: 9926: 9901: 9892:Corynebacterium 9885: 9832: 9784: 9779: 9749: 9744: 9715: 9694: 9663: 9582: 9577: 9547: 9542: 9537:Haverhill fever 9485: 9433: 9356: 9316: 9233: 9173:Spirochaetaceae 9158: 9140: 9110: 9105: 9084: 9065: 9046: 9037: 9031: 8975:Genital warts ( 8916: 8893: 8868: 8767: 8761: 8731: 8722: 8654: 8647: 8614: 8580:Alopecia areata 8558: 8540: 8526: 8483: 8462: 8438: 8428: 8385: 8344: 8330:Viral exanthems 8308: 8292: 8290: 8280: 8251:Pityriasis alba 8229: 8171: 8113: 8050: 7970: 7966:Zinc deficiency 7896: 7894: 7875: 7803: 7794: 7758: 7749:Nevus sebaceous 7683: 7680: 7650: 7645: 7644: 7593: 7592: 7509: 7444:Wayback Machine 7424: 7416: 7408: 7370:N. Engl. J. Med 7333:N. Engl. J. Med 7327: 7325:Further reading 7322: 7321: 7282: 7278: 7268: 7266: 7259: 7243: 7239: 7226: 7224: 7204: 7200: 7190: 7188: 7171: 7167: 7138: 7134: 7124: 7122: 7109: 7108: 7104: 7094: 7092: 7083: 7082: 7078: 7068: 7066: 7057: 7056: 7052: 7042: 7040: 7036: 7025: 7021: 7020: 7016: 7001: 6987: 6983: 6973: 6971: 6958: 6957: 6946: 6936: 6934: 6903:10.2307/3561468 6883: 6876: 6865: 6849: 6845: 6838: 6824: 6820: 6813: 6799: 6795: 6756: 6752: 6742: 6740: 6725: 6721: 6711: 6709: 6694: 6690: 6680: 6678: 6671: 6655: 6651: 6614: 6603: 6593: 6591: 6576: 6575: 6571: 6543: 6539: 6502: 6498: 6479: 6477: 6458: 6454: 6444: 6442: 6416: 6409: 6364: 6360: 6331:(13): 2271–80. 6321: 6312: 6305: 6291: 6287: 6280: 6258: 6254: 6249: 6245: 6235: 6233: 6226: 6210: 6206: 6197: 6193: 6185: 6181: 6171:Current Biology 6164: 6160: 6116:, 6(1), e1471. 6091: 6087: 6074: 6070: 6033: 6029: 6021:, 72, 451–472. 6013:, 156, 90–101. 6007: 6003: 5994: 5990: 5957: 5953: 5943: 5941: 5931: 5927: 5917: 5913: 5903: 5901: 5889: 5885: 5876: 5872: 5850: 5846: 5829:, 29, 703–738. 5824: 5820: 5777: 5773: 5763: 5759: 5749: 5747: 5734: 5733: 5729: 5684: 5680: 5641: 5634: 5627: 5613: 5609: 5594: 5590: 5580: 5578: 5557: 5553: 5514:(18): 1905–17. 5500: 5496: 5486: 5484: 5471: 5470: 5466: 5456: 5454: 5441: 5440: 5436: 5426: 5424: 5411: 5410: 5406: 5375:(3): CD001143. 5361: 5357: 5326: 5322: 5315: 5297: 5293: 5256: 5252: 5213:(6): CD007270. 5203: 5199: 5190: 5189: 5185: 5175: 5173: 5158: 5151: 5124: 5120: 5067: 5063: 5053: 5051: 5050:. 30 April 2019 5042: 5041: 5037: 5018: 5014: 5004: 5002: 4998: 4949: 4943: 4939: 4902: 4898: 4887: 4873: 4872: 4868: 4858: 4856: 4843: 4842: 4838: 4815: 4811: 4801: 4799: 4790: 4789: 4785: 4745: 4741: 4731: 4729: 4716: 4715: 4711: 4666: 4662: 4615: 4611: 4601: 4599: 4586: 4585: 4581: 4550: 4541: 4504: 4500: 4463: 4454: 4444: 4442: 4429: 4428: 4424: 4414: 4412: 4399: 4398: 4391: 4381: 4379: 4366: 4365: 4361: 4322: 4318: 4273: 4269: 4224: 4220: 4175: 4171: 4140: 4133: 4086: 4082: 4024: 4020: 4009: 3993: 3989: 3979: 3977: 3964: 3963: 3956: 3946: 3944: 3942: 3926: 3922: 3912: 3910: 3893: 3892: 3885: 3840: 3836: 3787: 3764: 3719: 3715: 3670: 3666: 3650: 3649: 3641: 3637: 3608:(14): 1358–63. 3598: 3589: 3544: 3540: 3530: 3528: 3515: 3514: 3510: 3465: 3456: 3411: 3407: 3368: 3353: 3308: 3304: 3265: 3254: 3215: 3172: 3133: 3122: 3112: 3110: 3097: 3096: 3092: 3085: 3071: 3060: 3050: 3048: 3035: 3034: 3030: 2999: 2995: 2985: 2983: 2974: 2973: 2969: 2962: 2944: 2940: 2909: 2902: 2863: 2856: 2811: 2804: 2775:(12): 1151–57. 2763: 2748: 2738: 2736: 2673: 2666: 2611: 2604: 2594: 2592: 2579: 2578: 2574: 2543: 2524: 2479: 2470: 2425: 2418: 2408: 2406: 2401:. 4 June 2015. 2393: 2392: 2377: 2338: 2247: 2237: 2235: 2222: 2221: 2190: 2183: 2167:"303. Syphilis" 2163: 2152: 2147: 2134: 2117:Hillary Clinton 2101:mental patients 2093:Harry S. Truman 2004:natural history 1980: 1970: 1907: 1901: 1807:Fritz Schaudinn 1771:causative agent 1611: 1606: 1600: 1532: 1526: 1522: 1520: 1516: 1514: 1510: 1508: 1504: 1502: 1498: 1496: 1492: 1488: 1484: 1482: 1478: 1476: 1472: 1470: 1466: 1464: 1460: 1458: 1454: 1452: 1448: 1427: 1426: 1422: 1420: 1416: 1414: 1410: 1408: 1404: 1402: 1398: 1396: 1392: 1390: 1386: 1384: 1380: 1371: 1365: 1357: 1341:fast heart rate 1325: 1316:desensitization 1301: 1299:Late infections 1247: 1219: 1214: 1186: 1169:third trimester 1149: 1123: 1107: 1102: 1066: 1052:(predominately 1000:False positives 981: 937: 921:sharing needles 876: 854:for subspecies 805: 779: 774: 762:mulberry molars 721: 715: 679:general paresis 661:aortic aneurysm 623: 606: 546:condyloma latum 494: 442:skin ulceration 425: 411:. There may be 401: 255:sexual activity 227:skin ulceration 172: 168: 29: 24: 17: 12: 11: 5: 10859: 10849: 10848: 10843: 10838: 10833: 10828: 10823: 10818: 10813: 10798: 10797: 10774: 10773: 10771: 10770: 10768:Tropical ulcer 10765: 10760: 10755: 10750: 10745: 10740: 10735: 10730: 10725: 10720: 10715: 10714: 10713: 10708: 10698: 10693: 10688: 10683: 10678: 10673: 10672: 10671: 10666: 10655: 10654: 10649: 10647:Pilonidal cyst 10644: 10639: 10638: 10637: 10632: 10618: 10613: 10612: 10611: 10601: 10600: 10599: 10588: 10586: 10580: 10579: 10576: 10575: 10573: 10572: 10567: 10562: 10557: 10552: 10550:Rat-bite fever 10547: 10542: 10537: 10532: 10527: 10522: 10517: 10512: 10506: 10504: 10500: 10499: 10497: 10496: 10487: 10485: 10479: 10478: 10475: 10474: 10472: 10471: 10463: 10458: 10453: 10448: 10443: 10438: 10433: 10407: 10399: 10394: 10387: 10382: 10380:Pasteurellosis 10376: 10374: 10370: 10369: 10367: 10366: 10361: 10356: 10351: 10342: 10337: 10323: 10321: 10317: 10316: 10314: 10313: 10308: 10303: 10298: 10293: 10288: 10283: 10278: 10273: 10268: 10263: 10258: 10253: 10248: 10246:Rickettsialpox 10243: 10235: 10230: 10225: 10220: 10215: 10210: 10205: 10200: 10195: 10190: 10188:Endemic typhus 10184: 10182: 10175: 10173:Pseudomonadota 10166: 10160: 10159: 10156: 10155: 10152: 10151: 10149: 10148: 10143: 10135: 10130: 10125: 10119: 10117: 10113: 10112: 10110: 10109: 10104: 10099: 10094: 10089: 10084: 10079: 10074: 10069: 10064: 10056: 10048: 10040: 10035: 10033:Lupus vulgaris 10030: 10025: 10020: 10015: 10010: 10005: 10000: 9995: 9990: 9985: 9979: 9977: 9973:Mycobacterium- 9966: 9964:Actinomycetota 9960: 9959: 9956: 9955: 9953: 9952: 9945: 9940: 9934: 9932: 9928: 9927: 9925: 9924: 9919: 9913: 9911: 9903: 9902: 9897: 9895: 9887: 9886: 9884: 9883: 9878: 9869: 9860: 9855: 9850: 9844: 9842: 9834: 9833: 9831: 9830: 9825: 9820: 9814: 9812: 9809:Staphylococcus 9801: 9792: 9786: 9785: 9778: 9777: 9770: 9763: 9755: 9746: 9745: 9743: 9742: 9737: 9732: 9726: 9724: 9717: 9716: 9714: 9713: 9708: 9702: 9700: 9699:Late pregnancy 9696: 9695: 9693: 9692: 9687: 9682: 9677: 9671: 9669: 9665: 9664: 9662: 9661: 9656: 9654:transplacental 9651: 9650: 9649: 9641: 9640: 9639: 9631: 9630: 9629: 9624: 9619: 9614: 9609: 9604: 9599: 9590: 9588: 9584: 9583: 9576: 9575: 9568: 9561: 9553: 9544: 9543: 9541: 9540: 9533:Rat-bite fever 9523: 9522: 9515: 9508: 9495: 9493: 9491:Fusobacteriota 9487: 9486: 9484: 9483: 9476: 9469: 9462: 9455: 9447: 9445: 9439: 9438: 9435: 9434: 9432: 9431: 9430: 9429: 9424: 9419: 9406: 9405: 9398: 9385: 9383: 9372: 9366: 9365: 9362: 9361: 9358: 9357: 9355: 9354: 9341: 9339: 9328: 9326:Leptospiraceae 9322: 9321: 9318: 9317: 9315: 9314: 9290: 9277: 9276: 9275: 9274: 9269: 9264: 9245: 9243: 9235: 9234: 9232: 9231: 9224: 9212: 9211: 9210: 9205: 9188: 9186: 9175: 9166: 9160: 9159: 9151:proteobacteria 9139: 9138: 9131: 9124: 9116: 9107: 9106: 9104: 9103: 9094: 9089: 9081: 9080: 9075: 9070: 9062: 9061: 9056: 9051: 9043: 9041: 9033: 9032: 9030: 9029: 9017: 9005: 9004: 9003: 8996:Herpes simplex 8993: 8981: 8972: 8964: 8963: 8962: 8957: 8952: 8947: 8939: 8926: 8924: 8918: 8917: 8915: 8914: 8909: 8903: 8901: 8895: 8894: 8892: 8891: 8882:Trichomoniasis 8878: 8876: 8870: 8869: 8867: 8866: 8854: 8842: 8830: 8818: 8806: 8790: 8777: 8775: 8769: 8768: 8760: 8759: 8752: 8745: 8737: 8728: 8727: 8724: 8723: 8721: 8720: 8715: 8710: 8705: 8703:Coxsackievirus 8700: 8695: 8690: 8685: 8680: 8675: 8670: 8665: 8659: 8657: 8649: 8648: 8646: 8645: 8640: 8635: 8630: 8624: 8622: 8616: 8615: 8613: 8612: 8607: 8602: 8597: 8592: 8587: 8582: 8577: 8572: 8566: 8564: 8560: 8559: 8557: 8556: 8553: 8551: 8542: 8536: 8535: 8532: 8531: 8528: 8527: 8525: 8524: 8519: 8514: 8509: 8499: 8497: 8493: 8492: 8489: 8488: 8485: 8484: 8482: 8481: 8476: 8470: 8468: 8464: 8463: 8461: 8460: 8455: 8449: 8447: 8440: 8434: 8433: 8430: 8429: 8427: 8426: 8420: 8415: 8413:Gyratum repens 8410: 8405: 8399: 8393: 8391: 8387: 8386: 8384: 8383: 8378: 8373: 8368: 8363: 8358: 8352: 8350: 8346: 8345: 8343: 8342: 8337: 8335:Toxic erythema 8332: 8327: 8325:Drug eruptions 8321: 8319: 8312: 8301: 8294: 8286: 8285: 8282: 8281: 8279: 8278: 8273: 8268: 8263: 8258: 8253: 8248: 8243: 8237: 8235: 8231: 8230: 8228: 8227: 8222: 8217: 8212: 8207: 8202: 8197: 8192: 8187: 8181: 8179: 8173: 8172: 8170: 8169: 8164: 8162:Lichen nitidus 8159: 8154: 8149: 8144: 8139: 8134: 8129: 8123: 8121: 8115: 8114: 8112: 8111: 8106: 8101: 8096: 8091: 8086: 8081: 8076: 8071: 8066: 8064:Herpes simplex 8060: 8058: 8052: 8051: 8049: 8048: 8043: 8038: 8033: 8028: 8023: 8018: 8013: 8007: 8002: 7997: 7992: 7986: 7980: 7978: 7972: 7971: 7969: 7968: 7963: 7958: 7953: 7948: 7943: 7938: 7933: 7928: 7923: 7918: 7913: 7907: 7905: 7898: 7887: 7881: 7880: 7877: 7876: 7874: 7873: 7868: 7863: 7858: 7853: 7848: 7843: 7838: 7833: 7828: 7823: 7818: 7813: 7807: 7805: 7796: 7795: 7793: 7792: 7787: 7782: 7777: 7772: 7766: 7764: 7760: 7759: 7757: 7756: 7751: 7746: 7741: 7736: 7731: 7726: 7721: 7716: 7711: 7706: 7700: 7698: 7689: 7685: 7684: 7679: 7678: 7671: 7664: 7656: 7647: 7646: 7643: 7642: 7631: 7614: 7602: 7601: 7599: 7595: 7594: 7591: 7590: 7579: 7568: 7549: 7530: 7510: 7505: 7504: 7502: 7501:Classification 7495: 7494: 7466:(4): 203–210. 7451: 7446: 7434: 7410: 7409: 7407: 7406:External links 7404: 7403: 7402: 7365: 7339:(9): 845–854. 7326: 7323: 7320: 7319: 7276: 7257: 7237: 7198: 7165: 7132: 7102: 7076: 7065:on 5 July 2017 7050: 7014: 6999: 6981: 6944: 6874: 6863: 6843: 6836: 6818: 6811: 6793: 6750: 6719: 6688: 6670:978-0786724130 6669: 6649: 6601: 6569: 6537: 6516:(2): 372–399. 6496: 6464:. Editorials. 6452: 6419:de Kruif, Paul 6407: 6358: 6310: 6303: 6285: 6279:978-0300113228 6278: 6252: 6243: 6224: 6204: 6191: 6179: 6158: 6085: 6068: 6027: 6001: 5988: 5951: 5925: 5911: 5883: 5870: 5864:, 54: 99–133. 5844: 5818: 5797:10.1086/429626 5771: 5757: 5727: 5698:(3): 195–206. 5678: 5632: 5625: 5607: 5588: 5551: 5494: 5464: 5434: 5404: 5355: 5320: 5313: 5291: 5270:(6): 877–878. 5250: 5197: 5183: 5149: 5118: 5061: 5035: 5012: 4937: 4923:10.1086/511429 4896: 4885: 4866: 4836: 4825:(9): e416–20. 4809: 4783: 4762:(21): 2321–7. 4739: 4709: 4660: 4609: 4579: 4539: 4498: 4452: 4422: 4389: 4359: 4326:Sex Transm Dis 4316: 4267: 4218: 4189:(2): 187–209. 4169: 4131: 4080: 4018: 4007: 3987: 3954: 3940: 3920: 3883: 3834: 3762: 3713: 3684:(3): 327–331. 3664: 3635: 3587: 3538: 3508: 3454: 3405: 3351: 3302: 3252: 3170: 3120: 3090: 3083: 3058: 3028: 3009:(5): 585–598. 2993: 2967: 2960: 2938: 2900: 2854: 2802: 2746: 2664: 2602: 2572: 2553:(6): 536–537. 2522: 2468: 2416: 2375: 2245: 2188: 2181: 2149: 2148: 2146: 2143: 2133: 2130: 2107:, without the 2047:medical ethics 1996:clinical study 1969: 1966: 1924:Syphilitic Man 1919:Albrecht Dürer 1900: 1897: 1869:Franz Schubert 1819:Sahachiro Hata 1811:Erich Hoffmann 1792:tabes dorsalis 1650:treponematosis 1610: 1607: 1602:Main article: 1599: 1596: 1529: 1528: 1521: 1515: 1509: 1503: 1497: 1491: 1489: 1483: 1477: 1471: 1465: 1459: 1453: 1447: 1442: 1421: 1415: 1409: 1403: 1397: 1391: 1385: 1379: 1378: 1367:Main article: 1364: 1361: 1356: 1353: 1324: 1321: 1300: 1297: 1246: 1243: 1218: 1215: 1213: 1210: 1197:European Union 1191:Syphilis is a 1185: 1182: 1173:antenatal care 1148: 1145: 1122: 1119: 1106: 1103: 1101: 1098: 1065: 1064:Direct testing 1062: 980: 977: 936: 933: 913:blood products 875: 872: 799:Main article: 786:Histopathology 778: 775: 773: 770: 717:Main article: 714: 711: 695:Romberg's sign 683:tabes dorsalis 622: 619: 605: 602: 493: 490: 424: 421: 400: 397: 206:caused by the 160: 159: 156: 152: 151: 148: 144: 143: 138: 134: 133: 124: 120: 119: 116: 110: 109: 99: 93: 92: 86: 82: 81: 75: 69: 68: 63: 57: 56: 45: 44: 36: 35: 27: 15: 9: 6: 4: 3: 2: 10858: 10847: 10844: 10842: 10839: 10837: 10834: 10832: 10829: 10827: 10824: 10822: 10819: 10817: 10814: 10812: 10809: 10808: 10806: 10796: 10786: 10785: 10782: 10769: 10766: 10764: 10761: 10759: 10756: 10754: 10751: 10749: 10746: 10744: 10741: 10739: 10736: 10734: 10731: 10729: 10728:Botryomycosis 10726: 10724: 10721: 10719: 10716: 10712: 10709: 10707: 10704: 10703: 10702: 10699: 10697: 10694: 10692: 10689: 10687: 10684: 10682: 10679: 10677: 10674: 10670: 10667: 10665: 10662: 10661: 10660: 10657: 10656: 10653: 10650: 10648: 10645: 10643: 10640: 10636: 10633: 10631: 10627: 10624: 10623: 10622: 10619: 10617: 10614: 10610: 10607: 10606: 10605: 10604:Boil/furuncle 10602: 10598: 10595: 10594: 10593: 10590: 10589: 10587: 10581: 10571: 10568: 10566: 10563: 10561: 10558: 10556: 10553: 10551: 10548: 10546: 10545:Leptospirosis 10543: 10541: 10538: 10536: 10533: 10531: 10528: 10526: 10523: 10521: 10518: 10516: 10513: 10511: 10508: 10507: 10505: 10501: 10495: 10493: 10489: 10488: 10486: 10484: 10480: 10470: 10468: 10464: 10462: 10459: 10457: 10454: 10452: 10449: 10447: 10444: 10442: 10441:Salmonellosis 10439: 10437: 10434: 10431: 10427: 10423: 10419: 10417: 10412: 10408: 10406: 10404: 10400: 10398: 10397:Rhinoscleroma 10395: 10393: 10392: 10388: 10386: 10383: 10381: 10378: 10377: 10375: 10371: 10365: 10362: 10360: 10357: 10355: 10352: 10350: 10348: 10343: 10341: 10338: 10336: 10332: 10328: 10325: 10324: 10322: 10318: 10312: 10309: 10307: 10304: 10302: 10299: 10297: 10294: 10292: 10289: 10287: 10284: 10282: 10279: 10277: 10274: 10272: 10269: 10267: 10264: 10262: 10259: 10257: 10254: 10252: 10249: 10247: 10244: 10242: 10240: 10236: 10234: 10231: 10229: 10226: 10224: 10221: 10219: 10216: 10214: 10211: 10209: 10206: 10204: 10201: 10199: 10196: 10194: 10191: 10189: 10186: 10185: 10183: 10179: 10176: 10174: 10170: 10167: 10165: 10161: 10147: 10144: 10142: 10140: 10136: 10134: 10131: 10129: 10126: 10124: 10121: 10120: 10118: 10114: 10108: 10105: 10103: 10100: 10098: 10095: 10093: 10090: 10088: 10085: 10083: 10082:Scrofuloderma 10080: 10078: 10075: 10073: 10070: 10068: 10065: 10063: 10061: 10057: 10055: 10053: 10049: 10047: 10045: 10041: 10039: 10036: 10034: 10031: 10029: 10026: 10024: 10021: 10019: 10016: 10014: 10011: 10009: 10006: 10004: 10001: 9999: 9996: 9994: 9991: 9989: 9986: 9984: 9981: 9980: 9978: 9976: 9970: 9967: 9965: 9961: 9951: 9950: 9946: 9944: 9941: 9939: 9936: 9935: 9933: 9929: 9923: 9920: 9918: 9915: 9914: 9912: 9910: 9909: 9904: 9900: 9896: 9894: 9893: 9888: 9882: 9881:Scarlet fever 9879: 9877: 9873: 9870: 9868: 9866: 9861: 9859: 9856: 9854: 9851: 9849: 9846: 9845: 9843: 9841: 9840: 9839:Streptococcus 9835: 9829: 9826: 9824: 9821: 9819: 9816: 9815: 9813: 9811: 9810: 9805: 9802: 9800: 9796: 9793: 9791: 9787: 9783: 9776: 9771: 9769: 9764: 9762: 9757: 9756: 9753: 9741: 9738: 9736: 9733: 9731: 9730:Breastfeeding 9728: 9727: 9725: 9723: 9722:breastfeeding 9718: 9712: 9709: 9707: 9704: 9703: 9701: 9697: 9691: 9688: 9686: 9683: 9681: 9678: 9676: 9675:transcervical 9673: 9672: 9670: 9666: 9660: 9659:TORCH complex 9657: 9655: 9652: 9648: 9647:Toxoplasmosis 9645: 9644: 9642: 9638: 9635: 9634: 9632: 9628: 9627:Fifth disease 9625: 9623: 9620: 9618: 9615: 9613: 9610: 9608: 9605: 9603: 9600: 9598: 9595: 9594: 9592: 9591: 9589: 9585: 9581: 9574: 9569: 9567: 9562: 9560: 9555: 9554: 9551: 9538: 9534: 9530: 9529: 9525: 9524: 9521: 9520: 9516: 9514: 9513: 9509: 9506: 9502: 9501: 9497: 9496: 9494: 9492: 9488: 9482: 9481: 9477: 9475: 9474: 9470: 9468: 9467: 9463: 9461: 9460: 9456: 9454: 9453: 9449: 9448: 9446: 9444: 9440: 9428: 9425: 9423: 9420: 9418: 9415: 9414: 9413: 9412: 9408: 9407: 9404: 9403: 9399: 9396: 9392: 9391: 9387: 9386: 9384: 9382: 9381: 9376: 9373: 9371: 9367: 9352: 9351:Leptospirosis 9348: 9347: 9343: 9342: 9340: 9338: 9337: 9332: 9329: 9327: 9323: 9312: 9308: 9307: 9302: 9301: 9296: 9295: 9291: 9288: 9284: 9283: 9279: 9278: 9273: 9270: 9268: 9265: 9263: 9260: 9259: 9258: 9257: 9252: 9251: 9247: 9246: 9244: 9242: 9241: 9236: 9230: 9229: 9225: 9222: 9218: 9217: 9213: 9209: 9206: 9204: 9200: 9197: 9196: 9195: 9194: 9190: 9189: 9187: 9185: 9184: 9179: 9176: 9174: 9170: 9167: 9165: 9164:Spirochaetota 9161: 9156: 9152: 9148: 9147:gram negative 9144: 9137: 9132: 9130: 9125: 9123: 9118: 9117: 9114: 9102: 9098: 9095: 9093: 9090: 9087: 9083: 9082: 9079: 9076: 9074: 9071: 9068: 9064: 9063: 9060: 9057: 9055: 9052: 9049: 9045: 9044: 9042: 9040: 9034: 9027: 9026: 9021: 9018: 9015: 9014: 9009: 9006: 9002: 8999: 8998: 8997: 8994: 8991: 8990: 8985: 8982: 8980: 8978: 8973: 8971: 8969: 8965: 8961: 8958: 8956: 8953: 8951: 8948: 8946: 8943: 8942: 8940: 8937: 8936: 8931: 8928: 8927: 8925: 8923: 8919: 8913: 8910: 8908: 8905: 8904: 8902: 8900: 8896: 8889: 8888: 8883: 8880: 8879: 8877: 8875: 8871: 8864: 8863: 8858: 8855: 8852: 8851: 8846: 8843: 8840: 8839: 8834: 8831: 8828: 8827: 8822: 8819: 8816: 8815: 8810: 8807: 8804: 8803: 8798: 8794: 8791: 8788: 8787: 8782: 8779: 8778: 8776: 8774: 8770: 8765: 8758: 8753: 8751: 8746: 8744: 8739: 8738: 8735: 8719: 8716: 8714: 8711: 8709: 8706: 8704: 8701: 8699: 8696: 8694: 8691: 8689: 8686: 8684: 8681: 8679: 8676: 8674: 8673:Lichen planus 8671: 8669: 8666: 8664: 8661: 8660: 8658: 8656: 8650: 8644: 8641: 8639: 8636: 8634: 8631: 8629: 8628:Onychomycosis 8626: 8625: 8623: 8621: 8617: 8611: 8608: 8606: 8603: 8601: 8598: 8596: 8593: 8591: 8590:Tinea capitis 8588: 8586: 8583: 8581: 8578: 8576: 8573: 8571: 8568: 8567: 8565: 8561: 8555: 8554: 8552: 8550: 8546: 8543: 8539:Miscellaneous 8537: 8523: 8520: 8518: 8515: 8513: 8510: 8508: 8504: 8501: 8500: 8498: 8494: 8480: 8477: 8475: 8472: 8471: 8469: 8465: 8459: 8456: 8454: 8451: 8450: 8448: 8444: 8441: 8437:Nonblanchable 8435: 8424: 8421: 8419: 8416: 8414: 8411: 8409: 8406: 8404: 8400: 8398: 8395: 8394: 8392: 8388: 8382: 8379: 8377: 8374: 8372: 8369: 8367: 8364: 8362: 8359: 8357: 8354: 8353: 8351: 8347: 8341: 8338: 8336: 8333: 8331: 8328: 8326: 8323: 8322: 8320: 8316: 8313: 8311: 8305: 8302: 8298: 8295: 8287: 8277: 8274: 8272: 8269: 8267: 8264: 8262: 8259: 8257: 8254: 8252: 8249: 8247: 8244: 8242: 8239: 8238: 8236: 8234:Hypopigmented 8232: 8226: 8223: 8221: 8218: 8216: 8213: 8211: 8208: 8206: 8203: 8201: 8198: 8196: 8193: 8191: 8188: 8186: 8185:Acne vulgaris 8183: 8182: 8180: 8178: 8174: 8168: 8165: 8163: 8160: 8158: 8155: 8153: 8150: 8148: 8145: 8143: 8140: 8138: 8137:Lichen planus 8135: 8133: 8130: 8128: 8125: 8124: 8122: 8120: 8116: 8110: 8107: 8105: 8102: 8100: 8097: 8095: 8092: 8090: 8087: 8085: 8082: 8080: 8077: 8075: 8072: 8070: 8069:Herpes zoster 8067: 8065: 8062: 8061: 8059: 8057: 8053: 8047: 8044: 8042: 8041:Parapsoriasis 8039: 8037: 8034: 8032: 8029: 8027: 8024: 8022: 8019: 8017: 8014: 8011: 8008: 8006: 8003: 8001: 7998: 7996: 7993: 7991: 7987: 7985: 7982: 7981: 7979: 7977: 7973: 7967: 7964: 7962: 7959: 7957: 7954: 7952: 7949: 7947: 7944: 7942: 7939: 7937: 7934: 7932: 7929: 7927: 7924: 7922: 7919: 7917: 7914: 7912: 7909: 7908: 7906: 7902: 7899: 7891: 7888: 7886: 7882: 7872: 7869: 7867: 7864: 7862: 7859: 7857: 7854: 7852: 7849: 7847: 7844: 7842: 7839: 7837: 7834: 7832: 7829: 7827: 7824: 7822: 7819: 7817: 7814: 7812: 7809: 7808: 7806: 7801: 7797: 7791: 7788: 7786: 7783: 7781: 7778: 7776: 7773: 7771: 7768: 7767: 7765: 7761: 7755: 7752: 7750: 7747: 7745: 7742: 7740: 7737: 7735: 7732: 7730: 7727: 7725: 7722: 7720: 7717: 7715: 7712: 7710: 7707: 7705: 7702: 7701: 7699: 7697: 7693: 7690: 7686: 7677: 7672: 7670: 7665: 7663: 7658: 7657: 7654: 7641: 7637: 7636: 7632: 7630: 7627: 7624: 7620: 7619: 7615: 7613: 7609: 7608: 7604: 7603: 7600: 7596: 7589: 7585: 7584: 7580: 7578: 7574: 7573: 7569: 7567: 7563: 7559: 7558: 7554: 7550: 7548: 7544: 7540: 7539: 7535: 7531: 7529: 7525: 7521: 7520: 7516: 7512: 7511: 7508: 7503: 7499: 7491: 7487: 7482: 7477: 7473: 7469: 7465: 7461: 7457: 7452: 7450: 7447: 7445: 7441: 7438: 7435: 7432: 7429: 7426: 7425: 7422: 7421: 7414: 7399: 7395: 7391: 7387: 7383: 7379: 7375: 7371: 7366: 7362: 7358: 7354: 7350: 7346: 7342: 7338: 7334: 7329: 7328: 7315: 7311: 7307: 7303: 7299: 7295: 7291: 7287: 7280: 7264: 7260: 7258:9781444345926 7254: 7250: 7249: 7241: 7234: 7222: 7218: 7217: 7212: 7208: 7207:Chris McGreal 7202: 7186: 7182: 7181: 7176: 7169: 7160: 7155: 7151: 7147: 7143: 7136: 7120: 7116: 7112: 7106: 7090: 7086: 7080: 7064: 7060: 7054: 7035: 7031: 7024: 7018: 7010: 7006: 7002: 7000:9780807833100 6996: 6992: 6985: 6969: 6965: 6961: 6955: 6953: 6951: 6949: 6932: 6928: 6924: 6920: 6916: 6912: 6908: 6904: 6900: 6896: 6892: 6888: 6881: 6879: 6870: 6866: 6860: 6856: 6855: 6847: 6839: 6833: 6829: 6828:Body dressing 6822: 6814: 6808: 6804: 6797: 6789: 6785: 6781: 6777: 6773: 6769: 6765: 6761: 6754: 6738: 6734: 6730: 6723: 6707: 6703: 6699: 6692: 6676: 6672: 6666: 6662: 6661: 6653: 6645: 6641: 6636: 6631: 6627: 6623: 6619: 6612: 6610: 6608: 6606: 6589: 6585: 6584: 6579: 6573: 6565: 6561: 6560: 6555: 6551: 6547: 6541: 6533: 6529: 6524: 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1955: 1950: 1948: 1944: 1940: 1939: 1934: 1930: 1926: 1925: 1920: 1911: 1906: 1896: 1894: 1890: 1886: 1882: 1878: 1877:Édouard Manet 1874: 1870: 1865: 1863: 1859: 1855: 1851: 1846: 1844: 1840: 1836: 1832: 1828: 1824: 1820: 1816: 1812: 1808: 1804: 1799: 1797: 1793: 1789: 1788:neurosyphilis 1784: 1780: 1776: 1772: 1768: 1764: 1759: 1757: 1753: 1752: 1748: 1744: 1740: 1735: 1731: 1727: 1726:Naples, Italy 1722: 1720: 1716: 1715:elephantiasis 1712: 1706: 1704: 1700: 1694: 1691: 1687: 1683: 1673: 1669: 1665: 1661: 1659: 1655: 1651: 1646: 1643: 1639: 1635: 1631: 1624: 1620: 1615: 1605: 1595: 1593: 1588: 1582: 1580: 1576: 1571: 1568: 1564: 1560: 1556: 1552: 1548: 1544: 1540: 1525: >500 1519: 350–500 1513: 315–350 1507: 280–315 1501: 245–280 1495: 210–245 1490: 1487: 175–210 1481: 140–175 1475: 105–140 1451: no data 1446: 1445: 1440: 1437: 1433: 1375: 1370: 1360: 1352: 1350: 1346: 1342: 1338: 1329: 1320: 1317: 1313: 1310: 1306: 1296: 1294: 1291: 1290:cephalosporin 1287: 1283: 1279: 1275: 1271: 1267: 1266:birth defects 1263: 1259: 1255: 1252: 1251:intramuscular 1242: 1240: 1236: 1232: 1231:suffumigation 1228: 1224: 1221:As a form of 1209: 1206: 1202: 1201:public health 1198: 1194: 1189: 1181: 1179: 1174: 1170: 1166: 1162: 1153: 1144: 1142: 1137: 1133: 1131: 1127: 1118: 1116: 1112: 1097: 1095: 1091: 1087: 1083: 1079: 1074: 1070: 1061: 1059: 1055: 1051: 1047: 1043: 1041: 1035: 1033: 1029: 1025: 1021: 1017: 1013: 1009: 1005: 1001: 998:(RPR) tests. 997: 993: 988: 986: 985:nontreponemal 976: 974: 970: 961: 957: 946: 941: 932: 930: 924: 922: 918: 917:donated blood 914: 909: 905: 901: 897: 893: 889: 885: 881: 871: 869: 868:doubling time 865: 861: 857: 853: 849: 845: 841: 837: 833: 829: 825: 821: 817: 816:Gram-negative 813: 809: 804: 803: 795: 791: 787: 783: 769: 767: 763: 759: 755: 751: 747: 743: 740:deformation, 739: 735: 731: 727: 720: 710: 708: 704: 700: 696: 692: 686: 684: 680: 676: 672: 668: 667:Neurosyphilis 664: 662: 658: 653: 651: 647: 642: 640: 639:neurosyphilis 632: 627: 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ulcer 9972: 9947: 9917:Gas gangrene 9906: 9890: 9864: 9837: 9807: 9735:Tuberculosis 9668:During birth 9526: 9517: 9510: 9498: 9478: 9471: 9464: 9457: 9450: 9443:Bacteroidota 9409: 9400: 9388: 9378: 9344: 9334: 9304: 9298: 9292: 9280: 9262:Lyme disease 9254: 9248: 9238: 9226: 9214: 9198: 9191: 9181: 9085: 9073:Epididymitis 9066: 9047: 9039:inflammation 9023: 9011: 8987: 8976: 8967: 8933: 8885: 8860: 8848: 8844: 8836: 8824: 8812: 8800: 8784: 8707: 8643:Ingrown nail 8215:Dermatophyte 8210:Gonococcemia 8195:Folliculitis 8020: 7836:Neurofibroma 7804:subcutaneous 7633: 7616: 7605: 7581: 7570: 7551: 7532: 7513: 7463: 7459: 7418: 7373: 7369: 7336: 7332: 7289: 7285: 7279: 7267:. 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Retrieved 2227: 2170: 2137: 2135: 2086: 2076: 2059:Peter Buxtun 2044: 2023:Macon County 2008: 1993: 1957: 1951: 1938:femme fatale 1936: 1922: 1916: 1866: 1854:pharmacology 1850:microbiology 1847: 1827:Paul Ehrlich 1815:arsphenamine 1802: 1800: 1783:pathogenesis 1779:prostitution 1760: 1755: 1749: 1723: 1707: 1695: 1678: 1666: 1662: 1647: 1634:Afro-Eurasia 1628: 1617:Portrait of 1583: 1572: 1535: 1469: 70–105 1457: <35 1425: 58–138 1363:Epidemiology 1358: 1349:lipoproteins 1334: 1312:penicillin G 1302: 1262:tetracycline 1248: 1223:chemotherapy 1220: 1190: 1187: 1158: 1134: 1124: 1115:animal model 1108: 1088:tagged with 1073:serous fluid 1067: 1039: 1036: 1024:endocarditis 1016:tuberculosis 989: 982: 966: 963:lymphocytes. 925: 877: 874:Transmission 855: 847: 839: 835: 834:(subspecies 827: 826:(subspecies 822:subspecies, 819: 811: 807: 806: 801: 789: 777:Bacteriology 722: 687: 665: 654: 643: 636: 607: 519: 434: 409:congenitally 402: 389:prostitution 381: 373:muscle pains 354:tetracycline 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1699:saddle nose 1690:spirochetes 1579:antibiotics 1547:stillbirths 1463: 35–70 1419: 29–57 1413: 20–28 1407: 11–19 1309:intravenous 1286:Ceftriaxone 1282:clindamycin 1258:Doxycycline 1090:fluorescein 1054:lymphocytes 994:(VDRL) and 979:Blood tests 969:blood tests 904:infectivity 810:subspecies 754:miscarriage 738:saddle nose 663:formation. 586:periostitis 562:weight loss 554:sore throat 530:lymph nodes 464:(44%), the 413:no symptoms 369:ceftriaxone 362:intravenous 350:doxycycline 335:antibiotics 309:blood tests 303:subspecies 301:T. pallidum 292:T. carateum 281:subspecies 278:T. pallidum 141:Antibiotics 102:Blood tests 10805:Categories 10626:Paronychia 10621:Cellulitis 10494:cellulitis 10405:cellulitis 10345:Cutaneous 9949:Mycoplasma 9899:Erythrasma 9872:Erysipelas 9863:Cutaneous 9336:Leptospira 9097:Urethritis 9054:Cervicitis 9025:Zika virus 9020:Zika fever 8907:Crab louse 8638:Paronychia 8479:Vasculitis 8403:Multiforme 8401:Erythema ( 8356:Cellulitis 8307:Blanchable 8056:Blistering 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