Pathogenesis (development of disease)
The gram-negative bacterium Treponema pallidum is transmitted primarily through direct sexual contact. In the process, it enters the body through microscopic skin lesions (skin wounds), especially in the genital and anal mucosa. Shortly thereafter, a systemic infection (infection in which the pathogens spread throughout the entire organism by being washed into the bloodstream) occurs due to infestation of the blood and lymph vessels. The so-called primary complex then forms in the area of the inoculation site (introduction or transfer of cells or microorganisms capable of growth into the organism). After that, without a sufficient therapy, the remaining stages occur.
Diaplacental (“through the placenta“) infection is possible.
Etiology (causes)
Behavioral causes
- Drug use including sharing of drug paraphernalia.
- Sexual transmission
- Promiscuity (sexual contact with relatively frequently changing different partners).
- Prostitution, especially among women from Central and Eastern Europe or Latin America.
- Men who have sex with men (MSM).
- Sexual contacts in the vacation country
- Unprotected coitus
- Sexual practices with high risk of mucosal injury (e.g., unprotected anal intercourse/anal sex).
Disease-related causes
- Other sexually transmitted diseases
- Previously undergone syphilis infection
- HIV infection
