Epidemiology

Since the 1940s, the incidence of syphilis declined drastically following the introduction of penicillin, but rose when HIV arrived from obscurity in the 1980s. In 2000, the rate of primary and secondary syphilis in the United States was 2.1 cases per 100,000 population. From 2001 to 2004, the rate increased to 2.7, primarily as a result of increases in cases among MSM. The 2006 morbidity and mortality report also reflects a substantial increase of syphilis among black men, emphasizing the need for enhanced preventive measures among blacks and MSM. The disparity among men and women has been observed across racial and ethnic groups and is highest in the South and

among non-Hispanic blacks. pathophysiology

T. pallidum rapidly penetrates intact mucous membranes or microscopic dermal abrasions, and within a few hours, enters the lymphatics and blood to produce systemic illness. During the secondary stage, examinations commonly demonstrate abnormal findings in the cerebrospinal fluid (CSF). As the infection progresses, the parenchyma of the brain and spinal cord may subsequently be damaged.

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