Syphilis. Syphilis has been known to exist for many centuries and was once known as the Great Pox. It is caused by the spirochete Treponema pallidum. Transmitted by sexual contact, the etiologic agent causes a disease occurring in three stages. The primary stage is accompanied by the chancre , a raised, hard, dry, crusty sore occurring at the site of infection. Spirochetes observed from the chancre constitute diagnosis. Penicillin therapy at this stage is successful. The secondary stage of syphilis occurs several weeks after the chancre disappears. This stage is accompanied by an influenza-like syndrome of the respiratory system, a skin rash over the body surface with spirochete-laden lesions (pox), loss of hair, and mild fever. Treatment continues to be successful at this stage. A latent period follows, and in a small percentage of cases, the disease
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