Patrick J Passarelli
@pjpass.bsky.social
Med-peds ID doc in the Northeast US, former peds chief, former Fulbright scholar to Russia. Deputy Editor of ID at theMedNet.org. Lover of 🐕🍯🌿🐿️🦅
May 17, 2025 at 12:04 PM
The incubation for #syphilis is 10-90 d, but spirochetemia and CNS invasion occur EARLY, including in primary syphilis. This was demonstrated in both humans & rabbits within years of the spirochete's discovery in the early 1900s.
Ask ALL patients with syphilis about neuro symptoms!
#IDsky
#medsky
Ask ALL patients with syphilis about neuro symptoms!
#IDsky
#medsky
February 25, 2025 at 3:24 PM
T pallidum has been shown to induce the production of matrix metalloproteinase-1 (MMP-1) in dermal cells, an enzyme involved in breaking down collagen, which likely helps the spirochetes to penetrate tissues.
#syphilis
#IDsky
#medsky
#microbiology
#syphilis
#IDsky
#medsky
#microbiology
February 23, 2025 at 5:05 PM
T pallidum has been shown to induce the production of matrix metalloproteinase-1 (MMP-1) in dermal cells, an enzyme involved in breaking down collagen, which likely helps the spirochetes to penetrate tissues.
#syphilis
#IDsky
#medsky
#microbiology
#syphilis
#IDsky
#medsky
#microbiology
Geographic rates of #syphilis vary widely from 0.5/100k in VT to 73.4/100k in SD (2023). The CDC recs universal screening in certain groups in high-risk areas, although this is not well-defined. Depending on your state, this may be an appropriate strategy to help stop the epidemic.
#IDsky
#medsky
#IDsky
#medsky
February 19, 2025 at 7:56 PM
Since 2021, rates of P&S #syphilis have been highest in the American Indian/Alaskan Native population due to poor access to care. The Indian Health Service and National Council of Urban Indian Health play key roles in this epidemic through increased screening and education efforts.
#IDsky
#medsky
#IDsky
#medsky
![In 2023, the highest rate of reported primary and secondary (P&S) syphilis cases was among non-Hispanic American Indian or Alaska Native persons (58.2 per 100,000), followed by non-Hispanic Black or African American persons (39.7 per 100,000).
There were no increases in the rate of reported P&S syphilis cases among any race or Hispanic ethnicity group during 2022 to 2023. Non-Hispanic American Indian or Alaska Native persons had the greatest five-year increase in rate of reported P&S syphilis (21.1 to 58.2 per 100,000; 175.8% increase from 2019).
During 2022 to 2023, the greatest decrease in rate of reported P&S syphilis cases was among non-Hispanic Native Hawaiian or other Pacific Islander persons (30.2 to 24.3 per 100,000; 19.5% decrease). Non-Hispanic Asian persons had the only five-year decrease in rate of reported P&S syphilis (4.6 to 4.4 per 100,000; 4.3% decrease from 2019).
This report includes data from years that coincide with the COVID-19 pandemic, which introduced uncertainty and difficulty in interpreting STI surveillance data. See Impact of COVID-19 on STIs (https://www.cdc.gov/sti-statistics/about/impact-of-covid-19.html) for more information.
See Technical Notes (https://www.cdc.gov/sti-statistics/annual/technical-notes.html) for information on STI case reporting formats and practices, including collected and derived variables displayed in this report. Table A (https://www.cdc.gov/sti-statistics/data-vis/table-selected-percunknown.html) provides information on unknown, missing, or invalid values of select variables.
Data for all figures are available at https://www.cdc.gov/sti-statistics/media/files/2024/11/2023-STI-Surveillance-Report-Data-Points.zip. The file “PS Syphilis - Rates by Race Hispanic Ethnicity (US 2019-2023).xlsx” contains the data for the figure presented on this slide.
[CDC STI Stastitics 2023]](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:5cba55sbz5o4s4r6eu73dckt/bafkreichwir77ajc7n52sndmuqsp365g7qibsdhai3ohhhdojciryqgjfy@jpeg)
February 18, 2025 at 9:04 PM
Syphilis disproportionately affects non-White, non-Asian racial and ethnic groups, largely due to reduced access to care. [CDC 2023 STI Statistics - www.cdc.gov/sti-statisti... ]
#syphilis
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#medsky
#syphilis
#IDsky
#medsky
February 15, 2025 at 4:28 PM
Syphilis disproportionately affects non-White, non-Asian racial and ethnic groups, largely due to reduced access to care. [CDC 2023 STI Statistics - www.cdc.gov/sti-statisti... ]
#syphilis
#IDsky
#medsky
#syphilis
#IDsky
#medsky
While syphilis can affect any organ system and sometimes cause dramatic signs and symptoms, most infants with congenital syphilis are asymptomatic!
[AAP Red Book, 33rd Edition; Sankaran et al - Congenital Syphilis—An Illustrative Review PMID 37628309]
[AAP Red Book, 33rd Edition; Sankaran et al - Congenital Syphilis—An Illustrative Review PMID 37628309]
February 13, 2025 at 10:31 PM
While syphilis can affect any organ system and sometimes cause dramatic signs and symptoms, most infants with congenital syphilis are asymptomatic!
[AAP Red Book, 33rd Edition; Sankaran et al - Congenital Syphilis—An Illustrative Review PMID 37628309]
[AAP Red Book, 33rd Edition; Sankaran et al - Congenital Syphilis—An Illustrative Review PMID 37628309]
McDonald et al found that lack of timely testing and adequate treatment contributed to 88% of the 3,761 reported cases of congenital syphilis in 2022 (McDonald et al. MMWR Morb Mortal Wkly Rep. 2023 Nov 17;72(46):1269–1274).
#syphilis
#IDsky
#pedsIDsky
#syphilis
#IDsky
#pedsIDsky
February 12, 2025 at 8:32 PM
McDonald et al found that lack of timely testing and adequate treatment contributed to 88% of the 3,761 reported cases of congenital syphilis in 2022 (McDonald et al. MMWR Morb Mortal Wkly Rep. 2023 Nov 17;72(46):1269–1274).
#syphilis
#IDsky
#pedsIDsky
#syphilis
#IDsky
#pedsIDsky
In 2023, there were almost 4,000 cases of congenital syphilis in the US (740% increase since 2014!!). Globally in 2022, there were 700,000 cases of CS (WHO).
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#IDsky
February 6, 2025 at 3:53 PM
In 2023, there were almost 4,000 cases of congenital syphilis in the US (740% increase since 2014!!). Globally in 2022, there were 700,000 cases of CS (WHO).
#IDsky
#IDsky
One clinical benefit of T pallidum's reductive genome is that it doesn't tend to acquire genetic elements conferring drug resistance, which is part of why it remains exquisitely S to PCN.
Resistance does occur - eg near-universal resistance to macrolides in US strains. See ALT text for reference.
Resistance does occur - eg near-universal resistance to macrolides in US strains. See ALT text for reference.
February 4, 2025 at 6:01 PM
One clinical benefit of T pallidum's reductive genome is that it doesn't tend to acquire genetic elements conferring drug resistance, which is part of why it remains exquisitely S to PCN.
Resistance does occur - eg near-universal resistance to macrolides in US strains. See ALT text for reference.
Resistance does occur - eg near-universal resistance to macrolides in US strains. See ALT text for reference.
T pallidum subspecies pallidum, the etiological agent of syphilis, is one of the pathogenic treponemes, thought to have evolved from a common ancestor many millions of years ago.
Norris, Weinstock. Comparative genomics of spirochetes. Pathogenic Treponema: Molecular and Cellular Biology. 2006.
Norris, Weinstock. Comparative genomics of spirochetes. Pathogenic Treponema: Molecular and Cellular Biology. 2006.
February 1, 2025 at 11:02 PM
T pallidum subspecies pallidum, the etiological agent of syphilis, is one of the pathogenic treponemes, thought to have evolved from a common ancestor many millions of years ago.
Norris, Weinstock. Comparative genomics of spirochetes. Pathogenic Treponema: Molecular and Cellular Biology. 2006.
Norris, Weinstock. Comparative genomics of spirochetes. Pathogenic Treponema: Molecular and Cellular Biology. 2006.