Secondary Syphilis in Cali, Colombia: New Concepts in Disease Pathogenesis

    Adriana R. Cruz, Allan Pillay, Ana V. Zuluaga, Lady G. Ramirez, Jorge Duque, Gloria E. Aristizabal, Mary Fiel-Gan, Roberto Jaramillo, Rodolfo Trujillo, Carlos Valencia, Linda L. Jagodzinski, David L. Cox, Justin D. Radolf, Juan C. Salazar
    Studysummary This study provides quantitative evidence that secondary syphilis is highly endemic in Cali, Colombia, and many untreated patients have high numbers of circulating Treponema pallidum spirochetes.
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    The study on secondary syphilis in Cali, Colombia, involved 57 patients, primarily women of Afro-Colombian or mestizo descent from low socio-economic backgrounds. It revealed a high prevalence of Treponema pallidum, with 46% of blood samples and 66% of skin biopsies containing Tp DNA, indicating significant spirochete presence despite immune responses. Clinical findings included common SS symptoms and 5% of patients experienced "moth-eaten-like" alopecia, which resolved with penicillin treatment. The study highlighted the systemic inflammatory nature of SS and the challenges in diagnosing early syphilis due to subtle symptoms. It emphasized the need for improved public health strategies and further research into the bacterium's immune evasion mechanisms.
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