 The spirals are so thin that they cannot be seen directly except using immunofluorescence

staining or dark field illumination and electron microscopy (Efrida; Elvinawaty, 2014).

 Because they are so thin, these microorganisms are not clearly visible except by dark field
lighting or by immunofluorescence staining.

 These anaerobic organisms are easily killed by soap, oxygen, sapranins.

 The structure of this bacteria consists of an inner cell membrane, the cell wall is coated with a
thin peptidoglycan olej, and the outer cell membrane.

 Periplasmic flagella (also known as endoflagelle) are found in the periplasmic space, between
two membranes. This organelle causes its own movements for T. pallidum such as a corkscrew
(Corkscrew) (LaFond & Lukehart, 2006).

 Flagellum filaments have a sheath / sheath and a core structure consisting of at least four major
polypeptides.

 The genus Treponema also has cytoplasmic filaments, also known as cytoplasmic fibrils.

 Filaments are shaped like ribbons, 7-7.5 nm wide. T. pallidum's outer membrane
intermembrane protein particles were few.

 This low protein concentration is thought to cause T. pallidum to avoid the host immune
response (Elvinawaty, 2014).

 Congenital syphilis and occupational syphilis are examples of nonvenereal syphilis.

 Congenital syphilis: This is the most severe result of syphilis in humans. Infection occurs by
vertical transmission from mother to fetus during pregnancy. If the mother has secondary
syphilis and is not treated for the same, the proportion of babies affected is higher than those
with untreated early latent syphilis. In more than 40% of untreated maternal infections, T.
pallidum causes late abortion, stillbirth, and death. Neonatal death can occur due to secondary
bacterial infection, fulminant hepatitis, or pulmonary hemorrhage. Babies with congenital
syphilis are usually born without obvious clinical manifestations of the disease. Poor diet and
rhinitis may be early signs of congenital syphilis. The manifestations of late-onset congenital
syphilis include neurosyphilis and involvement of the eighth cranial nerves, teeth, and bones.

 Occupational syphilis: This is a condition that may occur in medical personnel and paramedics
who treat secondary syphilis. The lesions usually develop on the palms of the hands of a
healthcare worker who are infected and can occur on other exposed parts of the body.

Reservoir, Source, and Transmission of Infection

 T. pallidum is a strict human pathogen and does not occur naturally in any animal species.
Humans are the only natural hosts. Human hosts infected with T. pallidum excreting serous
transudates from moist lesions, such as primary chancre, condyloma latum, mucosal patches,
etc., are a source of infection.

 Syphilis transmission occurs:

 Mainly through sexual contact with the inoculation of spirochetes through the mucous
membrane and abrasions on the epithelial surface.

 With transplacental vertical transmission. Early vertical transmission of syphilis during

pregnancy causes congenital infection in at least 50-80% of exposed neonates.

 By transfusion of T. pallidum- contaminated blood.