Syphilis

Treponema pallidum is a highly motile spirochete that penetrates intact mucous membranes through corkscrew motility. After inoculation, it disseminates hematogenously within hours. Primary syphilis (10-90 days post-exposure) manifests as a painless chancre with local immune infiltration. Secondary syphilis (6-8 weeks later) represents systemic dissemination with immune complex deposition causing rash, lymphadenopathy, and constitutional symptoms. Latent syphilis is serologically positive but clinically silent. Tertiary syphilis (years later) involves granulomatous inflammation (gummas), cardiovascular syphilis (aortitis, aortic aneurysm), and neurosyphilis (tabes dorsalis, general paresis). The nurse must recognize stage-specific presentations, coordinate serologic monitoring, manage penicillin therapy protocols, perform contact tracing, and screen for complications.