Treponema and Brachyspira

Abstract Spirochetal phylotypes identified in the human mouth belong exclusively to the genus Treponema . Brachyspira spp. are oxygen‐tolerant anaerobes differentiated by phenotypic growth characteristics and degree of beta‐hemolysis. The epidemiologic importance of Treponema denticola and other oral treponemes arises to a great extent from their occurrence as members of the polymicrobial consortium that causes gingivitis and periodontitis. Two Brachyspira species, Brachyspira aalborgi and Brachyspira pilosicoli , have been associated definitively with human intestinal spirochetosis. The method used for direct detection of Treponema pallidum depends upon the stage of disease, the clinical presentation, and the type of specimen obtained. T. pallidum can be detected in lesion exudate by darkfield microscopy or nucleic acid amplification tests. Most infants with congenital syphilis are asymptomatic at birth. Serologic tests play an important role in syphilis diagnosis by supplementing direct detection methods for early syphilitic lesions, for diagnosing latent infection, and confirming suspected tertiary disease.