What is it?
Syphilis is an ancient illness first described in the 15th century. It is a sexually transmitted disease caused by the bacteria, Treponema pallidum. This infection has been increasing in the world, infecting 20 people out of every 100,000. It has been especially prevalent in large cities.
Common Signs & Symptoms
Syphilis is a three-staged disease. In the first stage (”primary syphilis”), one or more painless skin ulcers (chancres), form at the site of inoculation.
|Primary Syphilis (Chancre)|
Two to eight weeks after the chancre heals, “secondary syphilis” begins. In this stage, the Treponema bacteria spreads throughout the body causing many possible types of rash, including the palm rash seen in the photo below. Commonly the rash is found on the palms and soles.
Because the rash can take so many different appearances, syphilis has been called “the great imitator”. A fever, sore throat, swollen glands, and just feeling lousy often occurs with secondary syphilis. Like primary syphilis, the signs & symptoms of secondary syphilis go away on their own.
Syphilis then becomes quiet (latent) for many years (with possible flares of secondary syphilis symptoms occurring from time to time). “Tertiary”, or late syphilis, often occurs 15 years or so after the initial chancre, and slowly gets worse and worse. It affects the brain and spinal cord, often causing mental illness and paralysis. It can also affect the heart causing inflammation of the aorta, and the deeper skin causing “gummas” which are rubbery lumps in the skin. In patients with HIV, many of the above classical signs & symptoms are not present, or are quite different.
Like many of the sexually transmitted diseases, a pregnant mother with syphilis can give it to the baby while in the womb. So called, congenital syphilis, can cause the baby to die before it is born (stillbirth). In those babies who survive, symptoms can involve the eyes, teeth, bones, liver, glands, lungs, and brain.
How’s it Diagnosed?
Syphilis is spread by touch of a chancre or one of the secondary rashes.These rashes are teeming with the bacteria. Diagnosis is made by taking a sample from the chancre and finding the cork-screwed shaped spirochete bacteria under the microscope (pictured).In those already in the latent phase, blood tests (RPR, VDRL, and FTA-ABS) can also alert the doctor to an infection. (All pregnant women have one of these blood test done, and many states still require one of these blood tests done before a marriage license will be issued.) Obviously, all sexual partners exposed to somebody with syphilis should be contacted and tested for the illness.
How’s it Treated?
Penicillin is still the first choice treatment in every stage of this illness, and usually cures the disease. Careful follow-up by the doctor is needed to be sure the disease is cured and does not return.
How do I avoid Getting It (Prevention)?
Abstinence or good condom use is the key to avoiding this disease. As any skin exposed to a chancre or other syphilitic rash can become infected, condoms are not always effective.
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