SYPHILIS
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.
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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.
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Secondary
Syphilis
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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.
Additional
Information
Get additional information on this and other diseases by
clicking here.
