Syphilis
Syphilis ( Greek syn, together, and philein, love ) is a contagious ulcerative disease caused by the spirochete Treponema pallidum palladium. Infection occurs through intimate contact with the infected lesion of a sexual partner. Several slang words have called syphilis, but it has been known as the ” great imitator” as its signs and symptoms mimic those of other diseases. The signs and symptoms depend on the stage of
- Primary
- Secondary
- Latent
- Tertiary
Initial signs of infection may be obscured, depending on the bacterial entry sites. Congenital syphilis is a disease acquired in utero from mother to child.
Mechanism Action of Pallidum:
T . Pallidum enters the body through mucous membranes, minor breaks, or abrasions of the skin. IItreplicates locally, inducing an ulceration, before it migrates to the regional lymph nodes, where it rapidly spreads throughout the body. Three recognized stages of syphilis occur in untreated individuals.
1- Primary Stage:
In the primary stage, after an incubation period of about 10 days to 3 weeks or more,
Symptoms:
- Painless
- Reddened
- Ulcer
- Chancre ( French, meaning destructive sore ) is a hard rigid that appears at the infection site and contains spirochetes.
Chancre And its Symptoms:
Contact with chancre during sexual contact may result in disease transmission. In about one-third of the cases, the disease does not progress further and the chancre disappears. SSerologicaltests are positive in about 80% of the individuals during this stage. The spirochete typically enters into the bloodstream and is distributed throughout the body. Within 2 to 10 weeks after the primary lesion appears, the disease enters into secondary stage.
2- Secondary Stage:
Which is characterized by a highly variable skin rash. By this time, 100% of the individuals are serologically positive.
Symptoms of Secondary Stage:
- Loss of hair in patches
- Malaise
- Fever
- Both chancre and rash are infectious
3- Latent Stage:
After several weeks, the disease becomes latent. During the latent period, the disease is not normally infectious except for possible transmission from mother to fetus. After many years a tertiary stage develops in about 40% of untreated individuals with secondary syphilis. During this stage masses of dead, fibrous tissues called Gummas from the skin, bone, and nervous system are termed as the result of hypersensitivity reactions. This stage is also characterized by a great reduction in the number of spirochetes in the body. Involvement of the central nervous system may result in tissue loss that can lead to
- Cognitive deficits
- Blindness,
- A shuffle walk or insanity
Many of these symptoms have been associated with such well-known people as
- Al Capone
- Francisco Goya
- Henry V III
- Adolf Hitler
- Scott Joplin
History Of Syphilis:
Syphilis was first recognized in Europe near the end of the fifteenth century. During this time the disease reached epidemic proportions in the Mediterranean areas. According to one hypothesis, syphilis is a new world origin and Christopher Columbus ( 1451-1560 ) and his crew acquired it in the West. Syphilis was initially called Italian disease, the French disease, and the great pox as distinguished from smallpox. Recognition of syphilis stages was demonstrated in 1838 by Philippe Ricord, who reported his observation on more than 2500 human inoculations.
Diagnosis of Syphilis:
Diagnosis of syphilis is through a clinical history.
- Physical examination
- Dark-field and immunofluorescence examination of lesion fluid for typical spirochetes
- Serologically Tests are very informative including VDRL and treponemal antibodies.
- PCR testing is also available to amplify and identify specific treponemal genes
Treatment Of Syphilis:
Treatment in the early stages of the disease is easily accomplished with a single dose of long-term acting.
- Benzathine Penicillin G
- A single dose of Azithromycin
Prevention Of Syphilis :
Prevention and control of syphilis depend on
- Public Education
- Prompt and adequate treatment of all new cases
- Follow-up on sources of infection and contacts so they can be treated,
- Prophylaxis to prevent exposure
At present, the incidence of syphilis as well as other sexually transmitted diseases is rising in most parts of the world. Between 1990 to 2000, the rates of syphilis declined 9 by 0% before increasing between 2001 and 2009. The rates began to decline again at 2in 010. An estimated 12 million new cases occur each year.
Summary:
In the United States, the rate of primary and secondary syphilis, in the civilian population declined 8 by 9.7% between 1990 and 2000. Unfortunately, the rate increased yearly between 2001 and those twenty-five to twenty-nine years of age. In 2010 there was a slight decrease in reported cases of syphilis. Importantly, syphilis incidence has increased worldwide as a secondary infection in HIV-positive individuals, conversely, untreated syphilis makes a person more susceptible to HIV infection.