Overview
Syphilis is an inflammatory disease caused by infection with the bacterium Treponema pallidum, affecting multiple organs of the body. It is primarily transmitted through sexual contact, though it can also spread from an infected mother to her unborn child. Without treatment, syphilis can lead to serious complications affecting various systems of the body, including the central nervous system and cardiovascular system.Medical Departments Involved
This condition is treated by specialists in infectious diseases, urology, gynecology, and dermatology.What is Syphilis?
Syphilis is a sexually transmitted infection (STI) caused by the spirochete bacterium Treponema pallidum. It is mainly spread through direct contact during sexual activity but can also be passed from mother to fetus. Though primarily associated with genital areas, it can affect the entire body, leading to severe inflammatory conditions in various organs.Causes
Syphilis is caused by the bacterium Treponema pallidum, which is transmitted through direct contact with syphilitic sores, often found on the genitals, anus, or rectum, and sometimes the mouth. The bacterium can also be transmitted from an infected mother to her baby during pregnancy. It is important to note that syphilis cannot be contracted through non-sexual means like using public restrooms, swimming pools, or sharing personal items.Symptoms
Syphilis progresses in distinct stages, each with its own set of symptoms:Primary Syphilis
The main symptom of early syphilis is a painless ulcer, known as a chancre. This sore generally appears at the site where the bacterium entered the body, most commonly the genital area or around the anus. The chancre is firm, round, and painless, appearing 10 to 90 days after infection and typically healing on its own in 3 to 6 weeks. Without treatment, syphilis will advance to the next stage.Secondary Syphilis
As the chancre heals, syphilis may progress to the secondary stage, which is characterized by a skin rash and mucous membrane lesions. The rash often appears on the palms of the hands and soles of the feet, which is a distinctive feature of this disease. Other symptoms may include fever, swollen lymph nodes, sore throat, headaches, muscle aches, and weight loss.Latent Syphilis
After the symptoms of secondary syphilis resolve, the infection can enter a latent phase, where no visible symptoms are present. This stage can last for years, and although the bacteria remain in the body, the disease may not cause any apparent issues unless it progresses to the tertiary stage.Tertiary (Late) Syphilis
Without treatment, syphilis can progress to tertiary syphilis, which may occur years after the initial infection. This stage can involve severe damage to internal organs such as the brain, heart, liver, bones, and joints. Common symptoms include cardiovascular problems and neurological complications.Neurosyphilis
Syphilis can also invade the nervous system at any stage of infection, leading to neurosyphilis. Symptoms may include headaches, altered behavior, and even stroke-like symptoms if the infection affects the brain's blood vessels.Diagnosis
Diagnosing syphilis involves either direct examination of the bacteria or blood tests:Direct Observation: Samples from syphilitic sores can be examined using a dark-field microscope to detect the Treponema pallidum bacteria.
Serological Testing: Blood tests such as the VDRL (Venereal Disease Research Laboratory) or RPR (Rapid Plasma Reagin) tests are commonly used to screen for syphilis. While these tests are quick and effective, false positives can occur in certain conditions like viral infections, lymphomas, tuberculosis, or pregnancy. For a more definitive diagnosis, specific tests like the FTA-ABS (Fluorescent Treponemal Antibody Absorption) or TPHA (Treponema pallidum Hemagglutination Assay) are performed.
If neurosyphilis is suspected, a spinal tap may be done to analyze the cerebrospinal fluid.
Treatment
The treatment for syphilis depends on the stage of the disease:- In the early stages (primary, secondary, or early latent syphilis), a single dose of intramuscular penicillin is typically sufficient.
- For late latent syphilis or cases without nervous system involvement, penicillin is administered once weekly for three weeks.
- If neurosyphilis is present, more intensive treatment with intravenous penicillin is necessary for 10–14 days.
Patients allergic to penicillin may require alternative antibiotic treatments.
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