Syphilis (Treponema Pallidum Infection)

Definition

Syphilis is a bacterial infection that is mainly transmitted through sexual contact. The infection usually starts with a chancre, a typical painless sore of syphilis, which develops at the site of entry of bacteria into the body. The location of the chancre can vary but is usually on the penis or in vagina, rectum or mouth. Although syphilis is a treatable infection, it does alert to the possibility of other sexually transmitted infections including HIV infection. Babies may contract syphilis from mothers during normal vaginal birth.

Symptoms

Syphilis can be classified into four stages depending on the duration of the disease. Varying symptoms are seen in different stages of syphilis.

Primary syphilis

Development of a painless sore or chancre, usually one but multiple may be present, usually develop is seen within a few weeks of exposure. It may go unnoticed and may heal on its own.

Secondary syphilis

Development of a non-itchy rash may develop after a few weeks of healing of the chancre usually beginning on the trunk and gradually spreading to the whole body including the palms of hand and soles of feet. Sores may be seen in the mouth or genital area. Other symptoms such as fatigue, body ache, swollen lymph nodes, fever and a sore throat may develop. The symptoms resolve within a few days but may keep recurring at intervals.

Latent syphilis

Untreated syphilis may go unnoticed when no symptoms are present. This stage can last for years or the symptoms may never recur. Such untreated syphilis may also further complicate into tertiary syphilis. The person may still be contagious in the early phases of the latent stage.

Tertiary or late syphilis

Syphilis which is untreated may complicate into tertiary or late syphilis. In this state the disease may spread to the brain, eyes, nervous system, heart, liver, bones, joints and blood vessels. Complications may occur very late, even after years of having the infection. Bumps called gummas can develop on the skin or any other organ such as bones or liver in late infections. Gummas cure with antibiotic treatment. Neurologic complications such as deafness, vision problems, meningitis, stroke, memory loss may occur. Cardiovascular complications include aneurysm formation or even damage to the heart valves.

Causes

Syphilis is a bacterial infection caused by the bacterium Treponema pallidum commonly spread through direct or sexual contact with the infected chancre. The bacteria may enter the skin through cuts or breaks in skin or mucosa. The disease is contagious in its primary and secondary stages and rarely in the early latent period. Congenital syphilis may be seen in newborns through spread of the infection from the infected mothers. Complications of pregnancy such as miscarriage or death of the baby within a few days may occur in among pregnant mother. Unprotected sex and having multiple sexual partners are the risk factors for syphilis.

Treatment

Blood antibody testing, culture of sores and CSF culture helps in the diagnosis of syphilis. Treatment of syphilis may not reverse the damage already caused due to the infection especially in the tertiary stage but can prevent further damage. Syphilis is easy to treat in early stages. Penicillin is the drug of choice. People who are allergic to penicillin may require desensitization to penicillin before treatment or may need to be treated with other antibiotics. All sexual partners are also treated. Sexual contact is avoided until treatment is complete and the infection has completely resolved.

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