What is syphilis?

Syphilis is a sexual transmitted disease of bacterial origin. The causative organism is Trepanoma pallidum, a spirochete bacterium. The course of the disease is divided in to fours stages – primary, secondary, tertiary and latent syphilis. It is also known commonly as lues. Syphilis occurs primarily by venereal contact. The condition can also be transmitted from an infected mother to her newborn.

What are the symptoms of syphilis?

Primary syphilis

In the primary form of syphilis lesions develop on the penis in males and vulva or cervix in females. The lesion is known as a chancre. It is slightly raised, ulcerated and non-bleeding in nature. It is usually painless unless infected. The lymph nodes become enlarged and rubbery in consistency.

Secondary syphilis

The secondary form of syphilis is highly contagious. In this stage mucocutaneous involvement is significant. Skin rashes, pigmentation and wart like lesions develop. Fever, sore throat and weight loss may also be experienced. Generalized lymph node enlargement is seen. Oral manifestations include mucous patches and snail track ulcers.

Latent syphilis

Latent syphilis is an asymptomatic condition which may develops after primary or secondary syphilis. The condition only shows positive serological findings.

Tertiary syphilis

Tertiary syphilis is characterized by development of ‘gumma’.Gumma is granulomatous lesion which later on ulcerates. The lesion can be present centrally or cortically. The nose becomes saddle shaped and patient is unable to stand erect unaided with his eyes closed. Deep punched out mucosal ulcers are seen in oral cavity.

What causes syphilis?

Syphilis is a sexually transmitted disease. The disease is caused by spirochete bacteria known as Trepanoma pallidum. The infection is primarily transmitted through sexual contact or by mother to child. The bacteria can be transmitted through intact mucous membrane contact or breached skin. The disease can also be transmitted by mucosal contact near a full blown lesion such as through kissing.Oral and vaginal forms of sex can also transmit the disease. The disease can also be transmitted by sharing infected needles or blood products. Unprotected sex increases the chances of getting the disease.

How is syphilis treated?

Treatment of primary and secondary uncomplicated syphilis includes a single dose of intramuscular penicillin. Those patients who are allergic to penicillin can be given alternative antibiotics like tetracyclines. Doxycycline is a tetracycline derivative that is effective in the treatment of syphilis.

Some patients after first injection of penicillin develop malaise, fever and rigors for a few hours. The reaction is peculiar to early syphilis and is known as Jarisch-Herxheimer reaction. To prevent this reaction prednisone can be administered prior to penicillin injection.

Pregnant mothers also need to be treated with antibiotics prior to delivery to ensure that the infection is not transmitted to the child during birth. If treatment is interrupted then in between it may be necessary to start it again from the beginning. Serological tests should be performed at regular intervals to confirm the cure of the disease. HIV testing and investigations for other sexually transmitted infections should also be conducted.


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