Syphilis is a sexually transmitted infection caused by Treponema pallidum and characterized by the appearance of a painless ulcer or chancre at the site of inoculation, associated with regional lymphadenopathy; shortly after inoculation, syphilis becomes a systemic infection with characteristic secondary and tertiary stages. During the past few years, the incidence of syphilis has increased and the clinical course and response to standard therapy may be altered in HIV-infected patients.
Causes of Syphilis
T.pallidum does not live or cause disease outside the human body. It is spread from person to person through direct contact with an infectious lesion. The spirochetes, passing through intact mucous membrane and abraded skin, divide locally, with resulting host inflammatory response and chancre formation, either a single lesion or, less commonly, multiple lesions. Primary syphilis is the most contagious stage of the disease. Shortly after invasion, spirochetes are then carried by the blood stream to every organ in the body. Later syphilis is essentially a vascular disease, lesions occurring secondary to obliterative endarteritis of terminal arterioles and small arteries and by the resulting inflammatory and necrotic changes.
Symptoms of Syphilis
Primary syphilis:
- chancres — (usually single yet may be multiple) painless sores on genitals, rectum, or mouth
- enlarged lymph nodes in the area adjacent to the chancre
Secondary syphilis:
- skin rash — usually throughout the body with both flat and raised patches which may involve the palms and soles of the feet.
- hair loss (alopecia)
- general symptoms such as fever, fatigue, loss of appetite, and aches and pains in bones
Tertiary syphilis:
- infiltrative, destructive lesions of skin, bones, or liver (gummatous syphilis)
- central nervous system disorders with involvement of the meninges, brain, spinal cord, eye, or auditory system.
Diagnosis
Some health care providers can diagnose syphilis by examining material from a chancre (infectious sore) using a special microscope called a dark-field microscope. If syphilis bacteria are present in the sore, they will show up when observed through the microscope.
A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe, and inexpensive blood test. A low level of antibodies will stay in the blood for months or years even after the disease has been successfully treated. Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.
Treatment
Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.
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