Syphilis is a bacterial infection caused by the spirochete Treponema Pallidum and is considered STD. Syphilis is readily treatable with penicillin, but if left untreated, it may cause severe damage to most bodily organs and can be life-threatening.
Syphilis is known as "The great imitator", as it mimics. Syphilis patients are at an increased risk of contracting HIV. Transmission occurs primarily through carnal contact, but infection can also be passed from mother to child during pregnancy, through blood transfer, and through non-carnal direct contact with infected skin lesions. Previous infection does not provide immunity, and patients who have been cured can catch the disease again if exposed to an infected person.
Syphilis develops in 3 symptomatic stages:
- Primary Stage: The first sign of infection is often a single, firm, round sore that develops around the location of exposure (genitals or mouth), usually 2-10 weeks after contact
- Secondary
- Tertiary
Which are typically separated by periods of no symptoms. There is also a prominent latent phase between secondary and tertiary syphilis. The disease is highly contagious during the primary and secondary stages, and may remain contagious into the early latent phase. The average time from exposure to developing symptoms is 3 to 4 weeks. Primary syphilis typically presents with a single, painless, firm open sore, called a chancre, at the site of direct contact with the infected lesion. The chancre usually heals spontaneously after a few weeks and may go unnoticed in many patients. Without treatment, however, the bacteria spread into the bloodstream, and the disease progresses to the second stage, characterized by a body-wide rash. This typically occurs a few weeks after the chancre heals, but it may also overlap with the first stage in some patients who still have the chancre. The rash is usually prominent in the palms or soles and is not itchy. Patients may also have a fever, swollen lymph nodes, and wart-like sores in moist areas of the skin. Rashes, headaches, sore throats, jaundice, and hair loss are some less common symptoms. The symptoms usually resolve without treatment within a few weeks.
Following the secondary stage is the latent phase, which may last for years, during which time the bacteria remain dormant and there are no symptoms, but tests for syphilis are positive.
This stage is generally not contagious, but lesions may sometimes appear on the skin or mucous membranes, and direct contact with these lesions can transmit the disease.
Tertiary syphilis develops in about a quarter of untreated cases, years or decades after the original infection. There are three major forms:
- Gummatous syphilis
- Cardiovascular syphilis
- Neuro syphilis
Gummatous syphilis is characterized by the presence of soft lumps of inflammatory tissue called gummas, which can infiltrate and destroy any organ.
Cardiovascular syphilis affects the aorta and heart valves, causing aortic aneurysms and aortic valve disease.
Neurosyphilis can manifest as a number of problems in the nervous system: from meningitis, seizures, strokes, to hearing loss, visual impairment, speech disorders, dementia, and other mental disorders. Pregnant women with syphilis may spread the disease to their child through the placenta or via contact with infected lesions during birth. Congenital syphilis can cause miscarriage, stillbirth, or birth defects in newborns. Some neonates with congenital syphilis are asymptomatic at birth, but develop symptoms within a couple of years before entering the latent stage.
Diagnosis is by serological tests for antibodies against the bacteria in blood or cerebrospinal fluid samples. Dark-field microscopy may be used to visualize spirochetes from chancre exudates or lymph node aspirates. Most syphilis cases can be treated with penicillin. Earlier stages require only a single injection. Additional injections are needed for later stages. Some other antibiotics may be used for non-pregnant patients who are allergic to penicillin. Pregnant women with penicillin allergies should undergo desensitization, so they can be treated with penicillin. Patients may experience a reaction known as a Jarisch-Herxheimer reaction (JHR) on the first day of treatment. The reaction usually subsides within 24 hours, but patients must be warned and observed.
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