A Family Doctor's Tale - SYPHILIS

DOC I HAVE SYPHILIS

Syphilis is not common nowadays especially in developed countries with good health care.
It may still be present in Africa and other less developed countries with poor health care facilities and medications. I have not seen a single case in the family clinic although there were a few cases seen during my student and hospital work days.

Syphilis is a infectious sexually transmitted disease caused by the bacterium Treponema pallidum.
It can be acute, subacute or chronic depending on the stage.

Syphilis is passed from a infected person through direct contact with a infected sore which occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. The bacteria can penetrate through normal mucous membrane and minor abrasions of the epithelium.
Transmission of the organism usually occurs during sexual contact.
Pregnant women with the disease can pass it to the babies they are carrying.

The signs and symptoms of syphilis may occur in four stages: 


Primary
These signs may occur from 10 to 90 days after exposure:
1.A small, firm, painless sore (chancre) appears on the body where the syphilis enter the body, usually the genitals, rectum, tongue or lips. A single chancre is typical, but there may be multiple sores.
2.Enlarged lymph nodes in your groin.
The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

Secondary
 The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:
1.Rash marked by red or reddish-brown sores over any area of the body epecially the palms and soles. The rash usually does not cause itching.
2.Fever
3.Fatigue and a vague feeling of discomfort
4.swollen lymph glands,
5.sore throat, 
6.weight loss,
7.Soreness and aching

The signs and symptoms of secondary syphilis will resolve with or without treatment.
Without treatment, the infection will progress to the latent and late stages of disease.

Latent
A period called latent syphilis in which no symptoms are present may follow the secondary stage. Signs and symptoms may not appear or the disease may progress to the tertiary stage.

Tertiary
Without treatment, syphilis bacteria may spread, leading to serious internal organ damage including the brain, nerves, eyes, heart, blood vessels, liver, bones,joints and finally death years after the original infection.
1.Neurological problems. These may include stroke; infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.
2.Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta  and of other blood vessels. Syphilis may also cause valvular heart disease, such as aortic valve insufficiency.

Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.

The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease. Untreated babies may become developmentally delayed, have seizures, or die.

Diagnosis is by:
1. dark-field microscope:  examining material from a chancre using this microscope.
If syphilis bacteria are present in the sore, they will show up when observed through the microscope.

2.A blood test for syphilis antibodies is accurate, safe, and inexpensive. 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.

Syphilis is easy to cure in its early stages.
Treatment with intramuscular injection of penicillin can kill the organism that causes syphilis.
If you're allergic to penicillin, other antibiotics such as erythromycin will kill the syphilis bacterium.
Treatment however will not repair damage already done.
Left untreated, the disease can lead to serious complications or death.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

Even if you were treated for syphilis during your pregnancy, your newborn child should receive antibiotic treatment.

To make sure you're responding to the usual dosage of penicillin, your doctor likely will want you to have periodic blood tests.Blood test may remain positive up to 18 months even after successful treatment of syphilis.

Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.

The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to 
1.abstain from sexual contact or
2.in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
3.Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior.
4.Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected.
5.Complications from syphilis such as neurosyphilis are rare because of better diagnosis and treatment