Syphilis
Source :
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002303/
Source :
http://en.wikipedia.org/wiki/Syphilis
what is Syphilis
Syphilis is an STD caused by the bacteria Treponema pallidum. It's sometimes called the "great imitator" because early symptoms are so similar to other diseases. The disease proceeds through stages -- In primary syphilis, a chancre -- an open sore that's usually painless -- appears, most commonly on the genitals, usually 10-90 days after exposure. In secondary syphilis, a skin rash appears, on any part of the body, including palms of hands & soles of feet. In tertiary syphilis, the disease spreads to internal organs, where it can do serious damage. A pregnant woman can pass the disease on to her child. Having syphilis makes a person more susceptible to HIV. Early diagnosis is important because syphilis is readily treatable with antibiotics.
Causes, incidence, and risk factors
Syphilis is a sexually-transmitted infectious disease. The bacteria that cause it spread through broken skin or mucous membranes.
Pregnant mothers infected with the disease can pass it to the baby developing in their womb. This is called congenital syphilis.
Syphilis is widespread in the United States. It mainly affects sexually active adults ages 20 to 29.
Syphilis has several stages.
Primary syphilis is the first stage. Painless sores ( chancres) form at the site of infection about 2-3 weeks after you are first infected. You may not notice the sores or any symptoms, particularly if the sores are inside the rectum or cervix. The sores disappear in about 4-6 weeks, even without treatment. The bacteria become dormant (inactive) in your system at this stage. For more specific information about this type of syphilis, see primary syphilis.
Secondary syphilis occurs about 2-8 weeks after the first sores form. About 33% of those who do not have their primary syphilis treated will develop this second stage. These symptoms will often also go away without treatment and again, the bacteria become dormant (inactive) in your system. For more specific information about this type of syphilis, see secondary syphilis.
Tertiary syphilis is the final stage of syphilis. The infection spreads to the brain, nervous system, heart, skin, and bones. The dormant bacteria may be detectable either by seeing the damage they cause to a part of the body, or through a blood test for syphilis. For more specific information about this type of syphilis, see tertiary syphilis.
Symptoms
The symptoms of syphilis depend on the stage of the disease. Many people do not have symptoms.
In general, painless sores and swollen lymph nodes are possible symptoms of primary syphilis. Those with secondary syphilis may also have fever, fatigue, rash, aches and pains, and loss of appetite, among other symptoms. Tertiary syphilis causes heart, brain, and nervous system problems.
Signs and tests
Blood tests can be done to detect substances produced by the bacteria that cause syphilis. The older test is the VDRL test. Other blood tests may include RPR and FTA-ABS.
Treatment
Antibiotics are an effective treatment for syphilis. The antibiotic of choice is penicillin. The dose and how it's given (into a muscle or into a vein) depend on the stage of syphilis. Doxycycline may be used as an alternative treatment in individuals who are allergic to penicillin.
Several hours after treatment of early stages of syphilis, you may have a reaction called Jarish-Herxheimer reaction. Symptoms of this reaction include:
Chills
Fever
General feeling of being ill
General joint aches
General muscle aches
Headache
Nausea
Rash
These symptoms usually disappear within 24 hours.
You must have follow-up blood tests at 3, 6, 12, and 24 months to make sure the infection is gone. You should avoid sexual conduct until two follow-up tests show that the infection has been cured. Syphilis is extremely contagious through sexual contact in the primary and secondary stages.
Syphilis is a reportable infection. That means that doctors must report any cases of syphilis to public health authorities, so that potentially infected sexual partners may be identified and treated.
Expectations (prognosis)
With prompt treatment and follow-up care, syphilis can be cured.
Late-stage syphilis can lead to long-term health problems, despite therapy.
Syphilis increase the risk of HIV transmission by 2 to 5 times and co infection is common (30-60% in a number of urban centers).[1][2] Untreated it has a mortality of 8% to 58% with a greater death rate in males.[1]
Complications
Complications of untreated syphilis include:
Damage to the skin and bones
Heart and blood vessel problems, including inflammation and aneurysms of the aorta
Neurosyphilis
Prevention
If you are sexually active, practice safe sex and always use condoms.
All pregnant women, people with HIV, and others at increased risk for having syphilis should be screened for syphilis.
Epidemiology
Syphilis is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world.[2] It affects between 700,000 and 1.6 million pregnacies a year resulting in spontaneous abortions, stillbirths, and congenital syphilis.[6] In Sub Saharan Africa syphilis contributes to approximately 20% of perinatal deaths.[6]
In the developed world, syphilis infections were in decline until the 1980s and 1990s due to widespread use of antibiotics. Since the year 2000, rates of syphilis have been increasing in the USA, UK, Australia and Europe primarily among men who have sex with men.[2] This is attributed to unsafe sexual practices.[2] Increased rates among heterosexuals have occurred in China and Russia since the 1990s.[2]
Model of the head of a patient with tertiary syphilis.