SYPHILIS
Syphilis is a sexually transmitted disease (STD) & is a bacterial infection usually
transmitted by sexual contact. Syphilis is found worldwide, and is the third most common
STD. The disease affects genitals, skin and mucous membranes, but it may also involve
many other parts of the body, including brain and heart.
Causes
The bacterial organism that causes syphilis is Treponema pallidum (fig 1). This
organism is extremely sensitive to light, air and changes in temperature. It can live only
within the human body.
It enters body through minor cuts or abrasions
in skin or mucous membranes. The most
common route of transmission is through
contact with an infected person's sore during
sexual activity. Other routes are through
transfusion of infected blood, through direct
unprotected close contact with an active lesion
(such as during kissing), and through an
infected mother to her unborn child during
pregnancy.
Fig.1 Bacteria causing Syphilis
Treponema pallidium.
Symptoms
Syphilis, typically first appears as a sore on the area where there has been sexual contact
with the infected person. If the infection goes untreated, it can progress to affect the
entire body.
Syphilis typically has three stages with varying symptoms - primary, secondary and
tertiary.
Primary: These signs may occur from
10 days to three months after exposure:
A small, painless sore on the
part of the body where the
infection was transmitted,
usually genitals, rectum, tongue
or lips. A single sore is typical,
but there may be multiple
sores(As seen in above pictures).
Enlarged lymph nodes in the
groin.
Fig.2 A sore over the upper lip of a person
a. Sore over vagina. b. Sore over Penis.
Fig.3 Primary Syphilis seen over sex organs.
Secondary: The symptoms of secondary syphilis may begin three to six weeks after the
sore appears, and may include:
Rash marked by red or reddish-
brown, small coin sized sores
over any area of the body,
including palms and soles (Fig.5)
Fever
Fatigue and a vague feeling of
discomfort
Pain in bones or joints.
Fig.4 Rashes over the hand of a person –
Secondary syphilis.
Tertiary: If the Syphilis is not treated in the first two stages, it will lead to tertiary stage
which is a serious stage involving spread and damage of internal organs which may lead
to death.
Neurologic problems. These may include stroke, infection of the brain and spinal cord
(meningitis), poor muscle coordination, numbness, paralysis, deafness or visual
problems, personality changes, and loss of memory (dementia).
Cardiovascular problems. These may include bulging and infection of large blood
vessels.
These signs and symptoms may disappear and reappear for up to two years.
Congenital: This type of Syphilis passed from mother (who is suffering from Syphilis) to
child during fetal development. The bacteria
will pass through the placenta to the fetus.
This type of disease is a serious condition and
can cause abortion. Even if the child is born it
will have lot of abnormalities and defects.
Some of the commonest problems seen in the
infant are- nasal discharge, nasal defect, bone
diseases, defect in the teeth, defect in the
brain, defect in the eyes and defect in the
ears.
Fig.5 Congenital syphilis- Child with
defective teeth.
Diagnosis
If any painless sores in the genital area and enlarged lymph nodes in the groin area is
noticed then immediately it should be reported to doctor. Treatment in the early stages of
syphilis can prevent serious, long-term illness and spread of the disease. To diagnosis
syphilis, following tests may be done
Tests:
Some of the tests used in diagnosis are,
1. Microscopic examination of the lesion looking for Treponema palladium bacteria.
2. Serological Tests: - These tests detects antibody for T. palladium bacteria.
E.g.: Fluorescent Treponemal Antibody absorption test (FTA-abs).
3. VDRL Test: Venereal Disease Research Laboratory test. This is a non specific test
for Syphilis. This is a routinely conducted test.
Complications
Untreated syphilis can lead to destruction of soft tissue and bone, heart failure, blindness
and a variety of other conditions. A female with untreated syphilis may transmit the
disease to her unborn child, which may result in death or deformity of the child. Doctors
are required to test pregnant females for syphilis at pregnancy. Tests of newborns of the
infected women are required at the time of delivery. People with syphilis also have an
increased risk of contracting HIV-AIDS. A syphilis sore can provide an easy way for
HIV to enter the bloodstream during sexual intercourse.
Treatment
Early diagnosis and treatment with penicillin can kill the organism that causes syphilis
and stop the progression of the disease. Left untreated, the disease can lead to serious
complications or death. Some of the medicines in use are penicillin, , doxycycline,
amoxycillin combined with probenocid, ceftriaxone & azithromycin.
Prevention
To reduce the risk of syphilis and other sexually transmitted diseases, one has to adhere
to practice of safe sex and follow ABC guideline, that is-
Abstinence - Not having sex before marriage or practicing it with more than one
sexual partner.
Being faithful towards your spouse.
Condoms should be used for any type of sex with any other.
Apart from the above, following steps have to be taken to prevent STD.
Avoid excessive use of alcohol or other drugs, which can cloud judgment and lead
to unsafe sexual practices.
A pregnant woman can avoid passing syphilis on to her unborn child by getting
tested and treated for the disease during pregnancy.
Conclusion
Lack of education and unsafe sex is triggering a rise in syphilis incidence all along,
particularly in urban areas. Although fortunately there is a cure for syphilis, the ultimate
goal is to prevent and control the spread of this infectious disease. The most important
step in this process is by bringing awareness among common man by doctors & other
social activists to put an end to this lethal disease.