Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum.
It progresses through distinct stages and can cause serious health problems if left untreated.
Syphilis can affect multiple organs and systems in the body, including the skin, mucous membranes, nervous system, and cardiovascular system.
Stages of Syphilis
1. Primary Syphilis:
Timeline: Occurs about 3 weeks after exposure but can range from 10 to 90 days.
Symptoms: Characterized by a single sore, called a chancre, which appears at the site where the bacteria entered the body (typically the genitals, anus, or mouth). The chancre is usually painless, firm, and round.
Healing: The chancre heals on its own within 3 to 6 weeks, but the bacteria remain in the body.
2. Secondary Syphilis:
Timeline: Typically starts 2 to 8 weeks after the chancre appears.
Symptoms: Includes skin rashes (often on the palms of the hands and soles of the feet), mucous membrane lesions, fever, swollen lymph nodes, sore throat, hair loss, headaches, weight loss, muscle aches, and fatigue.
Healing: Symptoms may resolve without treatment, but the infection progresses to the latent stage if untreated.
3. Latent Syphilis:
Timeline: Begins when primary and secondary symptoms disappear.
Symptoms: No visible symptoms. This stage can last for years. Latent syphilis can be early (within a year of infection) or late (more than a year after infection).
Infectivity: Early latent syphilis can still be contagious, while late latent syphilis is usually not.
4. Tertiary Syphilis:
Timeline: Can occur 10 to 30 years after the initial infection.
Symptoms: Severe medical problems including damage to the heart, blood vessels, brain, nerves, liver, bones, and joints. Manifestations include gummas (soft, non-cancerous growths), neurosyphilis (affecting the nervous system), and cardiovascular syphilis.
Severity: Can be life-threatening and cause significant disability.
Etiology
Causative Agent: The bacterium Treponema pallidum.
Transmission: Primarily through direct contact with a syphilitic sore during vaginal, anal, or oral sex. It can also be transmitted from mother to baby during pregnancy or childbirth, leading to congenital syphilis.
Pathogenesis
Entry: The bacterium enters the body through breaks in the skin or mucous membranes.
Dissemination: Treponema pallidum spreads through the bloodstream and lymphatic system.
Invasion: The bacterium can invade various organs and tissues, causing widespread infection.
Immune Response: The body mounts an immune response, but the bacteria can evade this response, leading to chronic infection if untreated.
Symptoms
1. Primary Stage:
Chancre at the infection site.
2. Secondary Stage:
Skin rashes, especially on palms and soles.
Mucous membrane lesions.
Fever, swollen lymph nodes, and sore throat.
Patchy hair loss.
Muscle aches, fatigue, and headaches.
3. Latent Stage:
No visible symptoms.
4. Tertiary Stage:
Gummas on various organs.
Neurosyphilis: Symptoms include severe headache, difficulty coordinating muscle movements, paralysis, numbness, and dementia.
Cardiovascular syphilis: Involvement of the heart and blood vessels, potentially leading to aneurysms or valve disease.
Diagnosis
Physical Examination: Identification of sores, rashes, or other symptoms.
Blood Tests:
I. Nontreponemal Tests: Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests to screen for syphilis.
II. Treponemal Tests: Fluorescent treponemal antibody absorption (FTA-ABS) and Treponema pallidum particle agglutination (TPPA) tests to confirm diagnosis.
Direct Detection: Darkfield microscopy or PCR to detect Treponema pallidum in samples from sores.
Treatment
1. Antibiotics:
Primary and Secondary Syphilis: A single intramuscular injection of benzathine penicillin G.
Latent Syphilis: Longer courses of benzathine penicillin G (three doses over three weeks).
Neurosyphilis: Intravenous penicillin G for 10-14 days.
2. Alternatives for Penicillin-Allergic Patients:
Doxycycline or tetracycline (for non-pregnant individuals).
Close monitoring and desensitization to penicillin for pregnant women.
Follow-Up:
Regular blood tests to ensure treatment effectiveness.
Evaluation and treatment of sexual partners.
Prevention
Safe Sex Practices: Use of condoms and dental dams.
Regular Screening: Particularly for sexually active individuals with multiple partners or those in high-risk groups.
Education and Awareness: Informing people about the risks and symptoms of syphilis.
Prompt Treatment of Infected Individuals: To prevent the spread of the infection.
Complications
Untreated Syphilis: Can lead to severe and irreversible damage to the heart, brain, and other organs.
Congenital Syphilis: Infection in newborns can cause severe complications, including deformities, neurological issues, or even death.
Syphilis is a serious infection but can be effectively treated and cured with appropriate antibiotics if diagnosed early.
Regular screening and prompt treatment are crucial in managing the disease and preventing its complications.