Syphilis is sexually transmitted disease (STD) caused by spirochaetes. This chronic systemic infection can cause sore lesions on genital and extra genital sites and if not treated can even cause death. Syphilis can be congenital that is transmitted by infected mother to the foetus or it can be acquired during life.
Mode of Transmission of Syphilis
Syphilis can be transmitted by sexual contact with an infected partner. Intimate contact with person having syphilitic lesion on lips, tongue or finger can also cause this STD. Syphilitic infection can also be transmitted by transfusion of infected blood. A person is at risk of this disease if he has vaginal, anal or oral sex with an infected person.
Stages of Syphilis
There are 3 stages of acquired syphilis; primary, secondary and tertiary syphilis depending on the time period after which syphilic lesions appear. In primary stage of syphilis, painless sores appear on genitals or extra genital sites in 2-4 weeks after exposure to infection. Secondary syphilis occurs 2-3 months after exposure and is a highly infective stage.
Mucous and vaginal ulcerations, rashes, lymph node enlargement and skin eruptions occur in this stage. Tertiary syphilis occurs few years after exposure to infection and lesions in liver, heart and nerve are seen in this stage. Tertiary syphilis lesions are less infective as compared to primary and secondary syphilis lesions.
Diagnosis of Syphilis
Syphilis can be diagnosed in the laboratory either by dark field microscopy or by serological tests. Causative bacteria, Treponema palladium may be found in primary sores or secondary mucous ulcerations. Specimen is taken and examined to reach a confirm diagnosis. Serological tests give positive results after 4 weeks of exposure to infection and are strongly positive in secondary stage of syphilis and congenital syphilis.
Treatment and Management of Syphilis
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If diagnosed in initial stages, disease becomes easy to cure. Syphilis can be treated with penicillin antibiotic. Spirochaete, Treponema palladium is sensitive to penicillin. Procaine penicillin or Benzathine penicillin can be given to syphilitic patients. Medicament dosage and duration varies with stages of syphilis.
Procaine penicillin is given in dosage of 600-1200 mg daily for 10-14 days and Benzathine penicillin injection can be administered intramuscularly on buttocks. Higher dosage of procaine penicillin and Benzathine penicillin is given in advanced tertiary syphilis and cardiovascular, neurovascular syphilis that too for a longer duration of time.
In patients allergic to penicillin, tetracycline or erythromycin can be administered. Surgical intervention is required for treatment of complications of advanced tertiary stage. Apart from antibiotics, there is no natural cure for this chronic systemic infection. Patients receiving syphilitic treatment therapy should abstain from oral, anal and vaginal sex until the syphilitic lesions are cured completely.
Prevention of Syphilis
To prevent spread of syphilis infection, patients need to be educated about safe sex. Intravenous needles should not be shared. Meticulous screening of all pregnant females should be done in antenatal clinics. Risk of this sexually transmitted disease can also be diminished with proper use of latex condom. Medical personnel should also be educated to observe some precautions when treating patients with syphilis.
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