Syphilis is a sexually transmitted disease caused by thin delicate spirochaetes, Treponema palladium. It is a chronic systemic infection and can be congenital or acquired. Congenital syphilis is transmitted by mother with early acquired syphilis to foetus and acquired syphilis is developed during life time by sexual intercourse with an infected person or by transfusion of infected blood.
Signs and Symptoms of Syphilis
Congenital syphilis is transmitted from an infected mother to its foetus. It is rare nowadays because of meticulous screening of pregnant females in antenatal clinics. Child born with congenital syphilis may show mucous patches on mouth pharynx and vagina and may also show bony lesions. Saddle nose appearance is characteristic of early congenital syphilis. Late lesions may appear in congenital syphilis in which characteristic Hutchinson’s teeth, mulberry molars or gummatous lesions of bones may be seen. Hutchinson’s teeth are notched, peg shaped permanent incisors.
Acquired syphilis is divided into 3 stages depending on the time period after which signs and symptoms of syphilis will appear and the type of lesions. 3 Stages of acquired syphilis are primary syphilis, secondary syphilis and tertiary syphilis.
It begins with a sore (Chancre) on genitals or extra-genital sites in 2-4 weeks after exposure to infection. This sore is firm and round. Chancre is painless initially and later, it ulcerates in the centre. Enlargement of regional lymph nodes may also occur in primary syphilis. Sore heals after 4-6 weeks without scarring, even in absence of treatment.
Photo Credit: Health68.com/health/conditions-diseases/migraine/headaches-may-plague-many-with-hiv-aids_28-22466.html
Secondary syphilis usually occurs 2-3 months after exposure to infection. This stage occurs once spirochaetes bacteria spread throughout the body. Generalized body infection leads to headache, fever, malaise and loss of appetite. Brown red patches which are symmetrical and non-itchy are seen on trunk and extremities. These rashes are wide spread and can be flat or elevated. These rashes usually last for weeks to months.
Superficial ulcers are also present on mucous membrane of mouth, throat and genitals in secondary stage of syphilis. Skin eruptions and lesions around anus can also be seen in this stage. There may be localized or generalized lymph node swelling present. In secondary syphilis, lymph nodes are enlarged, swollen, discrete and painless. In few cases, changes in cerebrospinal fluid (CSF) and patchy hair loss are also seen. Secondary syphilis is a highly infective stage.
This stage occurs after the signs and symptoms of secondary stage of syphilis have disappeared. There are no symptoms or signs in this stage and it can last for variable time period.
It occurs in one-third of untreated patients and may take ten or more years to develop. Onset of this stage is slow and progressive. Tertiary syphilis lesions are much less infective than other two stages. Common symptoms of tertiary syphilis are fever, bone pain, skin ulcers. Characteristic lesion of late syphilis is formation of gumma in organs like liver, testis, bone and brain. Tertiary syphilis may also produce irreversible damage to brain and heart and can also affect the nervous system.
Photo Credit: Drlauraberman.com/sexual-health/sexual-dysfunction/emotions-and-erections#/slide-3