Syphilis
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Syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. 



Reservoir

Humans.


Incubation period
From 10 days to 3 months, usually 3 weeks.


Mode of Transmission
It is transmitted from person to person sexually by direct contact with a syphilis sore (see below). They are generally present on the external genitals, vagina, anus or in rectum, lips and mouth.
Pregnant mothers can pass it on to their babies during their pregnancy and can result in:
  • Stillbirth or baby dies shortly after birth
  • Low birthweight

If babies are not treated immediately, they may develop serious complications within a few weeks. These include:

  • seizures,
  • delayed developmental stages
  • and even death

Signs and Symptoms

Primary Infection
A papule develops at the site of infection which ulcerates to become a painless, firm chancre which heals spontaneously within 2 - 3 weeks.

Secondary Infection
May be asymptomatic (no symptoms)
Within 4 - 10 weeks after the primary infection, there may be one or more of the following features:

  • Fever
  • Headaches
  • Sore throat
  • Arthrlagia
  • Fatigue
  • Patchy hair loss
  • Muscle aches
  • Generalized swollen lymph nodes
  • Widespread skin rash
  • Superficial ulcers in the mouth
  • Warty perianal lesions

Tertiary Infection

  • This occurs after a latent period of 2 years or more
  • May develop altered mental status
  • Neurological problems
  • Heart problems
  • A characteristic granulomatous lesion (gamma) develops in the skin, bones, liver and testes.

Congenital Syphilis

This presents between the second and sixth weeks after birth, early signs being:

  • nasal discharge,
  • skin and mucous membrane lesions
  • failure to thrive

Signs of late syphilis appear after 2 years of age when there are also characteristic bone and teeth abnormalities from earlier damage.


Diagnosis
Dark-field microscope: Examination of material from the chancre.

Blood tests:

  • May be negative in primary infection.
  • VDRL test: Positive within 3 - 4 weeks of infection, becomes negative in treated patients and in
  • some with late tertiary syphilis.
  • TPHA Treponema pallidum haemagglutination (Cofirmatory test - carried out when the VDRL
  • test is positive).
  • EIA - IgG and IgM.


Treatment

  • Antibiotics prescribed by medical doctor.
  • Treatment during early stages of syphilis (less than a year): two intramuscular injection of penicillin (unless allergic to penicillin).
  • Syphilis longer than a year: additional antibiotic doses.
  • Treatment will not repair damage already done by the disease.

Control and Prevention

  • Early detection and treatment of gonorrhoea.
  • Avoid multiples sexual partners - use condoms.
  • One should refrain from sexual intercourse while on treatment and should not have sex with previous sexual partners (within 60 days) until they have been tested and treated accordingly.
  • Newborns born to infected mothers should receive prophylaxis.
  • One should take care when disposing of discharges from lesions and contaminated articles.
  • If you would like further information or wish to make an appointment you can contact the GU Clinic on 21227981.

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