Syphilis

This is the most commonly sexually transmitted infectious disease caused by the bacterium spirochete Treponema pallidum. Left untreated, the disease can lead to severe complications and death. When diagnosed early, the disease is easily curable. Syphilis usually affects the genital organs, skin, and mucous membranes. As the disease progresses, other organs can also be affected, including the heart and central nervous system.

The bacteria causing syphilis enter the body through mucous membranes and skin lesions. The incubation period (time until the onset of symptoms) lasts about 3 weeks. After the incubation period, a chancre forms at the site of treponemal entry. This is primary syphilis. Chancres usually form on external genitalia, in the vagina, around the anus, or in the rectum. Sores can also appear on the lips or in the mouth. After 3-12 weeks, the sores heal leaving a scar.

The manifestation of secondary syphilis can be very diverse. A widespread rash all over the body is most commonly detected. The third stage of syphilis – late syphilis – is very rare nowadays. Tertiary syphilis can affect the heart and blood vessels system as well as the central nervous system.

A person can infect others during primary and secondary syphilis. The most common mode of transmission is sexual contact through the anus, vagina, mouth, where sores are touched. Infection can also occur by direct contact with sores, rashes (e.g., kissing). An infected mother can transmit the infection to the fetus. Treponemes are very sensitive to environmental conditions, so close contact is required to transmit them. Sharing the same toilet, bath, pool, clothes, or dishes does not transmit syphilis. Risk factors:

risky (unsafe) sexual intercourse, polygamy increases the risk of sexually transmitted diseases;
homosexual relationships between men without protective measures;
age from 15 to 25, although anyone can get infected during unsafe sexual intercourse.

During primary, secondary, and early latent syphilis, one injection of penicillin cures the disease. If patients are allergic to penicillin, oral antibiotics (doxycycline, tetracycline, or erythromycin) are prescribed for 2 weeks. To ensure the effectiveness of the penicillin dose, the doctor performs blood tests after treatment. During treatment, it is recommended to avoid sexual intercourse. When patients are diagnosed with late latent syphilis or tertiary syphilis, 3 penicillin injections are given weekly. A pregnant woman with syphilis must receive penicillin treatment. If syphilis is transmitted to the fetus, the bacteria can cause the development of congenital deformities and even death. If a pregnant woman was treated for syphilis, the newborn is also given antibiotics. After antibiotic treatment, a so-called Jarisch-Herxheimer reaction can occur within 2-12 hours. It is believed that the reaction is caused by a large number of bacteria dying. Patients may experience fever, chills, nausea, aching pains, and headaches. Symptoms disappear within 24 hours. To alleviate symptoms, it is recommended to rest more that day, take pain relievers (acetaminophen, ibuprofen), and drink more fluids.

Source | Glossary of Most Commonly Used Biomedical Terms and Concepts | Lithuanian University of Health Sciences | Academician Professor Antanas Praškevičius, Professor Laima Ivanovienė