Syphilis

Sexually transmitted diseases (STDs) are the most common infections in the United States and are epidemic in most parts of the world. Portals of entry of STD microorganisms and sites of infection include the skin, mucosal linings of the urethra, cervix, vagina, rectum and oropharynx. Syphilis is a sexually transmitted diseases caused by Treponema pallidum. Syphilis is an acute and chronic infectious disease acquired through sexual contact or may be congenital in origin.

The risk of acquiring syphilis increases proportionately with the number of sexual partners. Sexual activity of adolescence accounts an increased incidence of syphilis in that age group. Oral and anal sexual practice exposes a potentially great risk of the disease.

Because of perceived stigma and possible threat to emotional relationships, those with symptoms of syphilis or any other STDs often are reluctant to seek timely health care. In an untreated person, the course of syphilis can be divided into three stages: primary, secondary, and tertiary. These stages reflect the time from infection and clinical manifestations observed in that period.

Primary syphilis occurs 2 to 3 weeks after the initial exposure with the organism. A painless lesion is noted at the site of infection called a chancre. If they are untreated, these lesions usually resolve spontaneously within about 2 months.

Secondary syphilis occurs when the organism spreads from the original chancre to produce a generalized infection. The rash of secondary syphilis occurs approximately 2 to 8 weeks after the chancre, and involves the trunk, and the extremities, including the palms of the hand and the soles of the feet.

Transmission of organisms usually occurs at this stage when there is contact with the lesions. The symptoms may include lymphadenopathy, arthritis, fever, malaise, hair loss, and weight loss. Secondary stage is followed by a period of latency in which the infected person is free of the signs and symptoms of syphilis.

Tertiary syphilis is the final stage which presents as a slowly progressive inflammatory disease with the potential to affect multiple organs. 20% to 40% of those infected with syphilis may not reach this stage.

Venereal Disease Research Laboratory (VDRL) or rapid plasma reagin circle card test (RPR-CT) are used for screening and diagnosing. Penicillin G benzathine, an antibiotic is the current treatment of all stages of syphilis. People who are allergic to penicillin are usually treated with doxycycline.