Syphilis
Syphilis: This Chronic, infectious venereal disease begins in
the mucous membranes and rapidly becomes systemic, spreading
to nearby lymph nodes and the bloodstream. The infecting agent
is the spirochete Treponema pallidum. Syphilis spreads by
sexual contact during the primary, secondary and early latent stages
of infection. For those expecting mothers who has this
disorder, it may be spread to the neonate through the placenta.
Syphilis rank the third most prevalent reportable infectious
disease in the United States, and more common between the ages
of 15 to 39. If left untreated syphilis leads to crippling or
death. Prognosis is excellent with early treatment.
Symptoms:
Clinical features vary with the stage of the disease:
Primary syphilis: Applies to a period of 3 weeks after contact.
Patients may develop chancres - small fluid filled lesion on the
genitalia, fingers, anus, lips, tongue, nipples, tonsils, or eyelids
that eventually erode and develop indurated ( becomes
abnormally hard), raised edges and clear bases. Regional lymphadenopathy
may also occur (disease of the lymph nodes)
Secondary syphilis: Applies to a period from a few days to 8 weeks
after the onset of initial chancres. Patients may exhibit a
rash which can be macular (a distinguishable by color, thickening ,
spot), it can be papular ( a small circumscribed, solid,
elevated lesion of the skin), or it could be nodular (resembling nodules),
and it can be symmetrical mucocutaneous (pretaing to
mucous membrane and skin) lesions. Macules commonly erupt between rolls
of fat on the trunk and, proximally on the arms,
palms, soles, face, and scalp. Condylomata lata may develop it drives
in warm, moist areas such as the perineum, scrotum,
vulva, and between rolls of fat, the lesions may be enlarge and erode,
producing highly contagious, pink or grayish white
lesions.
Watch for signs of general lymphadenopathy; mild constitutional
symptoms such as headache, malaise, anorexia, weight loss,
nausea, vomiting, and sore throat. Patient may have brittle and pitted
nails, possible a low grade fever, and may have hair loss
(alopecia).
Latent syphilis: Characterized by an absence of symptoms
Late syphilis: This stage includes three subtypes; late
benign syphilis, cardiovascular syphilis, and neurosyphilis. Any
or all may
be present during this stage.
* Late benign syphilis: the typical lesion is a gumma
- a chronic, superficial nodule or deep granulomatous (a tumor like mass)
lesion that is solitary, asymmetrical, painless, and abnormally
hard (indurated). Other symptoms may affect the liver, causing
epigastric pain, tenderness, enlarged spleen, and anemia; also the
patient may develop upper respiratory involvement with
potential perforation of the nasal septum or palate.
* Cardiovascular syphilis: The patient may develop aortitis
(inflammation of the aortic), aortic regurgitation, or aortic aneurysm,
or the patient may experience no symptoms at all.
* Neurosyphilis: meningitis and widespread CNS (Central
nervous system) damage, symptoms includes, general paresis (slight
or incomplete paralysis ), personality changes, and arm and leg weakness.
Treatment:
Antibiotic therapy, treatment of choice is penicillin I.M. For early
syphilis, treatment may consist of a single injection of penicillin
G benzathine I.M. Syphilis of more than 1 year's duration should be
treated with penicillin G benzathine I.M. for 3 weeks.
Patient who is allergic to penicillin may be treated successfully with
tetracycline or erythromycin - 15 days for early syphilis; and
30 days for late infections; usually by mouth 4 times a day.
* Important to complete the course of therapy even after symptoms
subside.
* Have a recheck scheduled appointment with your doctor after
3, 6, 12, and 24 months to detect a possible relapse.
* For patients who is treated for latent or late syphilis should
receive blood tests at 6 months intervals for 2 years.
* Please inform your sex partner of his infection so they can
receive treatment, and to prevent the spread of this disease.
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