Syphilis is an acute and chronic infectious disease caused by the spirochete Treponema pallidum. It is typically acquired through unprotected sexual intercourse and it is also sexual in origin. By the start of the new millennium, it was predicted that 12 million people around the world are infected with this sexually transmitted disease and more than three fourths of reported cases originate from developing countries.
There is a close correlation between syphilis and the human immunodeficiency virus. It is not uncommon that people who were diagnosed with HIV have syphilis as well. This is highly attributed to the similar behavioral characteristics of high risk individuals with HIV and syphilis. The most noteworthy high risk behavior that exists between the two types of STD include unsafe sexual intercourse between men , prostitution and promiscuous sexual relationship with many partners.
Primary syphilis
In the untreated person, the course of syphilis can be devastating which can leave the person incapacitated as well as psychologically disturbed. An individual who has direct sexual contact with another person with existing infectious lesions caused by syphilis is highly susceptible in acquiring primary syphilis. In primary syphilis, initial clinical manifestations normally occur two to three weeks after initial inoculation with the causative microorganism. Approximately 3 to 90days after contact, a skin sore or lesion called chancre develops on the body part that came in contact with the infected lesion. These chancre lesions can be painful or tender which in most cases appear on the genitals. The visible lesions will usually resolve spontaneously within the span of two months even without the individual’s initiative in consulting medical treatment.
Secondary syphilis
Secondary syphilis occurs when the hematogenous spread of microorganisms from the original chancre sore leads to generalized infection. The rash of secondary syphilis occurs about 2 to 8 weeks after the chancre and it involves the trunk and extremities, including the palms of the hands and the soles of the feet. Transmission of the organism can occur through contact with these lesions. Generalized signs of infection may include lymphadectomy, arthritis, meningitis, hair loss, fever, malaise and weight loss. Moreover, after the secondary stage, there is a period of latency when the infected person has no signs or symptoms of syphilis. Latency can be interrupted by a recurrence of secondary syphilis.
Tertiary syphilis
Tertiary syphilis is the final stage in the natural history of the disease. It is estimated that between 20% and 40% of those infected do not manifest signs and symptoms in the final stage of this infection. Tertiary syphilis presents as a slow but progressive inflammatory disease with the potential to affect multiple organs. The most common manifestations at this level are aoritis and neurosyphilis as evidenced by dementia, psychosis, paresis, stoke or meningitis.
Medical management of syphilis
Treatment of all stages of syphilis is administration of antibiotics. Penicillin G benzathine is the medication of choice for early syphilis or early latent syphilis of less than one year’s duration. It is administered by intramuscular injection at a single session. Individuals with late or latent syphilis of unknown duration should receive three injections at 1-week intervals. However, those who are positively known to have hypersensitivity to penicillin are usually treated with doxycyline. A health care institution’s treatment guidelines for syphilis should be constantly updated per CDC guidelines.