Sexually Transmitted Diseases (STDs In Women) (cont.)
Syphilis
What is syphilis?
Syphilis is an STD that has been around for centuries. It is caused by a
microscopic bacterial organism called a
spirochete. The scientific name for the organism is
Treponema pallidum. The spirochete is a wormlike,
spiral-shaped organism that wiggles vigorously when viewed under a microscope.
It infects the person by burrowing into the moist, mucous-covered lining of the
mouth or genitals. The spirochete produces a classic, painless ulcer known as a
chancre.
Symptoms of syphilis
There are three stages of
syphilis, along with an inactive (latent)
stage. Formation of an ulcer (chancre) is the first stage. The chancre develops
any time from 10 to 90 days after infection, with an average time of 21 days
following infection until the first symptoms develop. Syphilis is highly
contagious when the ulcer is present.
The infection can be transmitted from
contact with the ulcer which teems with spirochetes. If the ulcer is outside of
the vagina or on the male's scrotum,
condoms may
not prevent transmission of the infection by contact. Similarly, if the ulcer is
in the mouth, merely kissing the infected individual can spread the infection.
The ulcer can resolve without treatment after three to six weeks, but the disease can recur
months later as secondary syphilis if the primary stage is not treated.
In most women, an early infection resolves on its own, even without
treatment. However, 25% will proceed to the second stage of the infection called
"secondary" syphilis, which develops weeks to months after the primary stage and
lasts from four to six weeks. Secondary syphilis is a
systemic stage of the disease, meaning that it can involve various organ
systems of the body. In this stage, patients can initially experience many
different symptoms, but most commonly they develop a
skin
rash, typically appearing on the palms of the hands or the bottoms of the
feet, that does not itch. Sometimes the skin rash of secondary syphilis is very
faint and hard to recognize; it may not even be noticed in all cases. This
secondary stage can also include
hair loss, sore throat,
white patches in the nose, mouth, and vagina,
fever, and
headaches. There can be
lesions on the genitals that look like
genital warts but are caused by
spirochetes rather than the wart virus. These wartlike lesions, as well as the
skin rash, are highly contagious. The rash can occur on the palms of the hands,
and the infection can be transmitted by casual contact.
Subsequent to secondary syphilis, some patients will continue to carry the
infection in their body without symptoms. This is the so-called latent stage of
the infection. Then, with or without a latent stage, which can last as long as
20 or more years, the third (tertiary) stage of the disease can develop. At this
stage, syphilis usually is no longer contagious. Tertiary syphilis is also a
systemic stage of the disease and can cause a variety of problems throughout the
body including:
- abnormal bulging of the large vessel leaving the heart (the
aorta), resulting in heart
problems;
- the development of large nodules (gummas) in various organs of the
body;
- infection of the brain, causing a
stroke, mental
confusion,
meningitis (type of brain infection), problems with sensation, or weakness (neurosyphilis);
- involvement of the eyes leading to sight deterioration; or
- involvement
of the ears resulting in deafness.
The damage sustained by the body during the tertiary stage of syphilis is severe
and can even be fatal.
Diagnosis of syphilis
Syphilis can be diagnosed by scraping the base of the ulcer and looking
under a special type of microscope (dark field microscope) for the spirochetes.
However, since these microscopes are rarely detected, the diagnosis is most
often made and treatment is prescribed based upon the appearance of the chancre.
Diagnosis of syphilis is complicated by the fact that the causative organism
cannot be grown in the laboratory. Therefore, cultures of affected areas cannot
be used for diagnosis.
Special blood tests can also be used to diagnose syphilis. The standard
screening blood tests for syphilis are called the Venereal Disease Research
Laboratory (VDRL) and Rapid Plasminogen Reagent (RPR) tests. These tests detect
the body's response to the infection, but not to the actual Treponema
organism that causes the infection. These tests are thus referred to as
non-treponemal tests. Although the non-treponemal tests are very effective in
detecting evidence of infection, they can also produce a positive result when no
infection is actually present (so-called false-positive results for syphilis).
Consequently, any positive non-treponemal test must be confirmed by a treponemal
test specific for the organism causing syphilis, such as the
microhemagglutination assay
for T. pallidum (MHA-TP) and the fluorescent treponemal antibody absorbed
test (FTA-ABS). These treponemal tests directly detect the body's response to
Treponema pallidum.
Treatment of syphilis
Depending on the stage of disease and the clinical manifestations, the treatment options for syphilis vary. Long-acting penicillin injections have been very effective in treating both early and late stage syphilis. The treatment of neurosyphilis requires the intravenous administration of penicillin. Alternative treatments include oral doxycycline or tetracycline.
Women who are infected during pregnancy can pass on the infection to the
fetus through the
placenta. Penicillin must be used in pregnant patients with syphilis since
other antibiotics do not effectively cross the placenta to treat the infected
fetus. Left untreated, syphilis can lead to
blindness or even death of the infant.
Next: Genital Herpes »
- amoxicillin, Amoxil, Dispermox, Trimox - Learn more about amoxicillin, including a description, generic and brand names, drug class and mechanism, preparations, storage, reasons for prescription, dosing, effect on pregnancy and nursing mothers, and common side effects.
- Pap Smear - Read about Pap smear, a test to screen for cervical cancer, and precancerous changes in the cervix. Risk factors for abnormal Pap include HPV, smoking medicaitons, and a weakened immune system.
- Scabies - Get the facts on scabies causes (mites), signs, symptoms and treatment. Learn what scabies looks like, how to get rid of it and whether dogs are scabies carriers.
Latest Medical News
Sexual Health RSS