Syphilis

Syphilis is a sexual transmitted disease or infection that, without proper treatment, can have major complications. It is produced by a bacterium named Treponema pallidum. This infection has alternative periods of activity and inactivity. The symptoms appear in the periods of activity. Although in the periods of inactivity the patient does not show any symptoms, he is still infected.

Transmission

• Anyone that comes in contact with a person infected with syphilis can get ill. Sexual contact is not the only way to get contaminated. The contamination can occur through a simple contact with the mouth, rectum or the genital organs of an infected person. However, the most common method remains vaginal, anal or oral sexual contact. The bacteria which causes syphilis is transmitted from a person to another by means of direct contact with an open lesion that appears during the first stage or with other lesion and mucous membranes which appear during the second stage. The lesions usually become visible on the external genital organs and anus. The lesions can sometimes be found in the area around the lips or even on them. The bacteria most frequently get in the human organism through the mucous membranes around the genital organs. Very rarely do the bacteria enter the body through cuts on the skin or kisses.
• Syphilis can be transmitted through the use of a needle previously used by a contaminated person.
• Another method is through blood transfusions, although it is extremely rare because the blood used for transfusions is tested for sexually transmitted diseases and the bacteria that cause syphilis cannot last more than 24-48 hours in the special conditions the transfusions blood is kept in.
• In the cases of pregnant women infected with syphilis the bacteria can push through the placenta and infect the fetus at any stage of pregnancy or birth.

Syphilis is not transmitted through a casual contact with bathroom toilets, door knobs, and the water in the pools, bathroom tubes or cloths.

Incubation

The period of incubation for syphilis (which is the period between the exposure to the infection and the moment when the first symptoms appear) is somewhere in an interval of 10-90 days. A lesion of the skin called chancre is the first symptom and it appears on average after 21 days.

A person with syphilis can transmit the disease to his/hers partners when primary and secondary lesions are present. The person infected can be contagious with pauses for years and is always contagious when open lesions or syphilis caused eruptions are present.

The infection has a four stage evolution, each stage with its own symptoms:

1. Primary syphilis represents the first stage during which the chancre appears. In the majority of cases it is found somewhere on the genitals. However, there are some cases in which the chancre appears in other parts of the body, in which case it swells and produces pus. The chancre heals itself without treatment leaving a thin scar.
2. Secondary syphilis is characterized by an eruption that appears before the chancre heals. Again, the lesions heal on their own and this time without any scars.
3. Latent syphilis is the third stage and it is the result of a lack of treatment.
4. Tertiary syphilis is the most destructive stage of the disease. However, this happens only if the person infected does not follow any treatment. There is also a form of syphilis called congenital: it occurs when the disease is transmitted from the mother to the infant during pregnancy or during the birth process.

The treatment of syphilis consists of antibiotics regardless of the clinical form of the disease, both to pregnant women and to newborns. A suitable treatment for pregnant women infected can prevent congenital syphilis. Moreover, newborns with congenital syphilis can benefit from antibiotic therapy which, although cannot correct malformations, can limit the evolution of other negative changes. Penicillin remains the preferred antibiotic for the treatment of all forms of syphilis. It is administrated intramuscular in the doses and frequency recommended by the doctor. If there is an allergic reaction to the penicillin, then another antibiotic can be administrated, usually Ceftriaxone. Large quantities of toxins are released at the beginning of the treatment with penicillin and the patient can have a Jarisch-Herxhaimer reaction. This is the reason why the treatment starts in small doses.