Syphilis (patient information)

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Syphilis

Overview

What are the symptoms?

What are the causes?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Syphilis?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

Syphilis On the Web

Ongoing Trials at Clinical Trials.gov

Images of Syphilis

Videos on Syphilis

FDA on Syphilis

CDC on Syphilis

Syphilis in the news

Blogs on Syphilis

Directions to Hospitals Treating Syphilis

Risk calculators and risk factors for Syphilis

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Overview

Syphilis is a frequently diagnosed sexually transmitted disease.

What are the symptoms of Syphilis?

Primary syphilis symptoms include:

  • Chancre -- a small, painless open sore or ulcer on the genitals, mouth, skin, or rectum that heals by itself in 3 - 6 weeks
  • Enlarged lymph nodes in the area containing the chancre

The bacteria continue to multiply in the body, but there are few symptoms until the second stage.

Secondary syphilis symptoms include:

Symptoms of tertiary syphilis depend on which organs have been affected. They vary widely and are difficult to diagnose. Symptoms of tertiary syphilis include:

What causes Syphilis?

Syphilis is a sexually transmitted, infectious disease caused by the spirochete Treponema pallidum. This bacterium causes infection when it gets into broken skin or mucus membranes, usually of the genitals. Syphilis is most often transmitted through sexual contact, although it also can be transmitted in other ways.

Syphilis occurs worldwide. Syphilis is more common in urban areas, and the number of cases is rising fastest in men who have sex with men. Young adults ages 15 - 25 are the highest-risk population. People have no natural resistance to syphilis.

Because people may be unaware that they are infected with syphilis, many states require tests for syphilis before marriage. All pregnant women who receive prenatal care should be screened for syphilis to prevent the infection from passing to their newborn (congenital syphilis).

Syphilis has three stages:

Secondary syphilis, tertiary syphilis, and congenital syphilis are not seen as often in the United States as they were in the past because of the availability of:

  • Free, government-sponsored sexually transmitted disease clinics
  • Screening tests for syphilis
  • Public education about STDs
  • Prenatal screening

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of syphilis.

If you have had intimate contact with a person who has syphilis or any other STD, or have engaged in any high-risk sexual practices, including having multiple or unknown partners or using intravenous drugs, contact your doctor or get screened in an STD clinic.

Diagnosis

  • Dark field examination of fluid from sore
  • Echocardiogram, aortic angiogram, and cardiac catheterization to look at the major blood vessels and the heart
  • Serum RPR or serum VDRL (used as screening tests to detect syphilis infection -- if positive, one of the following tests will be needed to confirm the diagnosis:)
    • FTA-ABS (fluorescent treponemal antibody test)
    • MHA-TP
  • Spinal fluid examination

Treatment options

Syphilis can be treated with antibiotics, such as penicillin G benzathine, doxycycline, or tetracycline (for patients who are allergic to penicillin). Length of treatment depends on how severe the syphilis is, and factors such as the patient's overall health.

For treating syphilis during pregnancy, penicillin is the drug of choice. Tetracycline cannot be used because it is dangerous to the unborn baby. Erythromycin may not prevent congenital syphilis in the baby. People who are allergic to penicillin should ideally be desensitized to it, and then treated with penicillin.

Several hours after getting treatment for the early stages of syphilis, people may experience Jarish-Herxheimer reaction. This is caused by an immune reaction to the breakdown products of the infection.

Symptoms and signs of this reaction include:

These symptoms usually disappear within 24 hours.

Follow-up blood tests must be done at 3, 6, 12, and 24 months to ensure that the infection is gone. Avoid sexual contact when the chancre is present, and use condoms until two follow-up tests have indicated that the infection has been cured.

All sexual partners of the person with syphilis should also be treated. Syphilis is extremely contagious in the primary and secondary stages.

Where to find medical care for Syphilis?

Directions to Hospitals Treating Syphilis

What to expect (Outlook/Prognosis)?

Syphilis can be cured if it is diagnosed early and completely treated.

Secondary syphilis can be cured if it is diagnosed early and treated effectively. Although it usually goes away within weeks, in some cases it may last for up to 1 year. Without treatment, up to one-third of patients will have late complications of syphilis.

Late syphilis may be permanently disabling, and it may lead to death.

Possible complications

In addition, untreated secondary syphilis during pregnancy may spread the disease to the developing baby. This is called congenital syphilis.

Prevention

If you are sexually active, practice safe sex and always use a condom.

All pregnant women should be screened for syphilis.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000861.htm


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