Overview
Syphilis is a sexually transmitted infection caused by the bacterial micro-organism, Treponema pallidum. T. pallidum is a gram negative spirochete (spiral-shaped). The infection is spread through sexual contact with infected individuals.
This is an infectious disease, that can also spread to other areas if left untreated. It affects the central nervous system(brain and spinal cord), eyes and other regions. This fact shows how serious and life-threatening untreated syphilis can be!
Epidemiology
- Globally, there are over 6 million new cases of syphilis per year.
- Worldwide case rate is 17-18 per 100,000 persons
- It is more common in men as compared to women, especially in men who are homosexuals.
- Highest prevalence occurs in the Western Pacific, Africa and the Americas.
- Most affected individuals are those aged 20-29 years old.
- It has been noted that lately, incidence in the US is on the rise.
- Estimated global deaths in 2015 were 107,000.
Causative Agent & Risk Factors
Causative agent for syphilis is Treponema pallidum subsp. pallidum.
Risk Factors:
Acquired syphilis;
- Men aged 29 years old and below
- Having unprotected sex
- Being HIV positive(people living with HIV)
- Having a sex partner who has syphilis
- Work in the sex industry
- Having multiple sexual partners
Congenital syphilis;
- Drug use by the mother
- Inadequate medical care for and treatment of syphilis during pregnancy
- Failure to get adequate prenatal care
Signs & Symptoms
Primary syphilis;
Chancre(painless sore on the penis, vagina or rectum)
Secondary syphilis;
- Non-itchy rash
- Wart-like sores in the mouth and around the genitals
- Sore throat
- Swollen lymph nodes
- Fatigue
- Fever
Symptoms of secondary syphilis resolve spontaneously. Without proper medical attention, they can re-appear and resolve over months or even years.
Latent syphilis;
- It is also referred to as the hidden stage, because of lack of symptoms.
- It occurs due to untreated secondary syphilis.
- It can last for several years.
- Without proper medical attention, it leads to health complications.
Tertiary syphilis;
- It is also called late stage syphilis.
- It affects;
- Brain and nerves
- Heart and blood vessels
- Liver
- Bones and joints
Congenital syphilis;
- Contracted by babies from infected and untreated mothers during delivery.
- The infection can also occur during pregnancy through the placenta.
- Although new born babies with congenital syphilis might fail to present any symptoms, some babies can have the following symptoms due to lack of treatment:
- Skin rashes
- Fever
- Jaundice
- Rhinitis(sneezing or stuffed, drippy nose)
- Anaemia
- Swollen spleen
Diagnostic Tests
- Blood tests
- Dark field microscopy of infected fluid9Fluid is picked from a syphilis sore on the skin)
Treatment & Management
Syphilis is 100% curable.
Drug treatment options include;
Penicillin G. This is the first-line treatment option. For syphilis that affects the central nervous system(CNS), large doses of intravenous penicillin G are administered because of benzathine penicillin has poor CNS penetration ability.
Doxycycline is the second line agent.
For patients who suffer from severe penicillin allergy, doxycycline or tetracycline is used.
For damage caused by syphilis to other organs, there is not yet a way identified for repairing the damages.
Complications
During pregnancy, it can cause;
- Miscarriage
- Premature birth
- Stillbirth
- Low birthweight
After birth, untreated syphilis can cause death within the newborn’s first 28 days of life.
Ways of Prevention
- Avoid getting involved in sexual activities where there is a risk of becoming infected
- Get tested for gonorrhea, to prevent transmitting to your partner just in case you have it
- Utilize barrier methods such as condoms during sex
- Getting involved in long-term monogamous relationships