Syphilis
Overview
A sexually transmitted disease caused by a bacteria (Treponema pallidum). The condition is often asymptomatic in the early stages but one or more sores may be present in the early stages. Untreated syphilis usually results in remission of visible symptoms but further severe damage may occur to internal organs and other body tissues which can result in death.
Symptoms
* Primary syphilis symptoms - Chancre - a painless open genital sore usually on penis or vagina; rarely hands, mouth or anus; sometimes inside vagina or on cervix. - Penis ulcer - Vaginal ulcer - Internal vaginal ulcer - Cervix ulcer - Hand ulcer - Mouth ulcer - Genital ulcer - Anal ulcer - less common than a genital ulcer - Very contagious - Enlarged groin lymph nodes - Enlarged lymph nodes - all over the body - Chancre disappears - the chancre will disappear with or without treatment - Enlarged lymph nodes return to normal * Secondary syphilis symptoms - about a third of untreated patients will progress. These symptoms appear 3-6 weeks after the chancre. (Or 1 to 6 months later.) - Skin rash - Small brown sores - Wart-like lumps - Genital wart-like lumps - Mouth lining rash - Rash on palms of hand - Rash on soles of feet - Rash on chest - Flu-like symptoms - Mild fever - Fatigue - Headache - Sore throat - Loss of appetite - Muscle aches - Tiredness - Patchy hair loss - Swollen lymph glands - Swollen underarm lymph nodes - Swollen groin lymph nodes - Swollen neck lymph nodes - Intermittent symptoms - the symptoms of secondary syphilis can come and go for up to 2 years - Very contagious - Chancre - may reappear - Multiple chancres - Genital ulcers - Mouth ulcers - Highly contagious phase of syphilis * Latent syphilis symptoms - No symptoms - Not contagious * Tertiary syphilis symptoms - Usually many months or years later. Less than a third of cases progress to tertiary syphilis - Greatly varied symptoms depending on organs affected by syphilis - Multiple non-cancerous tumors - Skin tumors - Muscle tumors - Bone tumors - Brain tumors - Spinal cord tumors - Heart tumors - Liver tumors - Stomach tumors * Late syphilis symptoms - after severe progression of tertiary syphilis - Mental illness - Blindness - Neurologic problems - Heart disease - Death - Neurosyphilis + No symptoms + Headache + Stiff neck + Fever + Seizures + Stroke-like symptoms + Paralysis + Numbness + Weakness + Visual problems * Sore * Skin rash * Mucous membrane sore * Fever * Swollen lymph gland * Sore throat * Headache * Weight loss * Hair loss * Rash on palms * Rash on soles * Faint rash * Red rash * Rough rash * Reddish-brown spots * Internal organ damage if untreated * Hearing damage if untreated * Progressive blindness if untreated * Dementia if untreated * Blood vessel damage if untreated * Brain damage if untreated * Nerve damage if untreated * Liver damage if untreated * Bone damage if untreated * Joint damage if untreated * Uncoordinated muscle movement if untreated * Eye damage if untreated * Paralysis if untreated * Numbness if untreated
Diagnosis
* Swab of chancre - in primary and secondary syphilis phases * Swab/scraping test * Syphilis blood tests * VDRL (Venereal Disease Research Laboratory) test * RPR (rapid plasma reagin) test * Syphilis antibody tests - Fluorescent treponemal antibody-absorption (FTA-ABS) test - Treponema pallidum hemagglutination assay (TPHA) * Lumbar puncture (spinal tap) - to test CSF for syphilis exposure * CSF syphilis tests * Repetition of blood tests - some blood tests take up to 3 months to be positive after infection.
Prognosis
Deaths from Syphilis: 33 deaths reported in USA 1999 (NVSR Sep 2001) Estimated mortality rate for Syphilis from incidence and deaths statistics: * Deaths: 32 (USA annual deaths calculated from this data: 33 deaths reported in USA 1999 (NVSR Sep 2001)) * Incidence: 70,000 (USA annual incidence calculated from this data: 70,000 cases (NIAID; CDC 2001) * 0.047% (ratio of deaths to incidence).
Treatment
* Penicillin * Injected penicillin * Other antibiotics - if allergic to penicillin * Repetition of blood tests - to ensure treatment successful; see tests for syphilis