Syphilis Causes and Treatment
Syphilis is a potentially fatal sexually transmitted disease caused by a bacterium (spirochete) called Treponema pallidum. The same organism causes another disease called yaws which is transmitted by close body contact (but not necessarily sexual contact). There is some argument about whether Columbus brought syphilis back with him from America, or whether yaws developed into a sexually transmitted disease at this time because of improving hygiene and housing in Europe.
Syphilis is transmitted from one person to another by heterosexual or homosexual contact, or it may pass in the blood from an infected person with the use of shared needles or blood transfusions (though in developed countries all blood donations are tested to prevent this last form of transmission). The disease can also be transmitted from the mother to her child during pregnancy to cause congenital syphilis.
Congenital syphilis is one of the greatest medical tragedies and occurs when a woman with active syphilis becomes pregnant. A newborn infant of such a mother may suffer from any one of a number of problems, including teeth abnormalities, deafness, misshapen bones, deformed nose, pneumonia, and mental retardation. The child is infectious when born and may develop more serious problems if the condition is not treated aggressively with antibiotics. Unfortunately, many of the defects suffered by these children cannot be cured, but plastic surgeons may correct the more obvious ones. To prevent this problem, all pregnant women are routinely tested for syphilis in the early months of pregnancy.
An infection with acquired syphilis passes through three main stages in a victim over many months or years. In its first stage, syphilis causes a sore (chancre) on the penis, the female genitals, or around the anus of homosexuals. This sore is painless, and heals itself after three to six weeks. There may be painless enlarged glands present in the armpit and groin that also disappear with time.
This is followed a few weeks or months later by a second stage that is characterized by a widespread rash, mouth and vaginal ulcers, and a slight fever. The patient is highly infectious at this stage and can easily pass on the disease to a sexual contact. The patient will usually recover from this stage and enter a latent period that may last many years. Complications that may develop during the rash stage include spread of the infection to involve the joints, brain, liver and kidney. These organs may be severely damaged and cause further symptoms in the patient.
After the latent stage, a relapsing stage with further attacks of the second stage may occur, but more commonly a third stage develops. In the third stage, which may occur many years after the other stages, tumors (gumma) develop in the liver, major arteries, bones, brain, skin and other organs. Depending upon the areas affected, the patient may develop many varying symptoms.
In the liver, cirrhosis and blockage of the bile ducts may lead to liver failure and jaundice. If arteries are involved, they can weaken to form aneurysms, dilate to cause pressure on other vital structures, and rupture to cause strokes, heart attacks and massive lethal internal bleeding. In the bones and joints, third-stage syphilis causes arthritis, bone weakness and severe bone pain. The skin and membranes in the mouth, nose and vagina may develop ulcers, scars and nodules that damage the tissue underneath them. These can spread down the larynx and into the lungs.
The brain is the most severely affected organ in long-standing syphilis, and here there are many different complications, including degeneration of the spinal cord to cause paralysis, blindness, headaches, muscle spasms, vomiting, confusion, insanity and death.
Syphilis is obviously not a pleasant disease to develop, and it is vital to diagnose its presence and treat it at an early stage. It can be diagnosed at all stages by one or more of a number of blood tests, or by finding the responsible bacteria on a swab taken from a genital sore in the first stage of the disease. The blood tests can show whether a person has ever had syphilis in their life, and whether they are still infectious. In advanced cases of third-stage syphilis, tests may also be carried out on the fluid around the brain (the cerebrospinal fluid).
Treatment of syphilis is highly effective, but only in the first two stages. Once the third stage of the disease has developed, any organ damage caused is irreversible. Treatment at this stage can merely prevent further damage. Penicillin (often as an injection) is the mainstay of treatment, but other antibiotics such as tetracycline and erythromycin may also be used. A course of antibiotics for a few weeks almost invariably cures the disease.
Because of the availability of effective antibiotics, the incidence of syphilis dropped markedly in the 1950s and 1960s, but in recent years its incidence is starting to rise again.
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