Syphilis

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Overview

Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Due to its many protean clinical manifestations, it has been named the “great imitator and mimicker.” The origin of syphilis has been controversial and under great debate, and many theories have been postulated regarding this.

The pre-Columbian theory looked at findings on skeletal markers of syphilis before 1490. However, there is insufficient proof, as evidenced by the DNA and paleopathology findings, to support the existence of syphilis before 1492.

The Columbian and most accepted theory postulates that syphilis came from Europe in the 1490s when Columbus arrived in the New World (America). Syphilis spread when Christopher Columbus arrived in Naples (Italy). After Naples lost the battle to the French troops, this new disease spread across Europe.[1]

Syphilis remains a contemporary plague that continues to afflict millions of people worldwide.

The infection progresses through 4 stages and can affect many organ systems. Luckily, the organism treponema is still sensitive to penicillin.

Symptoms

This rash is usually not itchy and may be accompanied by wartlike sores in your mouth or genital area. Some people also experience hair loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Causes

The cause of syphilis is a bacterium called Treponema pallidum. The most common way syphilis is spread is through contact with an infected person's sore during sexual activity. The bacteria enter the body through minor cuts or abrasions in the skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period.

Less commonly, syphilis may spread through direct contact with an active lesion, such as during kissing. It can also be passed from mothers to their babies during pregnancy or childbirth.

Syphilis can't be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs.

Once cured, syphilis doesn't return on its own. However, you can become reinfected if you have contact with someone's syphilis sore.

Risk factors

Anyone can contract syphilis. However, certain factors may increase your chances of contracting an infection. The following groups of people have an increased risk of contracting syphilis:


people who have sex without a barrier method, like a condom, with multiple partners

men who have sex with men

people who have HIV

people who have partners with syphilis

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Complications

Untreated syphilis infection can lead to irreversible neurological and cardiovascular complications. Depending on the stage, neurosyphilis can manifest as meningitis, stroke, cranial nerve palsies during early neurosyphilis or tabes dorsalis, dementia, general paresis during late neurosyphilis. Cardiovascular syphilis is also a result of tertiary syphilis and can manifest as aortitis, aortic regurgitation, carotid ostial stenosis, or granulomatosis lesions (gummas) in various body organs.

Untreated syphilis affects the course of HIV infection with higher virus replication and lowers CD4 counts and a faster rate of progression to late syphilis.[8] Primary and secondary syphilis during pregnancy lead to neonatal infection and adverse pregnancy outcomes if not timely treated.

Headache.

Stroke.

Meningitis.

Hearing loss.

Visual problems, including blindness.

Dementia.

Loss of pain and temperature sensations.

Sexual dysfunction in men.

Prevention

The best way to prevent syphilis is to practice safe sex. Use condoms during any type of sexual contact. In addition, it may be helpful to:

Use a dental dam (a square piece of latex) or condoms during oral sex.

Avoid sharing sex toys.

Get screened for STIs and talk with your partners about their results.

Syphilis can also be transmitted through shared needles. Avoid sharing needles if using injected drugs.