what is syphilis? fara dilla binti mohd razali nurul ain binti razali
DESCRIPTION
Syphilis Syphilis is a sexually transmitted disease (STD) or sexually transmitted infection (STI) that, when left untreated, can progress to a late stage that causes serious health problems. The infection alternates with periods of being active and inactive (latent). When the infection is active, symptoms occur. But when the infection is latent, no symptoms appear even though you still have syphilis. Anyone who comes into close physical contact with a person who has syphilis can develop syphilis. You don't have to have sexual intercourse to get syphilis because exposure can result from close contact with an infected person's genitals, mouth or rectum.TRANSCRIPT
What isSyphilis? Fara dilla binti Mohd Razali Nurul Ain binti
Razali Syphilis Syphilis is a sexually transmitted disease (STD) or
sexually transmitted infection (STI) that, when left untreated, can
progress to a late stage that causes serious health problems. The
infection alternates with periods of being active and inactive
(latent). When the infection is active, symptoms occur. But when
the infection is latent, no symptoms appear even though you still
have syphilis. Anyone who comes into close physical contact with a
person who has syphilis can develop syphilis. You don't have to
have sexual intercourse to get syphilis because exposure can result
from close contact with an infected person's genitals, mouth or
rectum. Statistic of occurrence !
Year Incident Rate 1997 6.08 1998 11.09 1999 11.70 2000 7.70 2001
5.98 2002 4.36 2003 4.27 2004 3.84 2005 3.44 2006 3.06 2007 3.19
Incident rate/100 000 population (in comparison with other
communicable diseases) Infectious syphilis by five year age group
and sex Causes Bacteria called Treponema pallidum.
Commonly transmitted through: Contact with an infected person's
sore during sexual activity. Through minor cuts or abrasions in
skin or mucous membranes. Less commonly spread through: Transfusion
of infected blood Direct unprotected close contact with an active
lesion (kissing) Infected mother to her baby during pregnancy or
childbirth (congenital syphilis). However, You won't get syphilis
from using the same toilet, bathtub, clothing or eating utensils as
an infected person, or from doorknobs, swimming pools or hot tubs.
Because Treponema pallidum is sensitive to light, air and changes
in temperature. Symptoms Primary stage Secondary stage Latent stage
Tertiary stage ~ Primary Stage ~ Symptoms :
During this stage of syphilis, a firm, painless open sore (skin
ulceration) called a chancre develops. Rarely, there may be
multiple lesions present although typically only one lesion is
seen. Because syphilis is usually passed from person to person
through sexual activities, chancres are often found in the genital
area, anus, or mouth, but they may also be found wherever the
bacteria entered the body. This commonly occurs within 3 weeks of
exposure but can range from 10 to 90 days.
In men, a chancre often appears in the genital area, usually (but
not always) on the penis. In women, chancres can develop on the
outer genitals or on the inner part of the vagina. A chancre may go
unnoticed if it occurs inside the vagina or at the opening to the
uterus (cervix). Swelling of the lymph nodes may occur near the
area of the chancre. The chancre lasts for 28 to 42 days, heals
without treatment, and may leave a thin scar. But just because the
chancre has healed does not mean the syphilis is cured or that a
person cannot pass the infection to others. Secondary Stages
Symptoms :
A skin rash and other symptoms occur during the secondary stage,
which begins 4 to 10 weeks after the initial infection. Secondary
syphilis is highly contagious through direct contact with the
mucous membranes or other surfaces affected by the skin rash. Other
symptoms common include fever, sore throat, weight loss, headache,
meningismus, and enlarged lymph nodes. A rash often develops over
the body and commonly includes the palms of the hands and the soles
of the feet. The rash usually consists of reddish brown, small,
solid, flat or raised skin sores that are less than 2 cm (0.8 in.)
across. But the rash may look like other more common skin problems.
Small, open sores may be present on mucous membranes. The sores may
contain pus, or moist sores that look like warts. In moist areas of
the body, the rash becomes flat broad whitish lesions known as
condylomata lata In dark-skinned people the sores may be a lighter
colour than the surrounding skin. The skin rash usually heals in 2
to 12 weeks on its own, without scarring. After healing, skin
discoloration may develop. Latent syphilis can be described as
either early or late.
Latent Stage have no symptoms. The latent stage can last for years.
Latent syphilis can be described as either early or late. 50% of
those infected with latent syphilis will progress into late stage
syphilis, 25% will stay in the latent stage, and 25% will make a
full recovery. EARLY LATENT SYPHILIS LATE LATENT SYPHILIS 2 years
or less from initial infection, w/o signs or symptoms of diseases
Treated with single intramuscular injection of penicillin > 2
years but w/o clinical evidence of diseases Requires 3 weekly
injections Tertiary Syphilis Occurs 1-10 years after the initial
infection
Characterized by : formation of gummas soft, tumor-like balls of
inflammation known as granulomasrepresent an inability of the
immune system to completely clear the organism. They may appear
almost anywhere in the body including in the skeleton. neuropathic
joint disease, which is a degeneration of joint surfaces resulting
from loss of sensation and fine position sense (proprioception).
The more severe manifestations include neurosyphilis and
cardiovascular syphilis. Tertiary Syphilis Cardiovascular
complications
In a study of untreated syphilis, 10% of patients developed
cardiovascular syphilis, 16% had gumma formation, and 7% had
neurosyphilis. Cardiovascular complications include syphilitic
aortitis, aortic aneurysm, aneurysm of sinus of Valsalva, and
aortic regurgitation. Syphilis infects the ascending aorta causing
dilation and aortic regurgitation. This can be heard with a
stethoscope as a heart murmur. The course can be insidious, and
heart failure may be the presenting sign after years of disease.
The infection can also occur in the coronary arteries and cause
narrowing of the vessels. Neurological complications
In some patients, manifestations include generalized paresis of the
insane which results in personality changes, changes in emotional
affect, hyperactive reflexes, and Argyll-Robertson pupil A
diagnostic sign in which the pupils constrict in response to
focusing the eyes on near objects[accomondate], but not to light
[not react to light]. Tabes dorsalis, also known as locomotor
ataxia, a disorder of the spinal cord, often results in a
characteristic shuffling gait. Neurosyphilis Neurosyphilis is a
slowly progressive and destructive infection of the brain or spinal
cord life-threatening complication. There are 4 different forms of
neurosyphilis: asymptomatic, meningovascular, tabes dorsalis, and
general paresis. Asymptomatic neurosyphilis precedes symptomatic
syphilis and is present in 15% of those with latent (hidden)
syphilis. In this case, abnormalities may be present in the
cerebrospinal fluid, but no symptoms are present. In
meningovascular neurosyphilis, cranial nerve palsies and pupil
abnormalities may be among a wide variety of symptoms. This may
also cause damage to blood vessels resulting in stroke.
Neurosyphilis In tabes dorsalis, progressive degeneration of the
spinal cord occurs causing an inability to walk. In general
paresis, paralysis, tremors, seizures, and mental decline occur as
a result of damage to brain cells. Gummas (inflammatory lesions)
may occur anywhere in the brain or spinal cord and can cause a wide
variety of neurologic deficits. Syphilitic aseptic meningitis
occurs as a chronic infection and may involve headaches, cognitive
changes and cranial nerve abnormalities. Diagnostic Tests
Microscopy of fluid from the primary or secondary lesion using
darkfield illumination can diagnose treponemal disease with high
accuracy. (to see whether syphilis bacteria are present or not)
Rapid Plasma Reagin (RPR) Venereal Disease Research Laboratory
(VDRL) Treponema pallidum hemagglutination assay (TPHA)
Fluorescent Treponemal Antibody Absorption (FTA-ABS) Enzyme-Linked
ImmunoSorbent Assay (ELISA) TREATMENTS AND DRUGS All stages
penicillin kill the bacteria.
One dose of penicillin is sufficient for early syphilis [less than
a year]. If longer than a year, additional doses needed. Allergic
reactions to penicillin (eg: anaphylaxis) may be treated with oral
tetracycline or doxycycline . Other altenative : Ceftriaxone ,
Azithromycin. Penicillin treatment for pregnant women with
syphilis.All pregnant women with syphilis should be desensitized
and treated with penicillin. Follow-up treatment. Penicillin
standard treatment for infants and children with congenital
syphilis. 24hour after treatment Jarisch-Herxheimer reaction.
Symptoms include fever, chills, nausea and headache. This reaction
usually doesn't last more than 1 day. TREATMENTS After you're
treated for syphilis, doctor will ask you to:
Follow-up tests for 6months and 12months [maybe more! ] after
treatment periodic blood tests needed to make sure you're
responding to the usual dosage of penicillin. Avoid sexual contact
until the treatment is completed and blood tests indicate the
infection has been cured. Notify your sex partners so that they can
be tested and get treatment if necessary. Be tested for HIV
infection. PREVENTION Abstain from sexual contact or to be in a
long-term mutually monogamous relationship with a partner who has
been tested and is known to be uninfected. Avoiding alcohol and
drug use may lead to risky sexual behavior. If you are sexually
active, practice safe sex and always use condoms. Correct and
consistent use of latex condoms can reduce the risk of syphilis
when the infected area or site of potential exposure is protected.
Condoms lubricated with spermicides (Nonoxynol-9 or N-9) protecting
against the transmission of STDs. Do not have sex with someone who
has an open sore on his or her sex organs or whom you know to be
infected. All pregnant women should be screened for syphilis.
SOURCES http://www.mayoclinic.com/health/syphilis/DS00374