Syphilis

The Great Imitator **Author:** Haley  Battis **Date:** 18 May 2010




 * Abstract: ** This paper consists of information about Syphilis, a sexually transmitted disease caused by a bacterium called //Treponema pallidum//. I go over the four stages of the disease, the available treatment, and how it is spread. Syphilis is often called the “great imitator” because many of its signs and symptoms are similar and unable to be distinguished from other diseases. The four stages of the disease are primary, secondary, latent, and tertiary. Syphilis is a curable disease if caught early and treated with antibiotics. If the disease is left untreated it can cause serious harm to many internal organs.

Diagnosis by a microscope is done taking a specimen from the chancre and examining it under a “darkfield” microscope to detect the organism itself. The Venereal Disease Research Laboratory and the Rapid Plasma Reagin test, followed by the fluorescent treponemal antibody-absorption test (used in case of a false positive test from the VDRL and RPR tests) are the blood-screening tests used to detect syphilis (womenshealth.com).
 * Introduction :** Syphilis, although curable, has still had a high number of reported cases. The U.S. Public Health Service had about 134,000 reported cases in 1990 (__Sexually Transmitted Diseases Sourcebook__). The four stages of the disease are Primary, Secondary, Latent, and Tertiary syphilis. The bacterium spreads from sores of an infected person to mucous membranes of the genital area, the mouth, or the anus of a sexual partner. It can pass through broken skin on other parts of the body and is a very fragile bacterium (__STD Sourcebook__). Syphilis can be diagnosed by a doctor’s diagnosis, microscopic identification, and blood tests.

There is no known natural immunity to the infection. In its early stages, an injection of penicillin can cure syphilis in a person who has had it for less than a year. Although treatment kills the bacterium and prevents further damage, it cannot take back any damage that has already been done (CDC.gov).


 * Discussion: **

The first stage of syphilis is the primary stage and is categorized by the appearance of a sore, or chancre at the spot where syphilis entered the body. Although the chancre may heal after three to six weeks, the infection will progress to the secondary stage without treatment (CDC).
 * Stages **

The next stage is the secondary stage, which is distinguished by skin rash and lesions. The rash may not itch but can be red or brownish and have a rough appearance. Not all rashes are apparent and they may appear while the chancre is healing or several weeks later. Other symptoms such as fever, headaches, weight loss, hair loss, and fatigue can also be present. Secondary syphilis can also heal without treatment but will progress to the latent stage.

The latent, or hidden stage begins when primary and secondary stages end. The infection stays inside the body and can last for several years. About 15% of people who aren’t treated for syphilis can enter the late stage of syphilis (CDC). During the early parts of the latent stage is when one can be contagious. You can, however, still infect your partner in the later stages if you engage in sexual contact. Not undergoing treatment during this stage leads to development of the Tertiary stage, which is the most serious.

The tertiary stage can appear anytime from one year after the development of the disease or decades later. It causes damage to internal organs like the heart, brain, eyes, blood, liver, and bones. Gummas, or soft growths can form and be found in different organs and may lead to neurological disease or heart valve disease. Paralysis, numbness, gradual blindness, and dementia can be symptoms of latent syphilis. In severe cases it can cause mental illness, blindness, deafness, neurological issues, and even death (bio.davidson.edu).

An intramuscular injection of penicillin can cure syphilis if administered early enough. Other drugs can be administered for patients that are allergic to penicillin. Periodic blood tests are advised to make sure that the infectious agent is completely destroyed (__STD sourcebook__). Once treated, one must obtain from sexual contact until all the sores are healed. It is also advised that they refrain from sexual contact until two follow up blood tests show that the infectious agent is completely gone. Several hours after treatment, it is possible to have a reaction called the Jarish-Herxheimer reaction. This will cause a person to get chills fever, joint and muscle aches, headache, nausea, and rash. The symptoms will usually disappear within twenty-four hours.
 * Treatment **

Pregnant woman are likely to pass the infection to her unborn child if the disease is active. About 25% of these pregnancies will result in stillbirth or neonatal death (__STD sourcebook__). Infants may show symptoms at birth, but most develop them between two and three months. Symptoms may include rashes, fever, yellowed skin, swollen liver or spleen, and hoarse crying sounds. Infants with congenital syphilis can have moist sores so extreme care must be taken while handling them.
 * Effects of Syphilis in pregnant women **

//Treponema pallidum// is microscopic in size and has a variable number of tight coils. It is motile and has a “typical” rolling motion in its relatively slow forward progress when seen under the microscope (__Syphilis, Gonorrhea, and the Public Health__). It is very delicate and killed by antiseptics and may attack any tissue within the body. It is often too thin to be seen on a Gram stain which is why dark field microscopy and immunofluorescence. The helical structure of //T. pallidum// allows it to move in a corkscrew motion through a viscous medium such as mucus. It gains access to host's blood and lymph systems through tissue and mucous membranes. Cornforth, Tracee. "Syphilis Diagnosis." //Women's Health Issues - Women's Health Questions and Answers - Women's Sexual Health//. About.com, 5 Dec. 2003. Web. 17 May 2010. []
 * // Treponema pallidum //**
 * Literature Cited **

Crain, Nels A. /, and Gladys L. Nelson. //Syphilis, Gonorrhea and the Public Health//. New York: Macmilliam, 1938. Print

"STD Facts - Syphilis." //Centers for Disease Control and Prevention.// Department of Health and Human Services, 4 Jan. 2008. Web. 17 May 2010. []

"STD Statistics Worldwide." //STD information//. AVERT, 30 Apr. 2010. Web. 17 May 2010. [] // Sexually Transmitted Diseases Sourcebook: Basic Information About Herpes, Chlamydia, Gonorrhea, Hepatitis, Nongonoccocal Urethritis, Pelvic Inflammatory ... AIDS, and More (Health Reference Series) //. Detroit: Omnigraphics, 1997. Print.

"Stages of Syphilis." //Biology @ Davidson//. Davidson College, n.d. Web. 17 May 2010. [|http://www.bio.davidson.edu/people/sosarafova/Assets/Bio307/stdouglas/Page%2002.htm]

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