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Health | Syphilis

The Stealthy STI Dr Shay Keating writes on the various stages of Syphilis, a sexually-transmitted infection (STI) Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema Pallidum. First identified in 1913, the infection is believed to have been around for centuries. It has been called ‘the great imitator’ because so many of the clinical signs and symptoms of syphilis are indistinguishable from other diseases. Syphilis is usually passed on through sexual contact with the infectious lesions of a person with syphilis. Pregnant women with the disease can also pass it to their babies. Many people infected with syphilis may not have symptoms for years and are at risk of late complications of the disease if not diagnosed and treated. The disease has primary, secondary and tertiary stages. Primary syphilis is marked by the appearance of a chancre. The chancre is typically a painless, firm skin ulceration which is usually solitary but there may be multiple lesions. It occurs on the penis, vagina, anus or rectum but may also occur on the mouth and lips. The time from infection to the appearance of the chancre is from 10-90 days, about 3 weeks on average. It appears at the point of initial exposure to the bacterium and heals spontaneously in about 3 58 EILE Magazine

to 6 weeks. Local lymph node swelling may occur. Many have no symptoms and may not seek medical advice. Without treatment the patient will develop secondary syphilis. The secondary stage begins on average 6 weeks after the untreated primary stage and is characterised by a skin rash and mucous membrane lesions. The rash can appear as the chancre is healing or several weeks after the chancre has healed. It is symmetrical, reddish-pink on the trunk and limbs and is not itchy. It can also involve the palms of the hands and soles of the feet where it appears as rough reddish-brown spots and in moist areas of the body can appear as whitish and flat lesions. Mucous patches appear in the genitals or in the mouth. Secondary syphilis is the most contagious stage of the disease and all of these lesions are very infectious. Other symptoms associated with secondary syphilis include fever, sore throat, fatigue, weight loss, headache, meningitis like symptoms. Rarely patients develop inflammation of the liver, eyes, kidneys, joints, stomach and colon. The signs and symptoms will resolve with or without treatment but without treatment the infection will progress to the latent and late stage disease. Latent syphilis is defined as proof

of infection from blood testing without signs or symptoms of the disease. The latent stage can last for years and may progress to tertiary syphilis. This is characterised by damage to the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Signs and symptoms of tertiary syphilis can include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness heart failure and dementia. Neurosyphilis refers to a site of infection involving the central nervous system, the brain and spinal cord. Patients may complain of numbness, weakness, headache, vertigo or psychiatric abnormality such as personality disorder. It can occur at any stage of syphilis. Advanced forms of neurosyphilis include a chronic dementia. Neurosyphilis is now most common in patients with HIV infection. Laboratory diagnosis of syphilis is by microscopy of fluid from the primary or secondary lesion (dark ground microscopy) and by blood tests. Lumbar puncture to analyse cerebrospinal fluid may be indicated if neurosyphilis is suspected. Syphilis is very treatable in its early stages. The first choice treatment of all stages of syphilis is penicllin, given

EILE Magazine – Issue 08 (January 2014)  

The LGBT magazine, for those who want another view. Features rugby player Stuart Reardon, poet & activist Carlos Andrés Gómez, Josh Mintz of...

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