Medicine for Africa - Medical Information Service

YPHILIS

Definition:
 
Syphilis, named by the Greek, meaning 'world [-wide] illness', is reemerging again as a major contributor to sexually transmitted diseases. The organism, a spiral shaped bacterium, called spirochaete, can be transmitted during sexual contacts between two people. 'Sexual contact' does not only imply sexual intercourse, it also includes any close bodily contact, that is oral as well as anal contact and intercourse, and often just a kiss. The offending agent is the spirochaete Treponema pallidum.

Pregnant women can also infect their baby while still bearing it in the womb (uterus), causing severe mental and physical deformations in the unborn child, even its death.

 
Symptoms:
 
Early symptoms can be very mild and often not even be recognized, especially in women. Medically, the disease process is divided into four major stages: the primary and secondary stages, a latent period, followed by the third and fourth, the late stage. In the first stage, the primary stage of syphilis, the infectious agent usually causes an ulcer (called chancre) which appears between 10 days and 3 months after sexual contact, most often between 2 and 6 weeks. While the ulcer is often recognized by men on the shaft of the penis, women may not feel this painless ulcer if it appears deep in the vagina, on the cervix or the vulva. Depending on the kind of sexual contact, this 'chancre' can also occur on the lips, the tongue, around the anus or other parts of the body. This ulcer is highly contagious while it persists; but even if the infected person does not seek treatment, the ulcer disappears after a few weeks and the disease progresses in about 1/3 of the infected people into the chronic stage two. The secondary stage of syphilis, stage two, is characterized by a skin rash which usually appears on the palms of the hands and the soles of the feet, but it may appear elsewhere and even cover the whole body. These brown colored sores (= blisters) contain bacteria and are highly contagious upon any contact, sexual or not. Additional symptoms may include patchy hair loss, swollen lymph nodes, general fatigue, headaches, a sore throat and low grade fever. If still untreated, the disease enters into a period of latency during which the affected person is not any longer contagious to the partner, and during which there are no symptoms. The third stage, called tertiary syphilis, often appears 3 to 5 years after the initial infection. By this time, the bacteria have invaded almost every part of the body and caused damage of varying extent, especially to the heart, the brain and eyes, the nervous system, bones and joints. According to the sites infected, the disease may express itself as heart disease, mental illness and blindness, varying neurological problems, as well as arthritis-like pains. Finally, the fouth or late stage, appears anywhere between 10 and 20 years after the initial infection and extends now into and up the spinal cord causing degeneration of nerve roots with varying expressions of functional deficits and nerve related deficiencies, even leading to total paralysis.

 
Diagnosis:
 
The disease can either be diagnosed by the physician because of its typical symptoms or it can be identified under a special microscope ( a 'darkfield' microscope). It can also be recognized by a group of blood tests which should be performed together in order to assure identification of the bacterium.