SYPHILIS
SYPHILIS
SYPHILIS
Etiology
The pathogenesis of Primary syphilis
The spirochete reaches the subepithelial tissues through inapparent breaks
in the skin or possibly by passage between the epithelial cells of a mucous
membrane.
It multiplies locally with a generation time of about 30 hours; although the
primary lesion is local, the organism also disseminates rapidly to local
lymph nodes and then to other organs by way of the bloodstream.
The primary lesion develops 2 to 10 weeks after infection as an indurated
swelling at the site of infection.
The surface necroses to yield a hard-based ulcerated lesion, termed the
chancre, which is teeming with spirochetes and is highly infectious.
The basic pathologic lesion is an endarteritis.
The small arterioles show swelling and proliferation of their endothelial
cells.
This reduces or obstructs local blood supply and probably accounts for the
necrotic ulceration.
Dense, granulomatous cuffs of lymphocytes, monocytes, and plasma cells
surround the vessels. Untreated, the lesion heals within 3 to 8 weeks. The
primary lesion is not always apparent.
The pathogenesis of Secondary syphilis:
Occurs 2 to 10 weeks after the primary hematoenous dissemination stage
and results in a secondary stage with varying degrees of severity.
Lesions are heavily infected with T. pallidum. In moist areas around the
vulva or anus, hypertrophic papular lesions (condyloma lata) can occur.
Generalized lymphadenopathy, fever, malaise, spienomegaly, sore throat,
headache, and arthralgia can be present.
Immune complexes of antibody, spirochetal components and complement
are present in arteriolar walls and account for some of he clinical
manifestations.
This stage may last several weeks and may relapse. It may be mild, however,
and go unnoticed by the patient. The factors that control the secondary
stage are unclear.
Symptoms
Syphilis has three stages:
Primary syphilis
Secondary syphilis
Tertiary syphilis (the late phase of the illness)
The incubation period for primary syphilis is 14 to 21 days. Symptoms of primary
syphilis are:
Small, painless open sore or ulcer (called a chancre) on the genitals, mouth,
skin, or rectum that heals by itself in 3 to 6 weeks
Enlarged lymph nodes in the area of the sore
The bacteria continue to grow in the body, but there are few symptoms until the
second stage.
The symptoms of secondary syphilis start 4 to 8 weeks after the primary syphilis.
The symptoms may include:
Skin rash, usually on the palms of the hands and soles of the feet
Sores called mucous patches in or around the mouth, vagina, or penis
Moist, warty patches (called condylomata lata) in the genitals or skin folds
Fever
General ill feeling
Loss of appetite
Muscle and joint pain
Swollen lymph nodes
Vision changes
Hair loss
Primary and secondary syphilis usually resolve without treatment. At that point,
syphilis becomes latent and may have no symptoms for many years. But, during
this time, it may be damaging organs leading to tertiary syphilis.
Tertiary syphilis develops in untreated people. The symptoms depend on which
organs have been affected. They vary widely and can be difficult to diagnose.
Symptoms include:
Damage to the heart, causing aneurysms or valve disease
Central nervous system disorders (neurosyphilis)
Tumors of skin, bones, or liver
Intervention
TREATMENT
A single injection of long-acting Benzathine penicillin G can cure the early
stages of syphilis. This includes primary, secondary, or early latent syphilis.
CDC recommends three doses of long-acting Benzathine penicillin G at
weekly intervals for late latent syphilis or latent syphilis of unknown
duration. Treatment will cure the infection and prevent further damage, but
it will not repair damage already done.
https://www.slideshare.net/drsomeshwaranamsana/syphilis-treponema-pallidum?
from_action=save
https://www.meddean.luc.edu/lumen/meded/mech/cases/case21/syphilis.htm#:~:text=The
%20pathogenesis%20of%20Primary%20syphilis&text=The%20primary%20lesion%20develops
%202,spirochetes%20and%20is%20highly%20infectious.
https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-
transmitted-infections/canadian-guidelines/syphilis/risk-factors-clinical-manifestation.html
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-
treated-a-to-z/syphilis
https://www.cdc.gov/std/syphilis/treatment.htm#:~:text=What%20is%20the%20treatment
%20for,secondary%2C%20or%20early%20latent%20syphilis.