Also known as Primary syphilis, secondary syphilis, or the great imitator
Description Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. The infection is usually transmitted person to person through minor cuts in the skin or mucous membranes (genitals or mouth) during sexual intercourse. Syphilis has three stages: Primary, Secondary, and Tertiary.
Symptoms
Primary Syphilis:
Genital ulcer-usually painless with firm, indented borders
Swollen lymph glands in the groin
Secondary Syphilis:
A rash is usually composed of red lesions that can either be small or large. The rash is also present on the palms and soles of the feet (only a few conditions have a rash in these places)
Condylomata Lata-sweeping skin lesions in the moist areas of skin and mucous membranes
Silvery ulcer patches on the mucous membranes (mouth or vagina)
Diffuse lymph node swelling in the body
Yellow skin or eyes (occasionally)
Low-grade fever
Lack of energy
Loss of appetite
Joint and muscle aches
Headaches
Neck stiffness (rare-a sign of meningitis)
Eye inflammation
Diagnosis
VDRL or RPR are screening tests
FTA-ABS (antibody test for syphilis) confirms the diagnosis
Microscopic exam-dark field microscopy techniques show Treponema pallidum from material that has been aspirated from lesions of the affected regional lymph nodes
Similar Conditions
Gonorrhea
Chlamydia
Chancroid
Herpes
HIV
Treatment
Penicillin by injection is the treatment of choice
Alternatives include Tetracycline, Doxycycline, or Azithromycin
There is no need for local treatment of lesions
Jarisch-Hersheimer reaction, the sudden killing of the Treponema pallidum bacteria that results in the release toxic products, may occur. This causes fever and a worsening of the current symptoms.
Treatment should not be stopped unless the symptoms are severe. Antipyretics (fever reducing medications such as Tylenol or aspirin) and corticosteroids can be used to prevent or modify this reaction.
The Jarisch-Hersheimer reaction generally resolves itself in 24 hours.
Prevention
Safe sex practices. Abstinence is ideal until the syphilis is properly treated.
Condoms are only effective in the covered areas
Exposed parts should be washed with soap and water after sex (both males and females) if couples do not refrain from engaging in sexual relations.
Persons exposed to syphilis in the preceding 3 months should be treated for presumed syphilis, as blood tests may initially be negative.
