"Syphilis" the contagious disease that should not be overlooked

"Syphilis" the contagious disease that should not be overlooked

Syphilis is a sexually transmitted infection caused by the bacterium Treponema Pallidum. The infection occurs through contact between the mouth, genitals, or other parts of the infected person's body and the syphilis sore of the recipient. Additionally, it can be transmitted from a mother to her unborn child during pregnancy or delivery, resulting in congenital syphilis. The details of this complication are not discussed here. Patients with syphilis may have varying symptoms depending on the stage of the disease.

During the primary stage, patients typically have a painless, hard chancre sore, which may be a single sore or multiple sores. These sores usually appear in areas where the patient had sexual contact, such as the genitals, mouth, anus, or rectum. The sore may last for about 3 to 6 weeks and heal on its own. If left untreated, the disease progresses to the second stage, which is often unnoticed due to the lack of pain and occurrence in hidden areas.

In the secondary stage, patients usually have a rash on their hands and feet, which may also appear on other parts of the body. The rash is usually reddish-brown and non-itchy, and patients may also experience sores in their mouth or genitals, sometimes called the "secondary rash." Other symptoms may include fever, sore throat, muscle aches, hair loss, and fatigue. These symptoms may disappear on their own, but if the patient does not get treatment, it can progress to the next stage.

Latent Stage Symptoms refer to a phase in which the patient may not exhibit any symptoms for many years, and the detection of syphilis during this phase may only be possible through blood tests.

On the other hand, the Tertiary Stage Symptoms occur in patients who have not received treatment since the earlier stages. During this stage, the disease can cause damage to the heart, brain, eyes, and other organs, and patients may experience severe symptoms such as difficulty moving their limbs, paralysis, numbness, blindness, heart disease, or even death. Sometimes, syphilis is called "The Great Imitator" because it can cause a wide range of symptoms that resemble those of other diseases.

Diagnosis:

Diagnosis often relies on symptoms and blood tests. Those who should receive a diagnostic examination include individuals with hard, ulcerated lesions in the genital or oral region, individuals with sexual partners who have syphilis or have symptoms of syphilis, and individuals who are pregnant or planning to become pregnant, in which screening for syphilis infection is now a routine part of prenatal care in Thailand.

Prevention:

The best way to prevent syphilis is to abstain from sex or have sex only with a partner who does not have syphilis and does not have sex with others. While condoms can reduce the risk of infection, they only protect the area they cover. If you are in a new relationship, it is recommended to get blood tests before having sex or getting married. It is important to note that washing the genitals, urinating, or douching after sex does not prevent infection.

Treatment:

Treatment can be done effectively using antibiotics. The recommended medication is benzathine penicillin G, which is injected into the muscle once for patients infected for less than a year. For those with long-term infections, multiple injections may be necessary. In cases where the patient is allergic to penicillin, doxycycline or tetracycline may be used instead. For patients with syphilis affecting the nervous system, benzylpenicillin injected into the bloodstream or ceftriaxone may be used. During treatment, patients may experience symptoms such as fever, headaches, and muscle pain (known as the Jarisch-Herxheimer reaction).

However, even after successful treatment, patients should be regularly monitored by blood tests every 3 months for a period of 3 years. It is important to follow the doctor's instructions strictly and inform current and past sexual partners to get tested and treated to prevent the spread of the disease. It is also recommended to avoid having sexual intercourse until both the patient and their partners have been treated to prevent reinfection or spreading to new partners.

Best wishes from the Obstetrics and Gynecology Department, Vibhavadi Hospital.