A photograph of mucous patches on the tongue due to secondary syphilis. This image depicts a lingual mucous patch on the tongue of a patient who was subsequently diagnosed with secondary syphilis. Without treatment, an infected person still has syphilis even though there are no signs or symptoms. It remains in the body, and it may begin to damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. At this stage, syphilis is usually no longer contagious.
Tertiary syphilitic gummas may mimic basal cell carcinoma. The gummatous tumors are benign and, if properly treated, in most cases will heal and the patient will recover. A photograph of a patient with tertiary syphilis resulting in gummas seen here on the nose. This patient presented with a gumma of nose due to a long standing tertiary syphilitic Treponema pallidum infection.
This patient presented with a swollen scrotum, which was diagnosed as a syphilitic gumma of the testicle. Condylomata lata lesions usually present as gray, raised papules that sometimes appear on the vulva or near the anus, or in any other warm intertriginous region.
Because this type of cutaneous lesion is also a symptom manifested by illnesses other than syphilis such as condylomata acuminata, a differential diagnosis must be performed in order to rule out other possibilities. This patient presented with a case of secondary syphilis manifested as perianal wart-like growths.
This patient presented with several infra-scrotal condylomatous lesions, which is one of the manifestations of secondary syphilis. This patient presented with secondary syphilitic lesions of vagina.
Early latent syphilis is latent syphilis where infection occurred within the past 12 months. Late latent syphilis is latent syphilis where infection occurred more than 12 months ago.
Latent syphilis can last for years. Tertiary syphilis is rare and develops in a subset of untreated syphilis infections;, it can appear 10—30 years after infection was first acquired, and it can be fatal.
Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms of tertiary syphilis vary depending on the organ system affected. Syphilis can invade the nervous system neurosyphilis , visual system ocular syphilis , or auditory system otosyphilis at any stage of infection.
These infections can cause a wide range of symptoms. When a pregnant woman has syphilis, the infection can be transmitted to her unborn baby. All pregnant women should be tested for syphilis at the first prenatal visit.
Some women need to be tested again during the third trimester 28 weeks gestation and at delivery. This includes women who live in areas of high syphilis morbidity, are previously untested, had a positive screening test in the first trimester, or are at higher risk for syphilis i. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases. An infected baby born alive may not have any signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die.
All babies born to mothers who test positive for syphilis during pregnancy should be screened for syphilis and examined thoroughly for evidence of congenital syphilis.
Treponemal tests e. Treponemal antibodies appear earlier than nontreponemal antibodies and usually remain detectable for life, even after successful treatment.
If a treponemal test is used for screening and the results are positive, a nontreponemal test with titer should be performed to confirm diagnosis and guide patient management decisions. Based on the results, further treponemal testing may be indicated.
Reverse sequence testing can identify persons previously treated for syphilis and those with untreated syphilis. False-positive results can occur in those with low likelihood of infection with reverse sequence testing as well. Special note: Because untreated syphilis in a pregnant woman can infect her developing baby, every pregnant woman should have a blood test for syphilis. All women should be screened at their first prenatal visit. Some patients should receive a second test during the third trimester at 28 weeks and again at delivery.
All infants born to mothers who have reactive nontreponemal and treponemal test results should be evaluated for congenital syphilis. A quantitative nontreponemal test should be performed on infant serum and, if reactive, the infant should be examined thoroughly for evidence of congenital syphilis. Skip to content. Syphilis: Fast Facts. Syphilis is a bacterial infection, caused by the bacteria Treponema pallidum.
Syphilis is passed on when infected lesions come in contact with the soft skin of the mucous membrane found inside the vagina, urethra or with an abrasion during vaginal, oral, and anal sex, even if there is no sexual penetration. There are four stages through which untreated syphilis progresses, each stage with its own unique signs and symptoms: primary, secondary, latent, and tertiary or late. While curable with antibiotics, complications that may develop in later stages cannot be reversed with treatment, including serious damage to the brain, heart, nervous system, and even death.
How common is syphilis? How is it transmitted? Sexual transmission Syphilis can be passed on when infected lesions come in contact with the soft skin of the mucous membrane found inside the vagina, urethra or with an abrasion during vaginal, oral and anal sex, even if there is no sexual penetration. It is most easily spread during the first primary stage because symptoms usually go unnoticed. Syphilis can also be contracted from exposure to lesions or syphilitic warts during the secondary stage.
If warts are present, they may easily spread the syphilis bacteria. Because symptoms of secondary syphilis can recur, a person who has entered the latency stage of syphilis can still transmit the disease. Nonsexual transmission Because syphilis bacteria are extremely fragile, they cannot be spread during contact with objects such as toilet seats or towels. People, especially healthcare workers, can be at risk for syphilis if an abrasion or cut on the skin comes into contact with a syphilitic lesion Mother-to-child Syphilis can be transmitted during pregnancy or during childbirth from a mother to her infant.
What are the symptoms? Primary Syphilis Chancre: The primary stage of syphilis is usually marked by the appearance of a single sore, known as a chancre, within 10 to 90 days after contact with the bacteria at the site of infection. It is usually appears as a single, painless sore, that is raised or elevated. Chancres may be found: outside the genitals, including the penis, scrotum and vagina; inside the vagina or rectum; at or around the anus; or, on the lips or in the mouth, though this is not as common.
The sore can last from three to six weeks. Incubation period An incubation period is the time between exposure to a disease and the first symptom. Contagious period A person with syphilis can easily pass the infection is contagious to physically intimate partners when primary- or secondary-stage sores are present.
Symptoms Syphilis develops in four stages, each with a different set of symptoms. Primary stage During the primary stage of syphilis, a sore chancre that is usually painless develops at the site where the bacteria entered the body. In men, a chancre often appears in the genital area, usually but not always on the penis.
These sores are often painless. In women, chancres can develop on the outer genitals or on the inner part of the vagina. A chancre may go unnoticed if it occurs inside the vagina or at the opening to the uterus cervix.
The sores are usually painless and are not easily seen. Swelling of the lymph nodes may occur near the area of the chancre. A chancre may also occur in an area of the body other than the genitals. The chancre usually lasts for 3 to 6 weeks, heals without treatment, and may leave a thin scar. But even though the chancre has healed, syphilis is still present and a person can still pass the infection to others. Secondary stage Secondary syphilis is characterized by a rash that appears 2 to 12 weeks after the chancre develops and sometimes before it heals.
The rash usually consists of reddish brown, small, solid, flat or raised skin sores that are less than 2 cm 0. But the rash may look like other more common skin problems.
Small, open sores may be present on mucous membranes. The sores may contain pus. Or moist sores that look like warts called condyloma lata may be present. In dark-skinned people, the sores may be a lighter color than the surrounding skin.
When syphilis has spread throughout the body, the person may have: A fever. A sore throat. A vague feeling of weakness or discomfort throughout the body.
Weight loss. Patchy hair loss, especially in the eyebrows, eyelashes, and scalp hair. Swelling of the lymph nodes. Nervous system symptoms of secondary syphilis, which can include neck stiffness, headaches, irritability, paralysis, unequal reflexes, and irregular pupils. Latent hidden stage If untreated, an infected person will progress to the latent hidden stage of syphilis. Relapses Some people with syphilis have a relapse of the infection during its latent stage.
Tertiary late stage This is the most destructive stage of syphilis. Complications of this stage include: Gummata, which are large sores inside the body or on the skin.
Cardiovascular syphilis, which affects the heart and blood vessels. Neurosyphilis , which affects the nervous system. Congenital syphilis Congenital syphilis refers to syphilis passed from a mother to her baby during pregnancy or during labor and delivery.
Screening should be done: footnote 2 , footnote 1 At the first prenatal visit for all pregnant women. At the beginning of the third trimester of pregnancy and again at delivery for women who are at high risk for syphilis.
Symptoms of congenital syphilis include: A highly contagious watery discharge from the nose. Painful inflammation. Contagious rash that frequently appears over the palms of the hands and soles of the feet.
Reduced red blood cells in the blood anemia. Enlarged liver and spleen. Failure to grow and develop normally failure to thrive. What Happens About 3 weeks—although the range is from 10 to 90 days—after a person is infected with syphilis, a sore chancre that is usually painless often appears on the genitals.
Complications of tertiary late syphilis include: Gummata, which are large sores inside the body or on the skin. What Increases Your Risk Your risk of syphilis increases if you: Have unprotected sex do not use condoms or do not use them correctly. This risk is especially high among men who have sex with other men MSM. Have multiple sex partners, particularly if you live in an area of the country where syphilis is more common.
Have a sex partner who has syphilis. Have sex with a partner who has multiple sex partners. Exchange sex for drugs or money. Have human immunodeficiency virus HIV infection and engage in any of the behaviors listed above. When should you call your doctor? Call to make an appointment if you: Have sores, bumps, rashes, blisters, or warts on or around the genital or anal area or on any area of the body where you think they could be caused by a sexually transmitted infection STI.
Think you have been exposed to a STI. Watchful waiting Watchful waiting is a wait-and-see approach. Exams and Tests Diagnosis of syphilis includes a medical history and a physical exam. Your doctor may ask you questions such as: Do you think you have been exposed to any sexually transmitted infections STIs? What are your symptoms? Do you have sores in your genital area or anywhere else on your body? Do you or your partner engage in sexual behaviors that put you at risk , such as having sex without a condom or having more than one sex partner?
Have you had an STI in the past? The physical exam may include: A careful examination of the skin and mouth to look for any rash or other abnormalities. For women, a pelvic exam to look for signs of syphilis. During the pelvic exam, your doctor will look for abnormal sores in the vagina or on the vulva, labia, rectal area, and inner thighs. These sores occur during the primary stage of syphilis. For men, a genital exam to look for signs of syphilis.
For newborns, an examination of both the newborn and the mother for symptoms. The evaluation for congenital syphilis begins with a review of the mother's health and testing the mother for syphilis. Additional testing should be done to find out if other sexually transmitted infections are present, especially: Chlamydia.
Human immunodeficiency virus HIV. People who have syphilis have a greater chance of being exposed to HIV. People at high risk of contracting syphilis include those who: Have unprotected sex do not use condoms or do not use them correctly. This risk is especially high among men who have sex with men MSM. Exchange money or drugs for sex prostitution.
Have human immunodeficiency virus HIV infection. Screening should be done: footnote 6 , footnote 4 At the first prenatal visit for all pregnant women. During the third trimester and again at delivery for pregnant women who have an increased risk for syphilis.
Treatment Overview Prompt treatment of syphilis is needed to cure the infection, prevent complications, and prevent the spread of the infection to others.
0コメント