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Syphilis
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It is venesal disease. It is caused by infecting organism known as Treponema pallidum. Treponema pallidum is a delicate spiral organism of 6 to 15 lm in length. The disease is transmitted by direct contact from a surface lesion containing the organisms. So the disease remains infective in the primary and secondary stage for first years. After that the disease may remain in the person’s body but ceases to be infective. The organism dies rapidly on drying, so early lesions are mostly seen in the moist areas, egr external genitalia, onus and mouth. Egr external genitalia, onus and mouth.

Stage of Syphilis

It is divided into four stages:

(1) Primary syphilis

(2) Secondary Syphilis

(3) Tertiary Syphilis

(4) Latent Syphilis

(1) Primary syphilis

In this case, a sore or hard chancre gradually develops at the site of entry of infecting organisms. The incubation period of syphilis is 3 to 4 weeks. It is characteristically hard, shallow and non bleeding ulcer, which is oval or round in shape. Its edge is raised and hyperaemic extending into dusky red oedematous surrounding skin.

It has been noted that the genital chancres are always painless but the extragenital chancres maybe painful and may occur in the anal or perianal region, lip, tongue, nipple, etc. The lymphnodes becomes enlarged, remains discrete and they are always painless.

(2) Secondary syphilis

This stage appears in the 2 to 3 months after the Primary syphilis, the actual range is about 1 month to 6 months. The commonest manifestation of secondary syphilis is generalized rash dull red or coppery incolour. There is also an appearance of snail-tract ulcers, which are formed by joining of small, round and superficial erosions in the mouth. Condylome lata is another characteristic manifestation of this stage of syphilis. A generalized painless lymphadenopathy also occurs at this stage.

(i) Early Congenital Syphilis:

The manifestations in this group appear with in few weeks in the new born. There may be syphilitic rhinitis with nasal discharge which interfere with suckling. Affection may be so severe as to cause death in early infancy due to syphilitic pneumonia.

(ii) Late Congenital Syphilis:

Hutchinson’s classical triad is seen in this case of syphilis. These include interstitial keratitis, 8 th nerve deafness and Hutchinson’s teeth-that is band shaped deformity of the upper central incisors. Other classical signs of late congenital syphilis are saddle nose, Glutton’s joint, etc.

Treatment of Syphilis

Penicillin is the antibiotic of choice in syphilis. Procaine Penicillin G 6 lacs units daily for 15 days is highly effective in early syphilis. In case of later syphilis the same dose should be prolonged upto 3 weeks. Serological tests should be performed at regular intervals for 20 years. Those patients who are allergic to penicillin in them tetracycline, erythromycin and cephaloridine antibiotics are used. Doxycycline is a very useful drug and should be used in the dose of 100 mg thrice daily for 15 days.

Some patients after first injection often develop malaise, pyrexia and rigors, for a few hours. This reaction is seen only in early syphilis and not in late syphilis. Prednsome 10 mg 4 times daily for 3 days may be given before penicillin injection to prevent this reaction. To prevent congenital syphilis the same dose of procaine penicillin G should be given to the mother for 15 days as early as possible in pregnancy.




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