Symptoms
In the first stage, a painless ulcer forms at the site of entry of the bacterium (“hard chancre”) weeks to months after infection. The lesion often occurs in the genital area and oral cavity, is accompanied by lymph node swelling, and usually disappears on its own within a few weeks. If left untreated, the pathogen can later spread further via the blood and cause numerous clinical pictures in various organs. Typical symptoms of secondary syphilis are a large skin rash, fever, swelling of the lymph nodes and anogenital warts. After a months- to years-long symptom-free latency period, the pathogen can eventually affect any organ system, for example, the heart and the central nervous system. Neurosyphilis is particularly dreaded and leads to the breakdown of nerve tissue. In many countries, about 1000 new cases per year have been reported in recent years (!) Other sexually transmitted diseases, such as HIV, often occur as co-infections, because syphilis increases the risk of contracting HIV. In summary, the following four stages are distinguished:
- Primary syphilis
- Secondary syphilis
- Latent syphilis
- Tertiary (late) syphilis
Causes
Syphilis is a sexually transmitted disease caused by the corkscrew-shaped spirochete. The treponemes are transmitted mainly during sexual intercourse and can enter the body through the mucous membrane and through pre-damaged skin. The skin and mucous membrane ulcers are very infectious. Transmission from mother to child via the placenta (congenital syphilis) and infection with contaminated blood products are also possible.
Diagnosis
Diagnosis is made by medical treatment based on patient interview, microscopic methods (dark-field microscopy), and laboratory methods (e.g., PCR, serology).
Drug treatment
Benzylpenicillin (penicillin G) administered intramuscularly is considered the first-line agent. Possible alternatives include tetracylines (doxycycline), cephalosporins (ceftriaxone), and macrolides (azithromycin).
Prevention
For prevention, safer sex rules should be followed:
- Use condoms
- Do not put semen and blood in the mouth
- In case of discomfort in the genital area immediately to the doctor
