Syphilis – An Old, Though Modern Disease

You all know that syphilis is a disease, which can be transmitted by sexual contact in almost all the cases. It is an infectious disease, contagious, whose evolution is chronic, intermittent. It is transmitted through genital contact, very rarely via other means and it can affect any tissue or organ.

Primary syphilis represents the invasion stage, which begins at the infecting contact and it is not remarked sometimes. Sometimes it can be noticed from the anamnesis a contact with an ill person with 1 – 8 weeks before. The typical lesion is represented by the chancre at the entrance, the most frequently the penis, the labia, or the uterine cervix.

The incubation takes on average 21 days, and it depends on more factors. The chancre begins with slight erosion, which changes rapidly into a superficial, painless ulceration. It is accompanied by hypertrophy of regional ganglions, which are isolated, mobile, and painless.

Secondary syphilis represents the dissemination period; it emerges at 7 – 10 weeks after the infecting contact and at 2 – 3 weeks since the occurrence of the primary syphilis sign, in the same time with microbes’ migration from ganglions where their number is big into circulation. A second incubation follows until the emergence of the first skin lesions, which occur after about 45 days since the first sign occurrence and 60 – 70 days since the infecting contact.

It is sometimes accompanied by fever. Almost any tissue of the body can be accidentally caught and hurt. However, the most frequent will be the lesions of the teguments and mucous membranes. Lesions on teguments are pustules like elements even if the most frequent rash looks like viral skin disease.

Recurrent syphilis occurs after insufficient or incorrect treatment. In this case, secondary syphilis can emerge again (in 3 to 9 months after treatment). Relapses can be only serologic, without any clinical manifestations. If clinical manifestations still occur, they can be skin and mucous membranes lesions, neurological symptoms, sore eyes, bones affections or visceral ones.

Latent syphilis represents a calm stage from clinical point of view, between secondary lesions resorption and tertiary symptoms emergence.

During this stage, the serologic reaction is positive, the LCR exam is negative; the radiological and clinical exam and the ECG highlight possible cardiovascular lesions.

Tertiary syphilis or the third stage can occur even after years of latency. Late lesions represent probably an allergic reaction of tissues at Treponema Pallidum and it can affect tissues like skin and mucous membranes. In this case, on the skin can occur tubercles formations, tubercles and ulcerate as well as nodules. On the other hand, mucous membranes can present tubercles and ulcerate lesions.

Congenital syphilis can be transmitted nowadays from mother to fetus, via fetus placenta flow, therefore during the baby’s intrauterine life. It cannot be transmitted from the father if the mother is healthy.

Precocious congenital syphilis is the type with which the child is born or it occurs during the first two years of life. It is characterized by blister like signs, sometimes ulcerous.

Late congenital syphilis occurs after the age of two and the lesions are associated to the third stage of disease.