Syphilis

Syphilis is an infection spread via sexual contact caused by the bacteria Treponema Pallidum. It is extremely contagious and has an impact on the genitals, skin, and other parts of the body, including the brain and heart.

Incubation period for Syphilis is 6 weeks.

What is the cause of Syphilis?

Treponema Pallidum is the organism that causes syphilis.

The Signs and Symptoms of Syphilis:

The signs and symptoms of syphilis are classified into four stages: primary, secondary, latent, and tertiary. Congenital syphilis develops when a pregnant woman with syphilis gives birth to a child.

1. Early/ primary syphilis
   Primary syphilis patients will develop one or more lesions. These lesions are often tiny and harmless. They commonly appear on the genitals, rectum, tongue, or lips. Syphilis symptoms appear 10 days to 3 months after exposure. The sores usually heal on their own, but the underlying disorders persist and reappear in the second or third stage of syphilis.
2. Secondary syphilis
   It lasts one to two months and starts within three to six weeks after exposure. A pink "copper penny" rash appears on the palms of the hands and the bottoms of the feet in people with this kind of syphilis. The following are the symptoms:
   • Rashes on the palms and soles that are red or reddish in color
   • Fever
   • Lymph node enlargement
   • Fatigue and a nagging sense of unease
   • Itching and aching
   Without therapy, the aforesaid symptoms fade in a few weeks or come and go throughout the year.
3. Latent syphilis
   At this stage, the virus is dormant and not causing symptoms. The symptoms and indications may never appear again, or the disease may develop to the tertiary stage.
4. Tertiary syphilis
   It is distinguished by destructive and non-infectious lesions of the skin, bones, and viscera. If the infection is not treated at this point, the syphilis-causing bacteria can spread and cause significant issues in the brain, heart, and nerves, resulting in paralysis, blindness, dementia, deafness, and even death. Tertiary syphilis symptoms include:
   • loss of coordination
   • numbness
   • loss in sight
5. Neurosyphilis
   It describes an infection of the central nervous system. It has the potential to cause:
   • headache
   • change in behavior
   • problems in movement

How to Diagnose Syphilis?

In its early stages, syphilis is difficult to identify clinically. As a result, it can be diagnosed as follows:

• VDRL blood tests (Venereal Disease Research Laboratory test)
• Direct testing- serous fluid discovered by chance

How Can we Prevent Syphilis?

• Use condoms properly during sex
• Avoid having intercourse with infected partners
• Vaccination against the illness as soon as possible
• Infected women should be advised not to have children.
• Pregnant women who have syphilis should get treatment as soon as possible.

How can we treat Syphilis?

• Early stage of infection
  The first-line therapy for uncomplicated syphilis is a single intramuscular dosage of antibiotics such as benzathine penicillin G. To lower the risk of birth abnormalities in pregnant women, doxycycline and tetracycline are administered as alternatives to benzathine penicillin G.

• Late stage of infection
  Because benzathine penicillin G has low penetration into the CNS in cases of neurosyphilis, substantial dosages of benzathine penicillin G are suggested intravenously for at least 10 days.

REFERENCE

Dr.Suwal S.N. & Tuitui R. (2063) A Textbook of Community Health Nursing, 1st edition, Vidyarthi Prakashan (P). Ltd. Kamalpokhari, Kathmandu

Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.

National Guidelines Prevention of Mother to Child Transmission of HIV in Nepal- Government of Nepal Ministry of Health and Population National Center for AIDS and STI Control, Kathmandu Nepal, April 2008

WHO Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV infection in infants: Toward Universe Access: Recommendations for a Public Health Approach (2006)

Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).