Syphilis

Definition

Syphilis (syphilis) is a bacterial infection that can be transmitted sexually. In the case of infection, there is a gradual, chronic course. The disease is popularly known as French disease . The naming dates back to 1494, when there was an outbreak of syphilis during the invasion by French troops during the Italian War.

Syphilis acquisita refers to acquired syphilis, for example through direct sexual contact.

Syphilis connata describes congenital syphilis, in which the unborn child becomes infected in the womb.

A distinction is also made between early syphilis and late syphilis. The first two stages up to a year after infection are summarized under the term early syphilis . Later stages and the latency phase are called late syphilis .

Causes of Syphilis

The disease is triggered by the spiral -shaped bacterium Treponema Pallidum . In recent years, the frequency of new infections has increased sharply, which is probably related to lax use of condoms and risky sexual behavior. Syphilis is a common comorbidity associated with HIV infection. Homosexual men in metropolitan areas are particularly at risk. Significantly more men than women are affected by the sexually transmitted disease.

risk of contracting syphilis

Infection can occur through close physical contact with an infected person. The disease is highly contagious, especially in the first two stages. Transmission can occur during vaginal, anal and oral sex . Bacteria pass through the skin barrier by penetrating through small injuries in the skin of the sexual partner. The bacteria can also be absorbed through the oral mucosa. If the disease is chronic in later stages, the risk of infection is significantly reduced. The disease can also be transmitted from expectant mothers via the placentabe passed on to their children. The transmission of syphilis via blood transfusions is not to be feared. Blood products are systematically tested, so infection can be almost completely ruled out. After the disease has healed, syphilis infection can occur again and again.

Symptoms of Syphilis

The symptoms of sick people are very different. The symptoms are divided into three to four stages. These stages usually follow one another in time. Symptoms are not always the same for every patient. Asymptomatic disease courses are possible, even people without symptoms can be sick with syphilis.

The first symptoms of primary syphilis appear two to three weeks after infection . The initial infection manifests itself as a small, reddish skin lesion with a hard edge. This so-called hard chancre is usually painless. Depending on the entry point of the pathogen, it can occur in the genital area, on the anus and in the area of ​​the lips, tongue and oral mucosa. Doctors call this local skin manifestation ulcus durum , or hard chancre. This is where the skin comes into contact with the bacterium, and the bacteria enter through a small skin defect. Ulcus durum is highly infectious. After about six weeks, the area heals and usually leaves scars. In addition, swelling of the nearby lymph nodes often occurs. This swelling of the lymph nodes is called lymphadenopathy in technical terms .

In the second stage, the bacteria spread. This phase is also called secondary syphilis . The body tries to fight off the infectious agents and reacts with fever, exhaustion and headaches . This immune reaction can lead to a skin rash and generalized swelling of the lymph nodes . The patchy rash usually appears on the entire surface of the body. The rash usually begins in the trunk area and spreads from there.

In addition, infectious, round nodules can occur, especially in the genital area. These condylomata lata are reminiscent of warts and can appear anywhere.

After the second stage has passed, there can be a latency period that can last from a few months to years. The patients are symptom-free. The disease can heal during this phase or it can flare up again and cause symptoms again.

During the third stage , the body reacts to the pathogen. On the one hand, cardiovascular syphilis can occur in the form of an aortic aneurysm , on the other hand, so-called gums can occur. Gums are skin lesions resembling small snake-shaped boils.

Years after the primary infection, the nervous system is eventually affected by the immune response to the bacteria. In the context of neurosyphilis , inflammation of the central nervous system can occur. Strokes can occur as part of neurosyphilis. Meningitis is also possible. Patients suffer from sensory disturbances, pain and seizures. When the nerves coming out of the spinal cord are affected, it is called tabes dorsalis. This can lead to disturbances in the coordination of movements and missing reflexes.

prognosis in syphilis

In some cases, the chronic disease heals on its own without antibiotic therapy. In other cases, there is permanent organ damage that can lead to death. With appropriate therapy using antibiotics, the cure rate is almost 100%.

Doctor consultation for syphilis

Even if the visit to the doctor seems uncomfortable, you should have yourself examined if you experience any symptoms. The specialist in the treatment of venereal diseases is the specialist in skin and venereal diseases (venereologist). But family doctors, gynecologists and urologists can also help you with questions. The sooner the disease is treated, the fewer health consequences syphilis can have.

Diagnose

The diagnosis is extremely difficult, especially in the late stages, since the disease can occur with very different symptoms and affects different organ systems. Syphilis rapid tests sometimes provide incorrect results and are less reliable than the diagnosis by the doctor.

• As part of a visit to the practice, the doctor will first conduct a detailed anamnesis interview , in which he will particularly address your symptoms and ask questions about your sexual behavior.
• If there is a defined skin lesion, a swab can be taken and examined under a microscope to identify the bacteria.
• In later stages, detection can be done with a blood test . After bacteria reach the bloodstream, the human immune system produces antibodies that target the infectious agents. In the diagnosis, blood is drawn from the patient and examined serologically. If antisyphilitic antibodies appear, disease activity can also be determined.

How can you protect yourself from syphilis?

To protect yourself from the disease, you should always use condoms or femidoms. These contraceptives offer good protection against syphilis and other sexually transmitted diseases.

As soon as you want to have unprotected sexual intercourse with a new partner, it makes sense for both of them to be tested for the presence of contagious sexually transmitted diseases. In many places, the health authorities offer free tests that you can have anonymously.

therapy of syphilis

The drug of first choice in the treatment of syphilis is the antibiotic administration of penicillin. In the case of allergies or intolerance reactions, another antibiotic can be prescribed as an alternative. During penicillin therapy, the body may react to the toxins released by the decaying bacteria. This reaction is called the Jarisch-Herxheimer reaction and presents with flu-like symptoms. If these symptoms occur, the therapy should still be continued, as this is a sign that the antibiotics are taking effect.

It is recommended that all sexual partners of the infected person be examined and treated if necessary. Depending on the stage, sexual partners from the last two years should be taken into account.

Sexual intercourse should continue to be avoided during therapy in order to avoid infecting the partner. After stopping the administration of antibiotics, it can be assumed that there is no longer any risk of infection.

Slow in HIV infection

Syphilis is often associated with HIV infection. The skin ulcers in syphilis can serve as a portal of entry for the human immunodeficiency virus. HIV patients are often immunologically compromised and severe immunosuppression occurs. The body’s defenses are severely weakened by the virus and are unable to fight off infectious agents. Simultaneous syphilis infection can lead to lues maligna , a very pronounced form of the sexually transmitted disease.

Syphilis in pregnancy

Infected mothers can transmit the disease to the child to be born. The bacteria get into the blood of the fetus via the placenta. The child can also be infected during the birth process. Sometimes the infection can also lead to miscarriage or stillbirth. If the child becomes infected, it is called congenital syphilis ( lues connata). The infants are notable for their patchy skin rashes and blisters on their hands and feet. In addition, a bloody cold occurs. Malformations of the teeth (barrel teeth), hearing loss and inflammation of the cornea (parenchymatous keratitis) also occur during infancy. The root of the nose can become infected, resulting in a saddle nose. As part of the maternity guidelines, all pregnant women are examined for the presence of a syphilis infection in order to prevent infection and to treat the expectant mothers in good time.

How can Med-Healths help?

Have you noticed a change in your skin? You can use the Med-Healths app to contact a doctor and tell him about your symptoms. You can also upload pictures of the skin lesion for the appointment. The doctor can prescribe you a medication, issue a prescription and, if necessary, write you off sick. He can also refer you to an appropriate specialist if further examinations are necessary.