SYPHILIS IN ENGLISH

                                                  

                                               SYPHILIS IN ENGLISH

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SYPHILIS-

—  Syphilis is a sexually transmitted disease. it is an acute and chronic disease characterized clinically by a primary lesion, a secondary eruption involving skin and mucous membranes.

CAUSATIVE AGENT-

Ø  Syphilis is caused by a bacteria named Treponema pallidum. It is  a  Gram- negative  bacteria (spirochetes)

MODE OF TRANSMISSION-

Ø  Contact with exudates from lesions of skin and mucous membranes of infected people, almost always as a result of sexual activity. 

Ø  Syphilis can also be spread from mother to baby during pregnancy.

Ø  Transmission can occur through blood transfusion if the donor is in the early stages of disease.

CLINICAL MANIFESTATIONS-

Ø  Clinical manifestations occurs in three stages in the natural history of disease syphilis.

—  Primary syphilis.

—  Secondary syphilis.

—  Tertiary syphilis.

—  Primary syphilis- Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. A painless lesion at the site of infection is called a chancre. Untreated, these lesions usually resolve spontaneously within about 2 months

—  Secondary syphilis-  Secondary syphilis occurs when the spreads from the original chancre  to other parts of body and leads to generalized infection.

—  The rash of secondary syphilis occurs about 2 to 8 weeks after the chancre and involves the trunk and the extremities, including the palms of the hands and the soles of the feet. Generalized signs of infection may include lymphadenopathy, arthritis, meningitis, hair loss, fever, malaise, and weight loss.

—  Tertiary syphilis- After the secondary stage, there is a period of latency, when the infected person has no signs or symptoms of syphilis. Than 40 % cases enters into tertiary syphilis phase. Tertiary syphilis is a slow progressive inflammatory disease with the potential to affect multiple organs.

—  In this final stage of the disease it involves the brain and heart, and is usually no longer contagious. At this point, however, the infection can cause extensive damage to the internal organs and the brain, and can lead to death.

DIAGNOSTIC INFECITONS-

Ø  The laboratory diagnosis of Syphilis infection is made by testing blood specimens.

—  Two types of tests are done for confirmation of syphilis- RPR [rapid plasma reagin] and VDRL [Venereal Disease Research Laboratory]

TREATMENT-

Ø  Recommended treatment for syphilis is use of antibiotics such as Long-acting penicillin G (benzathine penicillin), 2.4 million units in a single IM dose on the day that primary, secondary or early latent syphilis is diagnosed.

Ø  Alternative treatment for nonpregnant patients allergic to penicillin: either doxycycline PO, 100 mg twice/day for 14 days, or tetracycline PO, 500 mg 4 times/day for 14 days.

Ø  For early congenital syphilis, aqueous crystalline penicillin G, 50 000 units/kg/dose, given IV or IM every 12 hours during the first 7 days of life, and every 8 hours thereafter for 10–14 days

Ø  PREVENTION-

Ø  Emphasis should be placed on early detection and effective treatment of patients  contacts to prevent spread of infection

Ø  Health education to the community in general health promotion measures sex instruction that teaches the value of delaying sexual activity until the onset of sexual maturity.

Ø  Protect the community by preventing and controlling STDs in sex workers and their clients and by discouraging multiple sexual partners and  casual sexual activity.

Ø  Teach methods of personal protection applicable before, during and after exposure, especially the correct and consistent use of condoms.

Ø  Provide health care facilities for early diagnosis and treatment of STIs and encourage their use through education of the public about symptoms of STIs and modes of spread 

Ø  make these services culturally appropriate and readily accessible and acceptable, regardless of economic status. 

Ø  Establish active case-finding programs that include interviewing patients and partner notification.

Ø  For hospitalized patients, universal precautions for blood and body secretions. Patients should refrain from sexual intercourse until treatment is completed and lesions disappear.

Ø  A fundamental feature of programs for syphilis control is the interviewing of patients to identify sexual contacts from whom infection was acquired in addition to those whom the patient may have infected. (contact tracing and treatment)