The Doc on Syphilis
Syphilis is a disease caused by a coiled spirochete bacterium - Treponema Pallidum.
Syphilis is an infection that may not be noticed. There are three stages of syphilis and often the findings or symptoms are very mild.
Stage 1 syphilis manifests as a painless sore on the genitals, rectum or mouth. It may be overlooked because it is painless and heals. But despite the sore healing, syphilis is still inside. (Photos below)
Stage 2 syphilis usually shows up as a rash about 1-6 months after the primary infection or Stage 1. Noteably the rash is usually (not always) present on the palms of the hands which is an uncommon place for other rashes to develop. The painless and itch-free rash usually clears in about two weeks and again may be overlooked. The rash goes away without treatment, but the syphilis inside stays.
After the rash resolves there are usually no symptoms until much later.
Stage 3 syphilis may show up many years later with serious health problems including meningitis, loss of vision or hearing, paralysis, or heart ailments. Other scarring skin lesions (gumma) may develop.
Syphilis treatment: The most effective treatment is Penicillin given as two intramuscular injections. Other possible treatment options include doxycycline oral tablets.
If syphilis of the brain or other vital organs is suspected or documented, IV Penicillin is necessary.
Above- Illustration of Treponema pallidum Credit: Shutterstock
Test for syphilis at routine screens if you are sexually active.
From 2018 to 2022, reported cases of syphilis rose 80% in the U.S to over 200,000.
Kansas case numbers have increased from 495 in 2018 to 941 in 2022 with Wyandotte County leading.
Missouri case number have similarly increased from 1,914 in 2018 to 4,176 in 2022 with St. Louis County accounting for the greatest proportion of cases.
Those rates translate to somewhere >35/100,000 population in KC, KS and >65/100,000 in KC, MO.
Above Drawing of a cross section of a T Pallidum bacteria showing the cell wall which is the site of activity of Penicillin. Credit: TTSZ
Syphilis is a bacterial infection - T. pallidum.
It is diagnosed the first time usually with a treponemal immunoassay blood test which often remains positive even after treatment (for life).
Another type of test can be used to follow treatment response. It is an antibody test (VDRL or RPR) and is reported as a titer that can be followed to see if the disease is being controlled by the treatment.
For example 1:64 means current infection and 1:4 may mean previously treated infection.
Contact Dr. Lee at Sharon Lee Family Health Care at the Doc Shop:
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