Syphilis

• Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum.

• Affects both men and women, with a higher prevalence in men who have sex with men.
• Can be transmitted via sexual contact, from mother to foetus (congenital syphilis), and, rarely, through blood transfusion.

1. Primary Syphilis: Occurs 3 weeks after exposure.
2. Secondary Syphilis: Systemic spread of the bacterium.
3. Latent Syphilis: Early latent syphilis is within the first year of infection; late latent is beyond one year.
4. Tertiary Syphilis: Occurs years to decades after the initial infection.

• Primary Syphilis: Characterised by a painless ulcer (chancre) at the site of infection.
• Secondary Syphilis: Symptoms include rash (often affects palms and soles), mucous membrane lesions, fever, lymphadenopathy.
• Latent Syphilis: Asymptomatic phase.
• Tertiary Syphilis: Can affect multiple organ systems, including neurosyphilis, cardiovascular syphilis, and gummatous syphilis.

• Non-treponemal serological tests (VDRL, RPR) for screening.
• Treponemal tests (FTA-ABS, TPPA) for confirmation.
• Darkfield microscopy can detect the bacterium in primary and secondary syphilis.

• Primary, secondary, and early latent syphilis: Single dose of intramuscular benzathine penicillin.
• Late latent and tertiary syphilis: Three weekly doses of intramuscular benzathine penicillin.
• Neurosyphilis: Intravenous benzylpenicillin for 10-14 days.
• Alternative antibiotics for penicillin-allergic patients include doxycycline and azithromycin.

• Congenital Syphilis (transmission from mother to foetus): Can result in miscarriage, stillbirth, or severe neonatal infection.
• Increased risk of HIV acquisition

• Safe sex practices, including condom use.
• Screening and treatment of sexual partners.
• Prenatal screening to prevent congenital syphilis.

• Syphilis is a sexually transmitted infection, which occurs in stages (primary, secondary, latent and tertiary).
• Treponemal tests are required to confirm a diagnosis of syphilis.
• Clinical features are associated with the stage of infection, starting with a painless ulcer at the site of infection, which can progress to affecting multiple organ systems in the tertiary phase.
• Antibiotic treatment with benzathine penicillin is the mainstay of treatment.
• Safe sex, screening sexual partners and prenatal screening is crucial to prevent both syphilis and congenital syphilis.

https://cks.nice.org.uk/topics/syphilis/background-information/complications/