Caused by- Treponema pallidum
Infection-through abrasions in the skin/ mucus membrane and in adults usually sexually acquired.
- Blood transfusion
- Transplacental infection
- benign tertiary
-incubation period- 14-28 days (ranges from 9-90 days)
-primary lesion- chancre develops at site of infection usually in the genital areas.
-Etiopathogenesis- dull red macule> papule> erodes> indurated ulcer.
-Inguinal lymph nodes- moderately enlarged, mobile, discrete, rubbery.
-Chancre and lymph node- painless and non tender (unless presence of concurrent or secondary infection)
-Chancres may develop on the- vaginal walls, cervix
Extra genital regions- fingers, lip, tongue, tonsils, nipples, anus, rectum.
-Chancre resolves with in 2-6 weeks, leaving a thin atrophic scar.
-Incubation period- 6-8 weeks after development of chancre traponemes disseminate to produce multisystem disease.
-Clinical features- mild fever, malaise, headache.
-Rash- on trunk and limbs later involves palms and soles.
-Etiology- macular >maculopapular/ popular > generalised, symmetrical, non-irritable > later may formation of scales > last for upto 12weeks.
-Condylomatalata- (papules coalescing to plaques)
-Develops in- warm, moist sites. Eg. – Vulva, perianal area.
-Lymphadenopathy- generalised, non tender.
-Mucous patches at- genitals, mouth, pharynx/larynx.
-Other features- meningitis, cranial nerve palsies, anterior or posterior uveitis, hepatitis, gastritis, glomerulonephritis, periostitis.
-Resolves without treatment but may relapse within 1st year of infection.
-Presence of positive syphilis, serology and CSF abnormalities of neuro syphilis in an untreated patient with no evidence of clinical disease.
(a)Early latency- within 2 years of infection, may be transmitted sexually.
(b)Late latency- patient no longer sexually infectious, transmission from mother to foetus, rarely by blood, after several years of infection.
-Persists for many years
-over 60% patient with little or no ill health
-coincidental prescription of antibiotics for other illness may treat
-incubation period- 3-10 years after infection
-incident- now a days rare
-past involvement- skin, mucous membrane, bone, muscles, viscera.
- Chronic granulomatous lesion- “gumma”
Single or multiple, healing with scar.
- Skin lesion- nodules-ulcer
- Sub-cutaneous lesions
Ulcerate with gummy discharge, slow healing, tissue paper scars.
- Mucosal lesions- punched out ulcer,Gummatous involvement of tongue, healing leads to leucoplakia.
-Many years after initial infection.
-aortitis- aortic aneurysm, aortic incompetence, angina, typically affects ascending aorta sometimes aortic arch, rarely descending aorta.
-take years to develop.
-asymptomatic infection associated with CSF abnormalities.
-general paralysis of insane
-neurosyphilis and cardiovascular syphilis may co-exist and are sometimes referred as “quaternary syphilis”
-rare, where antenatal serological screening practised.
-antisyphilitic treatment in pregnancy treats the fetus.
-variety of outcomes after 4 months of gestation.
(a) miscarriage/stillbirth, premature/ at term
(b) Birth of syphilitic baby (sick, hepatosplenomegaly, bullous rash, pneumonia?)
(c) birth of baby who develops signs of early congenital syphilis during 1st few weeks of life.
(d) Birth of a baby with latent infection- either remain well or develops ceongenital syphilis stigmata later in life.
- Sign and symptoms of syphilis
-Fissures around mouth
-Rhinitis with nasal discharge (snuffles)
-Benign tertiary syphilis
-Paroxymal cold haemoglobinaemia
– Neuro syphilis, 8th nerve deafness
-Clutton’sjoint( painless effusion into knee joint)
-Mullberry molars (deficient dental enamel)
-High arched palate
-Rhagades (radiating scars around mouth, nose and anus)
-Salt and pepper scars on retina
-Bosssing of frontal and parietal bones.
In adult cases
- Serum collected from chancres> presence of T. pallidum
- Rapid plasma regain
- Specific antibody tests>enzyme immune assay IgGIgM (EIA)
TP haemgglutination assay (TPHA)
TP partical agglutination assay (TPPA)
- Chest X-ray, ECG, CSF examination.
In suspected cases
- EIA, IgM suggests early
- Investigation of mother, her partner or any sibling.
Homeopathic treatment of syphilis
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat syphilis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat syphilis that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of syphilis:
Mercurius – the mercurial preparations are the first to be employed in treating syphilis, Mercurius corresponds to the majority of symptoms of secondary syphilis, Mercurius corresponds to the majority of symptoms of secondary syphilis, to the syphilitic fever, to soft chancres pain which banish sleep as soon as the patient goes to bed are well met by the remedy.
Merc Cor – corresponds to active and destructive cases, as in syphilitic ulcerations, which are very destructive, serpiginous ulcers with ragged edges, phagedenic ulcerations and acute bubos.
Arsenic Album – useful remedy for constitutional syphilis, indispensible in the phagedenic Varity of ulcerations with the intense burning pains and in desperate cases of syphilitic infection.
Hepar Sulph – this remedy is indispensible when mercury has been abused.
Aurum Mur – syphilitic gonorrhoea; chancres on prepuce and scrotum; bubo in left groin; secondary syphilis; snuffles in children suffering from hereditary syphilis.
Aurum Met – secondary syphilis; also infantile, especially after abuse of mercury; iritis, marked by much pain around eye, as if in the bones; caries of nasal bones.
Carbo Veg – syphilitic ulcers with high edges which become irritable from local treatment; margins of sores sharp, ragged, undermined; discharge thin, acrid, offensive; ulcers much painful and easily bleed.
Badiaga – syphilis of infants, whole convolutes of hard, glandular swellings; bubo, left groin, hard, unequal, like scirrhus, violent burning stitches during night.
Carbo Animalis – constitutional or tertiary syphilis; coppery red blotches on skin, particularly on face, induration of glands; nasal syphilis.
Kreosote – tertiary syphilis; severe bone pains, aggravation at night; painfulness of scalp leading to alopecia. Central incisors in syphilitic children unevenly set, with irregular cutting edges, notched and pointed.
Other important medicines for syphilis
Nitric Acid, kali Iod, Phytolacca, Silicea, Kali Sulph, Sulphuric Acid, Kali Iod, Thuja, Aurum Ars, Apis Mel, Antim Tart, Calcaria Iod, Calcaria Sulph, Causticum, fluoric Acid, Colchicum, Phosphorous, Asafoetida, Conium, Lachesis, Platinum Met, Graphites, Belladonna, Kalmia, Sulphur and many other medicines.