Syphilis is a dangerous sexually transmitted disease (STD) that is induced by bacteria. The areas that may be infected by syphilis are the mouth, lips, genitalia, and anus. The most typical way of getting the disease is having sexual contact with a person ill with it. However, it is also possible for the illness to be passed from a mother to a baby during pregnancy. The following stages of syphilis are identified: primary, secondary, early latent, late latent, and tertiary (Mattei, Beachkofsky, Gilson, & Wisco, 2012). At the early stages, the symptom of the disease is a painless sore that is small in size that is called nontender genital chancre (Mattei et al., 2012, p. 434). It may cause swelling or a non-itchy rash. The symptoms may disappear, and a person may live with the disease for many years without being aware of it.
Exam findings include lesions that may be found on the patient’s fingers, tongue, nipples, anus, or some other extragenital sites (Mattei et al., 2012). When performing the examination, a doctor should be extremely thorough because the manifestations of the disease may be similar to many other illnesses. Therefore, it is necessary to inquire about the social and sexual history of the patient, ask about the number of sexual partners, the history of STDs, the use of condoms, and the intravenous use of drugs.
Syphilis is most commonly diagnosed through serologic testing and clinical findings (Henao-Martínez & Johnson, 2014). Still, it is noted that a single test is not enough to diagnose the disease. Therefore, serologic testing presupposes the detection of two antibody types (treponemal and nontreponemal). In the latest research, there is a tendency to do a treponemal antibody test and then perform a nontreponemal test if the first one was positive (Henao-Martínez & Johnson, 2014). While direct detection methods are not always accessible, there are several kinds of such tests. They are polymerase chain reaction, dark-field microscopy, and direct fluorescent antibody examination for T pallidum (Henao-Martínez & Johnson, 2014). The nontreponemal tests are “the rapid plasma reagin,” the venereal disease research laboratory test,” and “the toluidine red unheated serum test” (Henao-Martínez & Johnson, 2014, p. 116). However, these tests are rarely available in clinical centers, and healthcare practitioners usually rely on serologic testing and clinical examination results.
World Health Organization (WHO) (2016) outlines the following evidence-based recommendations for syphilis treatment. For adolescents and adults with early syphilis, benzathine penicillin or doxycycline once over no treatment or over procaine penicillin is recommended. For pregnant women, WHO recommends benzathine penicillin. For adolescents, adults, and pregnant women with the late or unknown stage of syphilis, benzathine penicillin should be applied once weekly for three weeks (World Health Organization, 2016). For infants whose mother received treatment, WHO suggests close monitoring.
Patient education includes sharing information about the ways of getting infected and teaching about the symptoms of the disease. The doctor should explain the following information to the patient:
- there are several stages of syphilis, and the sooner it is detected, the easier it will be to treat the illness;
- syphilis can be transmitted through sexual contact. Thus, it is necessary to avoid unprotected sex;
- syphilis can be passed from the mother to the baby, so it is crucial for pregnant to be extremely cautious in their sexual relationships;
- as soon as any symptoms of the disease are detected, it is necessary to address a doctor;
- condoms only protect from the sores on genital areas; the sores in other places can still be dangerous (“Syphilis – CDC fact sheet,” 2017). Since the disease is dangerous and may not be detected at once, it is crucial to teach people about the importance of having safe sex and paying regular visits to the doctor.
References
Henao-Martínez, A. F., & Johnson, S. C. (2014). Diagnostic tests for syphilis: New tests and new algorithms. Neurology Clinical Practice, 4(2), 114-122.
Mattei, P., Beachkofsky, T. M., Gilson, R., & Wisco, O. J. (2012). Syphilis: A reemerging infection. American Family Physician, 86(5), 433-440.
Syphilis – CDC fact sheet. (2017). Web.
World Health Organization. (2016). WHO guidelines for the treatment of Treponema pallidum (syphilis). Geneva, Switzerland: World Health Organization.