Syphilis
Syphilis is a sexually transmitted disease (STD) caused by a spirochaete bacterium, Treponema pallidum.
The route of transmission of syphilis is typically by sexual contact; however, there are examples of congenital syphilis (transmission from mother to child in utero) and ther non-sexual transmission, e.g. an obstetrician getting infected body secretion in an accidental cut.
The signs and symptoms of syphilis are myriad; before the advent of serological testing, diagnosis was more difficult and the disease was dubbed the "Great Imitator" because it was so often confused with other diseases.
Syphilis can be treated with penicillin or other antibiotics. Statistically, oral treatment is dramatically less effective than other treatments because patients tend not to complete the course. The oldest, and still most effective, method is to inject benzathine penicillin intramuscularly.
Another treatment is to administer several tablets of azithromycin orally under observation. This latter course may soon be obsolete, as strains of syphilis resistant to azithromycin have developed, and accounted for 56% of San Francisco infections in 2004. Other treatments are less effective as the patient is required to take pills several times a day.
If not treated, syphilis can cause serious effects such as damage to the nervous system, heart, or brain. Untreated syphilis can be fatal.
The first choice treatment for primary, secondary, and early latent infection remains penicillin, in the form of Benzathine penicillin G, 2.4 MU IM in a single dose. Individuals who have severe allergic reactions to penicillin may be effectively treated with oral tetracyclines (100 mg orally twice a day for 14 days). Ceftriaxone may be considered as an alternative therapy, although the optimal dose is not yet defined and close clinical and serologic follow-up is essential. If ceftriaxone is used for the treatment of early syphilis, some experts recommend 1 g daily, given intramuscularly or intravenously, for 8 to 10 days.
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Syphilis
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