What is Syphilis?
Syphilis is a Sexually Transmitted Disease. The bacteria ( spirochete ) usually enters the mucous membranes and spreads throughout the body if not treated with antibiotics.
- Primary Stage – Painless ulcer develops at the genitals.
- Secondary Stage– Rash develops on palms of the hands and soles of the feet
- Tertiary Stage– Development of a gumma, charcot joint and/or spread to the brain
Quickcare or ER?
Red flags that will take you to the ER include
- Severe pain
Generally, syphilis can be treated in a Quickcare clinic during the primary and secondary stages.
What will your doctor ask?
Your doctor will want to know your symptoms. Remember, a symptom is a description of your condition to your doctor. It is your story.
Answering the following questions will help your doctor to understand your condition
What makes it better?
What makes it worse?
Have you had unprotected sex with someone other than your regular partner ?
Do you have anything associated with it such as fever?
What will your doctor look for?
Your doctor will look for signs. Remember, a sign is an objective finding that a doctor sees during the examination.
The focus can then move to the genital lesion. Is it painful? Is there any pus?
Since there is a strong sense of infection, a doctor will want to see if the infection has spread.
Infections can spread to the lymph nodes or infections can cause fever.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis.
A sore on the genitals generally means a Sexually Transmitted Disease.
A test (dark field microscopy) of the wound is warranted.
Blood studies (VDRL and RPR) for syphilis are needed. Usually these tests are positive 2 weeks after the genital ulcer is present
What is the treatment of syphilis?
One question gets asked: “Is syphilis curable?”
Syphilis treatment is an antibiotic. Still the best antibiotic is Benzathine penicillin G. Alternatives are Doxycylcline or Tetracycline
How long will you be sick with syphilis?
Once syphilis is treated with Penicillin shot, the illness resolves fairly quickly.
Beware. During the course of the treatment of syphilis, you may get a reaction to the antibiotics. The syphilis bugs are getting killed and, in the process, release endotoxins. The endotoxins can create a fever to the patient. This reaction is called a Jarish-Herxheimer reaction.
Let me tell you a story
His family was always first.
When the long hours as an accountant wore on him, Ali grew lonely. His work day grew longer as he spent more time at the office. His eyes wandered from his spread sheet on the computer screen. The receptionist, who he had barely noticed before, now started to look good.
By the time he came to me as a patient, he was reluctant. I felt like a priest hearing a confession. His head did not look up as explained how he got a painless sore on his genitals.
In the case of Ali, he had syphillis in the early stages and thus needed a shot of Bicillin (2.4 million units)
In Ali’s case, he had noticed a painless ulcer at the base of his penis for the last two weeks. Nothing makes it better or worse. There was no associated fever or swelling elsewhere.
Ali’s ulcer cleared up in about a week.
His case (like all Sexually Transmitted Diseases) had to be reported to the Health Department. His wife had to be informed of his disease
I hope this helps