Primary stage: After the initial infection (direct sexual contact with affected individual), the bacterium spreads all over the body using the blood vessels and lymphatic system, and multiply rapidly. Primary lesions form within a few hours after infection, which contain large quantities of the Treponema bacteria.
Secondary stage: The bacterium invades tissues, cerebrospinal fluid, skin, and mucus membranes. It causes inflammatory rashes on the body (secondary lesions), within 4-12 weeks after the primary stage. This continues till a stage of dormancy is reached; after which multiple relapse or remissions take place (for the next 1-2 years).
Tertiary stage: After the secondary stage, there is a period of latency, which could last for many years. A third of all infections, then gradually progresses to Tertiary Syphilis. In this stage, the central nervous system is affected and several vital organs (heart, liver) may develop infections. This may take place after 3 years or sometimes even after 20 years. Tertiary Syphilis is classified into three key types, principally based on the infestation location. These are: Neurosyphilis, Cardiovascular Syphilis, and Gummatous Syphilis
Neurosyphilis is the progressive worsening of Syphilis. Hence, the risk factors for Syphilis are mentioned. These include:
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
Each stage of Syphilis presents with a different set of signs and symptoms. The progression to higher stages occurs because of non-treatment. After the secondary stage, there is a dormant (asymptomatic) stage, known as Latent Syphilis which may last for many years (even decades). All infections do not progress to the final (tertiary) stage.
Tertiary stage: About 30% of the untreated Syphilis cases move into this final non-infectious state, also known as Late Syphilis. The central nervous system is affected, several vital organs (such as the heart and liver) may develop infections, and nerve cells are permanently destroyed. This occurs between 3-15 years, sometimes even two decades after the infection was first contracted.
Tertiary Syphilis is classified into three key types, based principally on the infestation location. These are not mutually exclusive; hence, they can all be present together. However, some forms may be more dominant than the other:
Neurosyphilis: Based on whether there is a participation of the tissue and organ (parenchyma) of the central nervous system (termed late Neurosyphilis); or whether it is confined to the membranes/meninges surrounding the nervous system alone (termed early Neurosyphilis), there are 6 principal types:
Asymptomatic Neurosyphilis: In this stage, even though the cerebral spinal fluid (CSF) is affected and CSF analysis reveals abnormalities; there are no signs or symptoms.
Diagnosis of Asymptomatic Neurosyphilis is not easy. The following steps are helpful:
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis
Complications due to Neurosyphilis are mainly due to the formation of destructive tumors, resulting in severe neurological abnormalities, which can cause life-threatening situations. Severe complications occur when the Asymptomatic condition advances to late Neurosyphilis state.
Prompt, early diagnosis and appropriate treatment is the key to speedy recovery from Syphilis. However, with Syphilis – Tertiary, the bacterial infection has developed to a late stage (over many years) from which complete recovery with 100% return of normal body and brain function may not be possible. But, further advancement of Syphilis can be arrested, and fatalities avoided. The treatment measures include:
The onus is on all sexually mature individuals to ensure that they are generally well-informed (either by their healthcare providers or public health authorities) of the sexually transmitted syphilitic infection. They have to be also aware of the preventive measures and precautions to be taken, which include:
and connect with fellow professionals
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