Syphilis: Diagnosis, Prevention, Cure

«Introduction to syphilis

Diagnosis

Diagnosis of syphilis occurs through direct observation of symptoms (primary phase) and can be confirmed through microscopic examination of a tissue sample taken from the wound or through serological investigations. In the latter case, after collection, the blood sample is analyzed in the laboratory, searching for or grafting antibodies against syphilis (enzyme immunoassays, haemagluttination tests, microflocculation tests).

An early diagnosis of the disease is important, for this reason, when the symptoms described above (primary syphiloma) appear, it is advisable to immediately contact your doctor. Spontaneous healing is indeed possible but as we have seen it could only be apparent (latency phase); for this reason, if you have not already done so, it is good to contact a doctor immediately even if there is spontaneous regression of symptoms.

See also: VDRL and TPHA serological tests for the diagnosis of syphilis

Prevention

In the absence of an effective vaccine to avoid the spread of the disease, it is essential to implement adequate preventive measures. In fact, the chance of contracting syphilis significantly decreases if risky sexual behaviors are eliminated. And "so good:

use a condom during sexual intercourse
Avoid sexual contact with people at risk
Refrain from sexual intercourse in case of contagion, even if suspected and not yet confirmed
Regular blood tests after unprotected sex with a "suspect" person (syphilis can be diagnosed early even in the absence of symptoms)
Inform your partner of your illness, in this way they too can receive the necessary treatment
Notify all people with whom you have had sexual intercourse: in the previous three months in case of primary syphilis; in the previous six months in case of secondary syphilis; in the previous year in case of latent syphilis.
Get screened during the first trimester of pregnancy

It is recommended to perform diagnostic tests if you have frequent sexual intercourse with different people, especially in areas with a high risk of contagion (South America, South Africa, Southeast Asia).

Care

Syphilis could be successfully treated starting in 1943 when Fleming, Abraham and Chain discovered and isolated peniccilin. Today the therapy involves the administration of Penicillin G-benzathine, or other drugs in case of allergy to this antibiotic. Therapy is all the more effective the earlier it is started. The dosage and duration of treatment depend on the stage of the disease: the more advanced the syphilis is, the longer the therapy will be.

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Pregnancy and congenital syphilis

We speak of congenital syphilis when there is a transmission of the disease from the mother to the fetus. This infection generally occurs transplacental, but potentially can also occur during birth or during breastfeeding (if the nipples have syphiloma or syphiloderma).

Although transplacental infection can occur at any stage of pregnancy, the bacterium usually passes from mother to child after the sixteenth week of gestation, when the placenta is formed and more susceptible to infection.

The chances of the fetus contracting syphilis are greater the more recent the stage of the disease is in the mother. The vertical transmission of syphilis occurs in fact:

in 70-100% of cases if the mother is affected by primary and secondary syphilis
in 40% of cases if the mother suffers from syphilis in the early latency phase
in 6-14% of cases if the mother has late syphilis

The infection is very dangerous for the fetus since:

in 25% of cases the fetus dies (abortion)
in 25-30% of cases death occurs after birth
in 50% the fetus survives but the newborn develops rather serious infections that worsen over time

Congenital syphilis is divided into early and late, depending on whether the clinical manifestations arise before or after two years. In some cases the disease can remain silent for life

Screening during the first three months of pregnancy is very important as adequate drug treatment by the end of the 4th month avoids infection of the fetus.