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Syphilis
What are the symptoms of tertiary syphilis?
Tertiary syphilis mainly occurs two to three years, or even five to ten years or longer, after infection. The primary skin manifestations are gummas, which often occur on the extensor side of the lower legs, and can present as ulcerations, erosions, nodules, and hyperplasia. It may also involve bones, joints, the heart, and blood vessels. The main manifestations include aortitis, aortic valve insufficiency, and aortic aneurysms. When the nervous system is involved, it can present as spinal tuberculosis and general paralysis, which are symptoms of paralytic dementia. The diagnosis of tertiary syphilis requires serological tests and cerebrospinal fluid analysis. The treatment involves primarily penicillin and benzathine penicillin, with erythromycin or tetracycline as alternatives for patients allergic to penicillin, and requires a longer course of treatment.
What are the symptoms of syphilis?
Syphilis is divided into acquired syphilis and congenital syphilis, which is transmitted via the fetus. Acquired syphilis, based on the duration of the disease and using two years as a boundary, is further divided into early-stage syphilis and late-stage syphilis. Early-stage syphilis, particularly primary syphilis, mainly presents symptoms such as a chancre and scleradenitis, generally without systemic symptoms. Secondary syphilis occurs when primary syphilis is untreated or not completely treated, allowing the virus to enter the bloodstream from the lymphatic system and spread throughout the body. This causes damages to the skin, mucous membranes, and systemically, known as secondary syphilis. It can manifest as various forms of syphilitic rash, some resembling papular rashes, others similar to dermatitis, eczema, flat lichen, urticaria, psoriasis, pustular disease, and others. Some secondary syphilitic rashes are similar to flat genital warts, and sometimes syphilis can lead to alopecia. Syphilis can also affect mucous membranes, appearing in the mouth, tongue, pharynx, larynx, and genital mucous membranes, characterized by one or more areas of distinct erythema, vesicles, erosion, covered with a grayish-white membrane, generally painless. Some syphilis cases might affect bones, causing damage to bones and joints. Latent syphilis presents no obvious symptoms, and late-stage syphilis might involve the cardiovascular and nervous systems.
Can syphilis be completely cured?
Syphilis can generally be completely cured nowadays, except neurosyphilis which is somewhat harder to treat, as ordinary syphilis is curable and neurosyphilis may relapse occasionally. However, most current cases of syphilis fall into categories of latent, primary, or secondary syphilis. Tertiary syphilis is less common, and forms such as neurosyphilis and osteal syphilis belong to this stage. Therefore, when treated at a regular hospital with a standard treatment regimen, primarily using penicillin, administered as a long-acting intramuscular injection once a week, the recommended course of treatment usually consists of three to four weeks. If there is an allergy to penicillin, doxycycline can be used as an oral substitute for half a month.
Syphilis IgM negative represents what?
Syphilis IgM negative, which is primarily screened using the ELISA method. Generally, a negative IgM can temporarily rule out syphilis. If still uncertain, further confirmatory syphilis tests can be conducted, such as TPPA (Treponema Pallidum Particle Agglutination) or TPHA (Treponema Pallidum Hemagglutination). Usually, syphilis can be temporarily dismissed if IgM is negative. However, if symptoms of a primary chancre are present, such as genital ulcers, an early Syphilis IgM might be negative. In such cases where symptoms are clear but IgM is negative, it is typically advised to retest after one month. If the result turns positive, a confirmatory test should be performed to diagnose and treat syphilis.
Does the eugenic five-item check include syphilis?
Does the eugenic check for syphilis? Eugenic examination checks for toxoplasmosis, rubella virus, cytomegalovirus, and other mycoplasma, chlamydia, or parvovirus infections. These are generally diseases transmitted through the respiratory tract, and if infection occurs, they mainly affect the development of the fetus's brain or eyes, as well as the development of the liver and other internal organs. The test for syphilis, which is a type of sexually transmitted disease, belongs to infectious diseases. The eugenic check does not necessarily concern infectious diseases; it can be contracted through respiratory infection or by consuming contaminated food. However, syphilis is very specific in its transmission, which occurs through blood, mother-to-child transmission, or sexual contact. These two are not the same concept.
Does third-stage syphilis rash itch?
People with tertiary syphilis generally do not experience itching. Tertiary syphilis represents the later stages of the disease manifestation. Typically, the symptoms on the skin are neither painful nor itchy, which is the case for most individuals. However, some patients may feel differently from the majority, experiencing anomalies, or they might develop secondary conditions such as eczema or allergies, among others, possibly leading to mild itching and so on.
Can syphilis antibodies be detected during the hard chancre stage?
During the hard chancre phase of syphilis, a portion of cases can test positive for Treponema pallidum, although some tests may return negative results. In such cases, it is advisable to retest after one month. The earliest detectable antibodies for Treponema pallidum are usually of two types: a Treponema pallidum-specific antibody, which appears earlier than the non-specific antibodies. There are tests for non-specific antibodies, commonly referred to as RPR or TRUST, which are standard practices in major hospitals. Therefore, in early-stage syphilis or primary syphilis with hard chancre, it is possible to find Treponema pallidum-specific antibodies positive, RPR or TRUST negative, or both negative. If syphilis is strongly suspected in such cases, a retest is recommended after one month.
Is cervical lymphadenopathy related to syphilis?
Enlargement of cervical lymph nodes is somewhat related to syphilis. Although cervical lymph node enlargement is not necessarily solely caused by syphilis, if syphilis progresses to its secondary or tertiary stages, it tends to cause lymph node enlargement, and severe cases may even lead to ulceration. This happens because after a syphilis infection, immune responses in the lymph cells are triggered by the Treponema pallidum, leading to the enlargement of cervical lymph nodes, and also possibly the lymph nodes under the arms and in the groin area. In such cases, it is advised to seek timely medical attention, complete the necessary immunological testing, and ensure an accurate diagnosis of syphilis. If cervical lymph node enlargement occurs, prolonged treatment with penicillin should be administered, as it effectively controls the Treponema pallidum and can help reduce the severity of the lymph node enlargement.
Is third-stage syphilis contagious?
Third-stage syphilis is infectious, but its contagiousness is relatively weak compared to first-stage and second-stage syphilis. The titers detected in third-stage syphilis are usually lower, so its infectiousness is comparatively minor. However, third-stage syphilis still has the capability to infect others. Therefore, patients with third-stage syphilis must actively seek treatment and refrain from having sexual relations with others, while also enhancing their own immunity.
What are the early symptoms of syphilis?
Syphilis is divided into overt and latent syphilis. Latent syphilis, regardless of whether it is early or late stage, shows no symptoms at all and can only be confirmed by blood testing. The symptoms in the early stage are mainly those of overt syphilis, primarily manifestations of primary syphilis. The stages of primary, secondary, and tertiary syphilis begin with the appearance of a lesion at the site of infection, typically about 0.5 to 1 centimeter in diameter, with a hard, dark red nodule that feels like cartilage. The surface may have ulcers; it may be painless, or there may be no pain at all. Subsequently, nearby lymph nodes may become enlarged. This swelling of the lymph nodes is characterized by being painless, usually unilateral, with no redness or rupture. These are the clear symptoms of overt primary syphilis. If treated properly at this stage, recovery is generally rapid.