YOUNG ADULT PROBLEMS: SYPHILIS

Syphilis is a sexually transmitted disease caused by a bacterium called Treponema pallidum. It is transmitted through any form of intercourse -oral, anal or vaginal – but is more prevalent in the homosexual population following non-vaginal intercourse. Like most sexually transmitted diseases, Treponema passes into the tissues of the genitals, rectum or throat via seminal fluid or vaginal excretions entering small abrasions.

There are four stages, at any one of which the body’s immune system may overwhelm the infection, or treatment may be applied. The later the stage, the less likely it is that the outcome will be good.

Primary syphilis is characterized by a sore or chancre developing three to four weeks after infection. This sore is hard to heal but will spontaneously disappear about six weeks later. This is not a fixed time schedule and any lesion in the genital or anal area must be regarded with suspicion. Lesions in or around the mouth or throat must also be considered as potentially syphilitic especially in the promiscuous or in homosexuals.

At this stage investigation includes a swab that is placed under a microscope and a technique known as dark-field microscopy is used to identify the bacterium. It is necessary, sometimes, to repeat this as the bacterium may be missed by the swab technique.

Secondary syphilis manifests before the chancre heals or may be delayed for up to a year. Symptoms of a skin rash, sore throat, headache and fever in association with a history of a genital sore must raise suspicion.

Dark-field microscopy is again utilized and by this stage blood tests will be positive for syphilis.

Latent syphilis only occurs if an untreated secondary stage continues. This latent phase is symptomless and is due to the bacterium, for some reason, not replicating but lying dormant. Occasionally small lesions may appear but may not be considered relevant. Blood tests throughout this period of time, which may last a lifetime (the average, however, is 10-15 years), may be negative or only weakly positive.

Tertiary syphilis – the fourth stage – must be suspected in any condition that does not have another obvious answer. The Treponema generally attacks the mucous membranes, the skin and arteries and therefore can pass into any system. Syphilis took a marked decline in frequency after the Second World War but is now on the rise. Injudicious use of antibiotics has led to resistant strains and there are reports of Treponema strains that are, along with tuberculosis, proving resistant to all known antibiotics. What may be more worrying is a poorly substantiated but nevertheless growing concern that syphilis is directly related to HIV infection.

Any genital lesion must be investigated by a GP or specialist in this field.

Antibiotic use must only be undertaken once the sensitivity of that particular syphilitc strain is established.

Alternative therapies have been used for centuries but should only be used in a complementary fashion now, provided that antibiotics are effective (which they still are in most cases).

Choice of treatment should be selected by a complementary medical practitioner using homeopathic and herbal treatments.

Topical treatment is rarely needed because these lesions are generally painless but applications of Calendula or Hypericum cream may be beneficial.

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