$Unique_ID{BRK04247} $Pretitle{} $Title{Syphilis, Acquired} $Subject{Syphilis Acquired Lues Venereal Disease Behcet's Syndrome Bejel Candidiasis Chancroid Congenital Syphilis Herpes Progenitalis Pinta Yaws } $Volume{} $Log{} Copyright (C) 1991 National Organization for Rare Disorders, Inc. 842: Syphilis, Acquired ** IMPORTANT ** It is possible that the main title of the article (Acquired Syphilis) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Lues Venereal Disease Information on the following diseases can be found in the Related Disorders section of this report: Behcet's Syndrome Bejel Candidiasis Chancroid Congenital Syphilis Herpes Progenitalis Pinta Yaws General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Syphilis is a chronic infectious disease caused by a microorganism (treponema pallidum). It is transmitted by direct contact with an infected lesion, usually through sexual intercourse. When untreated, Syphilis progresses through primary, secondary and latent stages. Symptoms can remain dormant for years. Eventually any tissue or vascular organ in the body may be affected. Syphilis may also be acquired by the fetus in the uterus or before birth (Congenital Syphilis). Syphilis can be cured with appropriate treatment. Symptoms Untreated Syphilis progresses through primary and secondary stages (which are infectious), and may end without further symptoms or continue to progress into a latent stage that may last for years. Primary Syphilis is characterized by lesions (chancres) of the skin, anus, vagina or moist surface of the mouth. These lesions present themselves from 10 to 90 days after the patient has been exposed to the organism and are found at the sight of contact with the infected person. The lesions are usually painless and start as small, solid elevations (papules) of the skin which gradually develop into raised, firm ulcers with a slight yellow discharge. When untreated these lesions heal within four to six weeks and may leave scarring. Secondary Syphilis usually presents itself within two weeks to six months after the appearance of the primary lesions. This stage of the disorder is characterized by lesions of the skin and mucous membranes that may be pink or coppery in color, widespread, symmetrical, and follow the lines of skin cleavage. The skin lesions of secondary Syphilis are infectious and most often found on the genitalia, palms, and soles of the feet. Symptoms such as loss of appetite, sore throat, headache, low-grade fever, muscle aches, nasal discharge, and swollen lymph nodes may occur. There is a relapse in twenty five percent of the untreated cases, occuring most often in the first year. Secondary Syphilis usually lasts two to six weeks and some of the lesions may leave scarring. Latent Syphilis occurs when Primary and Secondary Syphilis have gone untreated. There are no noticeable symptoms, and the diagnosis can only be made through laboratory tests. Patients may relapse during the first two to four years of infection, and infectious Secondary Syphilis lesions may reappear. In about one third of the cases the disease spontaneously cures itself. Another third will remain infected but show no signs of the disease. The final third will eventually develop late Syphilis. Late Syphilis is not contagious and usually progresses slowly. Benign (non-contagious) tumors may develop on any part of the body. These tumors usually involve the skin and bones. Cardiovascular problems, seizures, personality changes, impotence, bladder dysfunction, and eye problems such as optic atrophy and Argyll Robertson pupils (a pupil that fails to react to light but still reacts to distance) may also be present with late Syphilis. Dementia and blindness may result. Causes Syphilis is caused by the microorganism treponema pallidum and acquired through sexual contact with an infected person. Occasionally health workers have become infected while examining patients with infectious lesions. It may also be acquired by kissing someone with oral infectious lesions. Infected mothers can transmit Syphilis to the fetus in the womb. (For more information on Congenital Syphilis choose "Syphilis, Congenital" as your search term in the Rare Disease Database.) Affected Population There are about 80,000 cases of Syphilis reported each year in the United States. The highest rate of Syphilis is among 20 to 24 year old men and women. It is more common among persons who have sexual contact with numerous partners. The ratio of male:female cases of infectious Syphilis is currently 3:1. There has been a dramatic increase in Congenital Syphilis during recent years due to the use of "crack" cocaine and the increase in prostitution to support drug abuse. Related Disorders Symptoms of the following disorders can be similar to those of Acquired Syphilis. Comparisons may be useful for a differential diagnosis: Behcet's Syndrome is a relapsing inflammatory disease with unknown cause. The most common symptoms include oral and genital ulcers and inflammation of the eyes. The joints, blood vessels, central nervous system, and gastrointestinal tract may also be involved. Attacks may last a week to a month and recur spontaneously. Behcet's syndrome is not a venereal disease. (For more information on this disorder, choose "Behcet" as your search term in the Rare Disease Database). Bejel, or endemic syphilis, is an infectious disease caused by an organism (treponema pallidum II) related to and identical in appearance to that causing venereal syphilis. This infection causes lesions of the skin and bone and is common among children in the mediterranean countries of the Middle East, northern Africa, parts of eastern Europe, Arabia, subsaharan Africa, and Southeast Asia. In the United States, however, it is rare. Bejel is transmitted by physical, nonsexual contact and the sharing of eating and drinking utensils. (For more information on this disease choose "Bejel" as your search term in the Rare Disease Database.) Candidiasis (Candida Albicans) is a normally harmless yeast infection found in the mouth, intestinal tract, and vagina. This disorder is an infection caused by a fungus called Candida; most commonly the Candida albicans variety. It is also known as a yeast infection and it usually affects the skin and/or the mucous membranes of the mouth, intestines, or the vagina. Candida infections are rarely serious in otherwise healthy people. In rare cases it may spread through other parts of the body if the patients immune system is not functioning properly. In severe cases it may affect the blood, the membrane lining the heart muscle, or membranes around the brain (meninges). (For more information on this disorder, choose "Candidiasis" as your search term in the Rare Disease Database.) Chancroid is a sexually transmitted infection caused by the bacillus Hemophilus ducreyi. The incubation period for this disease is two to fourteen days. Chancroid affects the skin and starts as an inflamed patch of skin which eventually becomes a painful ulcer. Lesions are usually single but may be multiple. In males these lesions are usually found on the penis or around the anus. The lesions on females are normally found on the vagina, cervix, vulva, or around the anus. This infection is rare in the United States but common in Africa and Southeast Asia. Chancroid is usually treated with the antibiotic erythromycin. Congenital Syphilis is a chronic infectious disease caused by a microorganism (treponema pallidum) acquired by the fetus in the uterus or before birth. Symptoms of early Congenital Syphilis include fever, skin problems and low birth weight. In late Congenital Syphilis the symptoms of the disease do not usually become apparent until two to five years of age. In rare cases the disease may remain latent for years with symptoms not being diagnosed until well into adulthood. Symptoms of Congenital Syphilis may include inflammation and hardening of the umbilical chord, rash, fever, low birth weight, high levels of cholesterol at birth, aseptic meningitis, anemia, enlarged liver and spleen, jaundice (yellowish color of the skin), shedding of skin affecting the palms and soles, convulsions, mental retardation, inflammation around the bones, nasal discharge, hair loss, inflammation of the eye's iris, and pneumonia. (For more information on Congenital Syphilis choose "Syphilis, Congenital" as your search term in the Rare Disease Database.) Herpes Progenitalis is an infection of the genital skin caused by the herpes simplex virus. This infection is spread through sexual contact and lesions may appear within 4 to 7 days after contact. These lesions start out as blisters and may have a watery discharge. Both men and women may experience headaches, muscle aches and tender swollen lymph nodes in the groin. The blisters crust over and heal without treatment. Symptoms may last about 3 weeks. The disorder is contagious for up to two weeks after the lesions appear. The virus may remain latent and then reoccur at any time. There is no cure for this infection but lotions may be used to relieve pain, and the drug Acyclovir may prevent recurrent attacks. Pinta is an infectious disease caused by the microorganism treponema carateum. It is closely related to the microorganism which causes some other venereal diseases. Pinta is transmitted nonsexually and is characterized by rashes and discoloration of the skin. Small bumps develop and within several months reddish, scaly areas appear most often on the face, hands, and feet. It is common in the hot lowlands of Central and South America, but is rare in the United States. (For more information on this disease choose "Pinta" as your search term in the Rare Disease Database) Yaws is a nonvenereal infectious disease caused by the microorganism treponema pertenue which is related to syphilis. This disorder is common in children and is characterized by skin and bone lesions. Yaws is rarely found in the United States but is common among children in the humid tropics of Africa, South and Central America, the West Indies, and the Far East. (For more information on this disease choose "Yaws" as your search term in the Rare Disease Database.) Therapies: Standard Antibiotics are used to treat Acquired Syphilis. Penicillin is the treatment used most often. In some cases other antibiotics such as tetracycline or erythromycin may be used. Preventative treatment should be given to anyone who has been in sexual contact with an infected person within 90 days. It is very important that the patients history (especially sexual) be taken, and a battery of tests performed, in order to determine the stage of Syphilis affecting the patient. Therapies: Investigational This disease entry is based upon medical information available through February 1991. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Acquired Syphilis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Centers for Disease Control (CDC) 1600 Clifton Road, NE Atlanta, GA 30333 (404) 639-3534 American Social Health Association 100 Capitola Dr., Suite 200 Research Triangle Park, NC 27713 (919) 361-8400 National Sexually Transmitted Diseases Hotline (800) 227-8922 Council for Sex Information and Education 444 Lincoln Blvd., Suite 107 Venice, CA 90291 NIH/National Institute of Allergy and Infectious Diseases (NIAID) 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5717 For local treatment centers contact any state or local health department listed in your phone directory. These agencies can refer you to testing facilities for venereal diseases. References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1719-24. CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 1713-22. Clinical Dermatology, 2nd Ed.: Thomas P. Habif, ed; The C.V. Mosby Company., 1990. Pp.222-28. Congenital Syphilis Presenting in Infants After the Newborn Period: D.H. Dorfman, and J.H. Glaser; N Engl Med; (Nov. 8, 1990, issue 323 (19)). Pp. 1299-302.