CD-ROM Today 1996 January/CD-ROM Today 1996 January.iso/dp/0424/04247.txt

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$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
     [phone]

     Centers for Disease Control (CDC)
     1600 Clifton Road, NE
     Atlanta, GA  30333
     [phone]

     American Social Health Association
     100 Capitola Dr., Suite 200
     Research Triangle Park, NC  27713
     [phone]

     National Sexually Transmitted Diseases Hotline
     [phone]

     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
     [phone]

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.