It is claimed that Treponema pallidum, which is the cause of syphilis, was brought to Europe by the foals after the discovery of Christopher Columbus in 1493. Some of these foals joined the siege of Charles VIII, France, and spread the disease. This illnesses Naples illness after the incident by the French, Italians by disease in France is given as syphilis name meaning frenk disease anılmıştır.türkiye disease.
Syphilis began to lose its former importance after the discovery of penicillin in the 1940s. To date, penicillin-resistant trepanomapallidium strain has not been detected. Today, cases of third revulsion, cardiovascular syphilis and neurosyphilis, which are mentioned in classical books, are extremely rare.
The active trepanoma pallidum is 6-20 micrometers in length and is very mobile. Its movement is clearly seen in the dark field microscope. T.pallidum has not been produced in culture media yet. Therefore, the diagnosis is made only by the appearance of T.pallidum in the material taken from the lesion or the detection of antibodies in the blood.
The incubation period in syphilis is 3-4 weeks. The first symptom is a painless, ground-hard, pink-matte, superficial ulceration with a diameter of 4-5 mm, usually seen in the genitals. This lesion contains abundant spirochetes. It can be confused with chancr, ulkusmol, scabies chancre, herpes genitalis and genital aphthae. One week after the chancre comes out, growth is observed in the nearest lymph node (usually in the inguinal area). The chancr lasts 6-8 weeks and heals without a trace. If the chancr vagina is in the rectum or cervix, it may not be noticed by the patient. The symptoms of secondary syphilis (period 2) begin on average 6 weeks (2 weeks-6 months) after Şankr. Some of these symptoms are macules, pink lymphadenopathies, mild fever, headache, hair loss in the form of moth fever, and thickening in the voice. Papular lesions can be seen on the trunk, arms, legs, palms and soles. When these papules are located in the genital area, they are called "candiloma lata". In mucosal region, the papules are called "plaque mucosa". All these skin lesions are extremely contagious because they contain abundant spirochetes.
The second period is very light in 25% of patients and is not noticed. The symptoms of the second period will regress within a few months and the disease will latent early. In this period, which can extend up to 2-4 years, symptoms may recur. Roseoles can be confused with infectious diseases such as measles, rubella, fever and rash, and papular lesions with scabies and psoriasis (psoriasis). If the disease is not treated during this period, it is entered late. Screening tests (nonspecific tests) are positive in the late period, but most patients have no symptoms. Some patients (17%) may have lesions progressing with tissue damage such as gom (gumma) and tubercle.
Diagnosis in syphilis, as in other infectious diseases
- Determination of the Existence of the Agent
- It is placed by detecting antibodies against the agent.
Treponemas can be detected in the material taken from lesions (chancr, rozeol). In addition, specific ELISA tests that detect antigens belonging to the agent have become more and more common in recent years.
Antibodies formed in syphilis are of 2 types:
- They are specific antibodies against antigens contained in T. Pallidum. TPHA (Treponema Pallidum Hemagglutination Assay), FTAABS (Florescent Treponemal Antibody Absorption) detect these antibodies.
- Nonspecific antibodies against substances (such as cardiolopin) that result from tissue damage. Since these antibodies are not specific, tests that detect their presence are also not completely reliable. It can give false positive results in various diseases with tissue damage. These tests are VDRL (Veneral Disease Research Laboratory), RPR (RapidPlasma Reagin) and are used in screening studies. Acute diseases where VDRL and RPR give false positive results include pneumonia, flu, infectious, mononucleosis, soft chancre, malaria, scarlet fever and hepatitis. These tests may be positive in chronic diseases such as leprosy, tuberculosis and collagen tissue diseases. In cases with HIV infection, since the negative results of serological tests will cause diagnostic difficulties, the direct agent should be shown. In these cases, treatment-resistant central nervous system involvements were observed.
Syphilis treatment is regulated by laws in our country. Penicillin-resistant T.pallidum strain has not been detected to date, and the first choice in treatment is penicillins. Dose and duration vary depending on the stage of the disease. Erythromycin is recommended in cases of syphilis + pregnancy or in case of penicillin allergy. VDRL titers should decrease after successful treatment. In those who are treated early, this is 6-12. In diseases that last longer than 1 year, after 12-18 months.