Friday, July 3, 2009
DIAGNOSIS AND TREATMENTS
Syphilis is detected by symptoms and verified by one of several tests performed on the blood or spinal fluid, the most common of which is the VDRL (venereal disease research laboratory) test. The preferred drug for treatment is benzathine penicillin, which is given in two injections one week apart for all stages but neurosyphilis. For this advanced stage, the antibiotic is given three times at weekly intervals. Syphilis control includes tracking down all sexual contacts of infected persons and treating those who had contact during the infectious period. Use of condoms offers some protection against contracting syphilis
STAGES AND SYMPTOMS
The primary stage of syphilis is characterized by a small lesion, called a chancre, which appears at the site of infection three to six weeks after exposure. Fluid from the chancre is extremely infectious. In the secondary stage, occurring about six weeks later, a generalized rash appears. Painless ulcers develop in the mouth, and broad, wartlike lesions, which also are highly infectious, may appear in the genital area. Headache, fever, and enlarged lymph glands are sometimes observed. These symptoms usually disappear in 3 to 12 weeks.
The disease then enters a latent stage in which no outward signs or symptoms occur, but inflammatory changes may take place in the internal organs. The latent stage can last 20 to 30 years. In 75 percent of the cases, no further symptoms appear. When the final stage, tertiary syphilis, does occur, however, it may produce hard nodules, called gummas, in the tissues under the skin, the mucous membranes, and the internal organs. The bones are frequently affected, as well as the liver, kidney, and other visceral organs. Infection of the heart and major blood vessels accounts for most deaths.
A prominent part of neurosyphilis, which occurs in nearly 15 percent of the tertiary cases, is tabes dorsalis, or locomotor ataxia (see Paralysis). Also present are a lack of muscular coordination, loss of urinary control, and degeneration of the reflexes; psychosis may ensue. Infection in the uterus may lead to miscarriage, to stillbirth, or to the birth of a child with congenital syphilis. Infected children often bear typical signs, such as high forehead, saddlenose, and peg-shaped teeth. By the second decade of life, central nervous system deterioration may appear.
The disease then enters a latent stage in which no outward signs or symptoms occur, but inflammatory changes may take place in the internal organs. The latent stage can last 20 to 30 years. In 75 percent of the cases, no further symptoms appear. When the final stage, tertiary syphilis, does occur, however, it may produce hard nodules, called gummas, in the tissues under the skin, the mucous membranes, and the internal organs. The bones are frequently affected, as well as the liver, kidney, and other visceral organs. Infection of the heart and major blood vessels accounts for most deaths.
A prominent part of neurosyphilis, which occurs in nearly 15 percent of the tertiary cases, is tabes dorsalis, or locomotor ataxia (see Paralysis). Also present are a lack of muscular coordination, loss of urinary control, and degeneration of the reflexes; psychosis may ensue. Infection in the uterus may lead to miscarriage, to stillbirth, or to the birth of a child with congenital syphilis. Infected children often bear typical signs, such as high forehead, saddlenose, and peg-shaped teeth. By the second decade of life, central nervous system deterioration may appear.
syphilis,
Syphilis, infectious disease caused by the spirochete Treponema pallidum (see Bacteria) and usually transmitted by sexual contact or kissing. Infection from contaminated objects is infrequent, because drying quickly kills the organisms. A fetus carried by a woman with syphilis may contract the disease, a condition called congenital syphilis
Paul Ehrlich
Paul Ehrlich
German bacteriologist Paul Ehrlich won the 1908 Nobel Prize in physiology or medicine. Ehrlich put forth fundamental theories explaining the chemistry of immunity and developed a number of chemical treatments for diseases.
Authorities believe that syphilis was introduced into Europe in 1493 by crew members returning from Christopher Columbus's first expedition to America; by the 16th century, syphilis had become the major public disease. The spirochete responsible for syphilis was discovered only in 1905, however, by the German zoologist Fritz Schaudinn. In 1906 the German bacteriologist August von Wassermann developed the first blood reaction test for the disease's diagnosis, and in 1909 the German bacteriologist Paul Ehrlich discovered the first effective treatment: the arsenic-containing compound Salvarsan. In 1943 the antibiotic penicillin was shown to be highly effective against syphilis, and it is still the preferred treatment for the disease.
Effective therapy and intensive public-health measures reduced the number of cases reported in the United States from 106,000 in 1947 to 25,500 in 1975, but the number rose again to about 35,500 cases in 1999. During the 1970s most cases of syphilis in men occurred in homosexuals, but the increase in the 1980s appeared to be largely among heterosexuals. This trend increased the incidence of congenital syphilis, which causes a high rate of morbidity and mortality in infants. People who also have acquired immunodeficiency syndrome (AIDS) are more likely to develop serious forms of syphilis and to suffer relapses after treatment that usually would be curative
Paul Ehrlich
Paul Ehrlich
German bacteriologist Paul Ehrlich won the 1908 Nobel Prize in physiology or medicine. Ehrlich put forth fundamental theories explaining the chemistry of immunity and developed a number of chemical treatments for diseases.
Authorities believe that syphilis was introduced into Europe in 1493 by crew members returning from Christopher Columbus's first expedition to America; by the 16th century, syphilis had become the major public disease. The spirochete responsible for syphilis was discovered only in 1905, however, by the German zoologist Fritz Schaudinn. In 1906 the German bacteriologist August von Wassermann developed the first blood reaction test for the disease's diagnosis, and in 1909 the German bacteriologist Paul Ehrlich discovered the first effective treatment: the arsenic-containing compound Salvarsan. In 1943 the antibiotic penicillin was shown to be highly effective against syphilis, and it is still the preferred treatment for the disease.
Effective therapy and intensive public-health measures reduced the number of cases reported in the United States from 106,000 in 1947 to 25,500 in 1975, but the number rose again to about 35,500 cases in 1999. During the 1970s most cases of syphilis in men occurred in homosexuals, but the increase in the 1980s appeared to be largely among heterosexuals. This trend increased the incidence of congenital syphilis, which causes a high rate of morbidity and mortality in infants. People who also have acquired immunodeficiency syndrome (AIDS) are more likely to develop serious forms of syphilis and to suffer relapses after treatment that usually would be curative
varicose
Varicose Vein, dilated (enlarged) and often twisted vein just below the skin that develops when the valves in the vein no longer function properly or when blood volume in the vein increases. Varicose veins develop most commonly in the legs, but also occur in the anus (hemorrhoids), esophagus, and testes in males (varicocele).
Varicose veins in the legs are characterized by a purplish-blue color. These veins may become prominent and readily visible. Varicose veins may be painful and cause swelling of the ankles and ulcerations on the skin of the legs. Venous thromboses (blood clots) may develop within varicose veins. If these blood clots break off from the vein and enter the circulatory system, they may cause a dangerous obstruction elsewhere, as in the smaller arteries of the lungs. Simple superficial varicose leg veins are treated by applying pressure all along their length with an elastic stocking. Larger varicose veins may be removed by a physician with a chemical solution or surgery.
Dilation and inflammation of the veins in the membranes of the anus or rectum produce hemorrhoids, also called piles. Mild hemorrhoids may only itch, but advanced cases are painful and cause bleeding. Topical ointments may provide temporary relief from discomfort. Doctors recommend a diet rich in high fiber foods to improve regularity of bowel movements. The most serious cases require surgical removal of the dilated veins.
Varicose veins in the legs are characterized by a purplish-blue color. These veins may become prominent and readily visible. Varicose veins may be painful and cause swelling of the ankles and ulcerations on the skin of the legs. Venous thromboses (blood clots) may develop within varicose veins. If these blood clots break off from the vein and enter the circulatory system, they may cause a dangerous obstruction elsewhere, as in the smaller arteries of the lungs. Simple superficial varicose leg veins are treated by applying pressure all along their length with an elastic stocking. Larger varicose veins may be removed by a physician with a chemical solution or surgery.
Dilation and inflammation of the veins in the membranes of the anus or rectum produce hemorrhoids, also called piles. Mild hemorrhoids may only itch, but advanced cases are painful and cause bleeding. Topical ointments may provide temporary relief from discomfort. Doctors recommend a diet rich in high fiber foods to improve regularity of bowel movements. The most serious cases require surgical removal of the dilated veins.
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