Syphilis and infertility

Commentary

Newsday Reporter

37 Minutes Ago

Dr Maxwell Adeyemi –

DR MAXWELL ADEYEMI

Syphilis is a bacterial infection that was once a major public health threat. It is a highly contagious infection that can be spread through sexual activities, including oral and anal sex, with an infected person without the use of a condom or latex barrier. Many times the infected person may not even know they have the disease.

Causes of syphilis

Syphilis is caused by a bacterium called Treponema pallidum. It is spread through contact with an infected person’s sore during sexual activity. The bacteria enter the body through minor cuts in the skin or mucous membranes. Less commonly, syphilis may spread through direct contact with an active lesion, such as during kissing. It can’t be spread by using the same toilet, bathtub, clothing, eating utensils, swimming pools or hot tubs as an infected person. Once cured, syphilis does not return on its own, but someone can become re-infected if contact is made with syphilis sores.

Stages and symptoms

Primary syphilis: The first symptom of syphilis is appearance of a painless sore (chancre), which appears at the point of entrance of the bacteria into the body. An infected person can have one to several chancre sores which usually develops about three weeks after exposure. Many people who have syphilis may not notice the chancre because it’s usually painless and hidden. The chancre will heal on its own within three to six weeks

.

Secondary syphilis: A few weeks after the sore has healed, one may start to experience a rash that begins on the trunk and which will eventually cover the entire body, including the palms and the soles of feet. This rash is usually not itchy and may be accompanied by wart-like sores in your mouth or genital area. Some people also experience hair loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Latent syphilis: If left untreated, the disease moves from the secondary stage to the hidden (latent) stage, when it becomes asymptomatic. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary stage.

Tertiary syphilis: Complications from syphilis infection develops when syphilis is left untreated. In this stage, the disease may damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.

Neurosyphilis: At any stage, syphilis can spread and cause damage to the brain, nervous system and also, the eyes.

Complications of syphilis

Without treatment, syphilis can lead to damage throughout the body. It increases the risk of HIV infection and can cause problems during pregnancy. Treatment can help prevent future damage but cannot repair or reverse damage that has already occurred. In the late stage of syphilis, bumps (gummas) can develop on the skin, bones, liver or any other organ. Gummas usually disappear after treatment with antibiotics.

Neurological problems: Syphilis can cause a number of problems within the nervous system, including headache, stroke, meningitis, hearing loss, visual problems, dementia, loss of pain and temperature sensations, sexual dysfunction in men and bladder incontinence.

Cardiovascular problems: These may include bulging and swelling of the aorta (the body’s major artery) and of other blood vessels. Syphilis may also damage heart valves.

HIV infection: Adults with sexually transmitted syphilis or other genital ulcers have an increased risk of contracting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter the bloodstream during sexual activity.

Pregnancy and childbirth complications: Syphilis may be passed to an unborn baby. Congenital syphilis is extremely dangerous to a newborn baby, with a significant chance of fatality when untreated. It greatly increases the risk of miscarriage, stillbirth or death of the newborn within a few days after birth.

Diagnosis of syphilis

Syphilis can be diagnosed by testing of blood and spinal fluids.

Blood tests are used to detect the presence of antibodies that the body produces to fight infections. The antibodies to the syphilis-causing bacteria remain in your body for years, so these blood test can be used to determine a current or past infection. Some of these tests includes:

Venereal disease research laboratory test: This test is used to screen the blood for an antibody produced in people with syphilis. This antibody is not produced as a reaction to syphilis alone, so the test result could be positive for reasons other than syphilis. There are other specific lab tests to detect syphilis.

Cerebrospinal fluid screening test: Nervous system complications may require collection of a sample of cerebrospinal fluid through a lumbar puncture for syphilis screening.

Prevention of syphilis

There is no vaccine for syphilis. The only way to completely avoid getting syphilis is abstinence. The following can also help reduce the risk of infections:

• Using condoms during sexual activity

• Avoiding alcohol and recreational drugs which can compromise your judgment, leading to unsafe sexual practices.

Treatment of syphilis

There are no home remedies or over-the-counter drugs that will cure syphilis, but it is easy to cure in its early stages. Penicillin is one of the most widely used antibiotics and is usually effective in treating primary and secondary syphilis infection. People who are allergic to penicillin will likely be treated with a different antibiotic. Neurosyphilis can also be treated by taking daily doses of penicillin intravenously. This will often require a brief admission to hospital. Unfortunately, the damage caused by late syphilis cannot be reversed. The bacteria can be killed, but treatment will most likely focus on easing pain and discomfort.

During treatment, sexual activities should be avoided until all sores are completely healed. If you’re sexually active, your partner should be treated as well. Don’t resume sexual activity until you and your partner have completed treatment.

Effects of syphilis on fertility

Although, a direct effect of syphilis on male fertility has not been reported, complications of syphilis can affect male fertility. It can also cause epididymitis (blockage in the epididymis). Prolonged syphilis infection may also lead to the development of Tabes Dorsalis – when the disease starts to cause nerve degeneration. One of the consequences of late-stage syphilis in male is erectile dysfunction.

In women, syphilis can cause pelvic inflammatory diseases which can lead to endometrial damage resulting in infertility. Syphilis may also lead to devastating effects during pregnancy and on newborns. Spontaneous abortion and still birth occur in 50 per cent of pregnancies, with mortality of infected infants being over ten per cent.

Contact Dr Maxwell at 363-1807 or 757-5411.

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