Tuesday, May 17, 2022

What Does Syphilis Do To The Brain

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How Common Is Syphilis

Did you know that Syphillis can affect your brain? |Neurosyphillis

During 2019, there were 129,813 reported new diagnoses of syphilis , compared to 37,968 new diagnoses of HIV infection in 2018 and 616,392 cases of gonorrhea in 2019.1, 2 Of syphilis cases, 38,992 were primary and secondary syphilis, the earliest and most transmissible stages of syphilis. In 2019, the majority of P& S syphilis cases occurred among gay, bisexual, and other men who have sex with men . Specifically, MSM only and men who have sex with men and women accounted for 47% of all P& S syphilis cases, as well as 56% of all male P& S syphilis cases. However, in recent years, the rate of P& S syphilis has been mostly increasing among MSM as well as heterosexual men and women.

Congenital syphilis continues to be a concern in the United States. According to preliminary 2020 data, more than 2,000 cases of congenital syphilis were reported, compared to 65 cases of perinatal HIV infection during 2018.1, 9 Preliminary data also showed rates of congenital syphilis are highest among mothers who were non-Hispanic American Indian or Alaska Native , followed by mothers who were non-Hispanic Native Hawaiian or other Pacific Islander and mothers who were non-Hispanic Black or African American .9

Treatment Of Organic Psychosis

In pharmacologic management, one aims toward achievement of symptom stabilization. In the setting of agitated behavior with resistant psychotic symptoms related to neurosyphilis, olanzapine, the atypical antipsychotic alternative, has demonstrated efficacy. Presently, however, there are no specific guidelines to address psychiatric symptoms in neurosyphilis.

Diagnosis And Treatment Of Syphilis

Before making a diagnosis and recommending a treatment plan, your doctor will conduct a medical history and physical exam. You may be asked the following questions to determine your plan of care:

  • Do you think you have been exposed to any STIs?
  • What are your symptoms?
  • Do you have sores in your genital area or anywhere else on your body?
  • Do you or your partner engage in risky behaviors, such as having sex without a condom or having more than one sex partner?
  • Have you had an STI in the past?

The physical exam may include:

  • Examination of the skin and mouth to look for rashes or other abnormalities.
  • A pelvic exam to look for abnormal sores in the vagina or on the vulva, labia, rectal area, and inner thighs.
  • A genital exam to look for sores around the penis and scrotal area.

A diagnosis usually is confirmed with one of several blood tests. A technique called dark-field examination uses a microscope to see whether syphilis bacteria are present.

If you learn you have syphilis, it is important to alert your sexual partner so they can also seek treatment, Shank says. Taking precautionary measures and treating the infection early are important to maintaining your reproductive health.

After treatment, it is important to follow up with your provider. To ensure your treatment is successful and to avoid additional risks, you may be asked to do the following:

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How Is Syphilis Spread

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can spread from an infected mother to her unborn baby.

Example of a primary syphilis sore.

Secondary Stage Of Syphilis

SYPHILIS  Zion Medical Solutions Ltd

When it begins: The secondary stage of syphilis begins within 6 months of the syphilis sores going away. Some people enter this stage immediately after their sores clear.

What you may notice: As the disease spreads throughout your body, many signs and symptoms can develop. The most common are:

  • Rash

  • Sores on moist areas

  • Fever

  • Problems with your reflexes

  • Paralysis

The secondary stage lasts several weeks to several months. Once this stage ends, the signs and symptoms will go away.

While most signs and symptoms go away, this doesnt mean the syphilis goes away. Without treatment, syphilis often moves to the next stage.

Are you contagious? Yes. Syphilis is very contagious during this stage. If you have sex , you can easily give your partner syphilis.

While less common, you can give your partner syphilis through kissing if you have syphilis sores inside your mouth or on your lips.

Syphilis rash

A rash can develop anywhere, but it often appears on the palms and soles. It may cause spots, blisters, or many other signs.

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What Is The Treatment For Syphilis

For detailed treatment recommendations, please refer to the 2021 CDC STI Treatment Guidelines. The recommended treatment for adults and adolescents with primary, secondary, or early latent syphilis is Benzathine penicillin G 2.4 million units administered intramuscularly in a single dose. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units administered intramuscularly each at weekly intervals. The recommended treatment for neurosyphilis, ocular syphilis, or otosyphilis is Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units intravenously every 4 hours or continuous infusion, for 10-14 days. Treatment will prevent disease progression, but it might not repair damage already done.

Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations are not appropriate replacements for benzathine penicillin, as these combinations provide inadequate doses of penicillin. 8

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

How Long Can You Live With Syphilis

You’ll still be infected even if you don’t have symptoms. This is known as “latent syphilis” and it can last for decades and lead to serious problems if not treated. It’s still possible to pass on the infection during this stage, although this usually only happens within 2 years of becoming infected.

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Can Stage 3 Syphilis Be Cured

Late stage syphilis can be cured but the damage done to the body is permanent. Syphilis can invade the nervous system at any stage of infection, and causes a wide range of symptoms, including headache, altered behavior, difficulty coordinating muscle movements, paralysis, sensory deficits, and dementia.

What Are The Long Term Symptoms Of Syphilis

Syphilis, Causes, Signs and Symptoms, Diagnosis and Treatment.

These syphilis symptoms may come and go for up to 2 years. They include body rashes that last 2 6 weeks often on the palms of your hands and the soles of your feet. There are lots of other symptoms, including mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache, and muscle pains.

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Tips To Prevent Syphilis

The first step in neurosyphilis treatment is preventing syphilis. Since syphilis is an STI, your best option is to practice safe sex. You can discuss this with your doctor. Condoms can reduce the chance of contracting syphilis. However, syphilis can be contracted through touching genitals outside of the area covered by the condom.

People dont always know they have been infected with syphilis because symptoms can remain hidden for years. An initial sore or sores at the infection site may appear a few weeks or months after contracting the disease. Although these sores heal on their own, the disease can remain. Later, a rash of rough, not itchy, reddish brown spots will appear at the infection site or on another part of the body. If you plan on being sexually active, get tested for STIs on a regular basis. If you have syphilis, you can pass it on to others, including your unborn baby.

Other symptoms of syphilis include:

  • swollen lymph glands

How Big Is A Syphilis Sore

Syphilitic chancres and mucous patches usually are painless, unless they become secondarily infected. Both of these lesions are highly infectious. The chancre begins as a round papule that erodes into a painless ulcer with a smooth grayish surface . Size can range from a few millimeters to 2 to 3 cm.

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Syphilis Risk And Prevention

Any sexually active person can contract an STI through unprotected vaginal, anal, or oral intercourse. Its important to discuss your lifestyle and risks with your health care provider.

Currently, no vaccine exists to prevent syphilis. But you can help avoid spreading the infection by following three important recommendations:

  • Abstain from sex. The only specific way to avoid syphilis is to abstain from sexual intercourse, including oral sex.
  • Practice monogamy. Choosing to engage in any sexual act with only one person reduces your risk.
  • Use a latex condom. Condoms can reduce your risk of contracting many sexual diseases, particularly if the condom covers a syphilis sore. But sometimes sores cannot be covered by a condom. Even if the infection is not active, it can still spread.

If you are experiencing the symptoms of syphilis, its important for you to see a health care provider as soon as possible. Visit our website to find a provider near you.

What Are The Signs And Symptoms In Adults

Syphilis symptoms &  treatment

Syphilis has been called The Great Pretender, as its symptoms can look like many other diseases. However, syphilis typically follows a progression of stages that can last for weeks, months, or even years:

Primary Stage

The appearance of a single chancre marks the primary stage of syphilis symptoms, but there may be multiple sores. The chancre is usually firm, round, and painless. It appears at the location where syphilis entered the body. These painless chancres can occur in locations that make them difficult to notice . The chancre lasts 3 to 6 weeks and heals regardless of whether a person is treated or not. However, if the infected person does not receive adequate treatment, the infection progresses to the secondary stage.

Secondary Stage

Latent Stage

The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. Without treatment, the infected person will continue to have syphilis in their body even though there are no signs or symptoms. Early latent syphilis is latent syphilis where infection occurred within the past 12 months. Late latent syphilis is latent syphilis where infection occurred more than 12 months ago. Latent syphilis can last for years.

Tertiary Syphilis

Neurosyphilis and Ocular Syphilis

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What Happens If Syphilis Is Left Untreated

  • What Happens If Syphilis Is Left Untreated? Center
  • Untreated syphilis can lead to permanent damage to multiple body systems such as the brain, heart, and eyes and result in life-threatening complications. Syphilis can be cured completely in the initial stages with antibiotics . Timely treatment can help prevent complications. There is no treatment available to repair or reverse damage that has already occurred. The common complications that can occur include the following:

    Gummas: Small bumps or tumors called gummas can develop on the skin, bones, and other organs such as the liver in the late stage of syphilis. Gummas usually disappear after treatment of syphilis with antibiotics.

    Neurological complications: Syphilis can damage the brain and nervous system causing the following:

    • Meningitis
    • Dementia presenting with memory problems
    • Loss of pain and temperature sensations
    • Aneurysm of the aorta and other blood vessels
    • Damage to the heart valves

    Genitourinary complications:

    Urinary incontinence

    Human immunodeficiency virus infection: Patients with syphilis have a significantly increased risk of contracting HIV. Chancres bleed easily, leading to easy transmission of HIV during sexual activity.

    Pregnancy and childbirth complications: Congenital syphilis increases the risk of miscarriage, premature birth, stillbirth, or death of the baby soon after birth. The child can develop have visual problems and deafness.

    What Are The Signs & Symptoms Of Primary Syphilis

    The main symptom of primary syphilis is a one or more chancres . They develop about 3 weeks after someone is infected. The chancres happens where the sexual contact happened . They are usually painless.

    The chancre goes away in about 36 weeks, even without treatment. But without treatment, syphilis will move on to the next stage, secondary syphilis.

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    Csf Analysis And Disease Activity

    In patients with serologic evidence of syphilis, the presence of neurosyphilis can be determined only by CSF analysis. The CSF should be examined in all patients with suspected neurosyphilis. If adequacy of prior treatment is uncertain, if relapse is suspected, or if the CSF has not been evaluated, lumbar puncture is necessary.

    Although active neurosyphilis probably can occur with normal spinal fluid, there is usually a pleocytosis or elevated protein . In addition there should be a one or more positive CSF serologies .

    In neurosyphilis, the CSF VDRL or RPR tests usually are negative, but when positive they suggest active neurosyphilis. Intrathecal production of antitreponemal antibodies can be measured and is expressed as an index. A high index indicates that antibody is being produced at a higher rate in the CNS than outside the CNS, indicating the presence of neurosyphilis. An antibody index usually is not needed but may assist in distinguishing active from inactive disease.

    Although not part of the diagnostic criteria for syphilis, most patients have elevated immunoglobulin G levels in the spinal fluid, with oligoclonal bands.

    A diagnosis of neurosyphilis is made when there is serologic evidence of CNS invasion by treponemes . The activity of the process can be assessed by the extent of CSF abnormalities and a CSF VDRL titer when positive. In troublesome cases a CSF antibody index may be helpful.

    Joseph R. Berger, in, 2003

    Which Std Can Cause Brain Damage

    Syphilis epidemic after STI reaches highest levels last seen in 1940s says infectious disease expe

    Syphilis is a sexually transmitted infection caused by bacteria. Even though it is curable, if syphilis isnt treated, it can cause serious damage to your brain, heart, nervous system, and even lead to death.

    Neurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years.

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    Where Is Syphilis Most Common

    In the United States rates of syphilis have increased among men between 2000 and 2007. Rates are six times greater in men than women and seven times greater in African Americans than Caucasians. More than 60% of cases are in men who have sex with men. It occurs most commonly in those between 15 and 40 years of age.

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    Treatment Of Symptomatic Neurosyphilis Or Asymptomatic Neurosyphilis

    This population has a greater risk of neurorelapse therefore, assiduous follow-up is required. For now, therapy that is considered standard for nonimmunocompromised individuals should remain the standard for immunocompromised individuals. Patients in this category also include those with syphilitic eye disease, syphilitic auditory disease , cardiovascular syphilis, or gummatous syphilis.

    Either of the following is acceptable treatment:

    • Aqueous PCN-G at 2-4 million U intravenously every 4 hours alternatively, continuously for 10-14 days

    • Procaine PCN-G at 2.4 million U/d intramuscularly plus probenecid at 500 mg orally 4 times per day for 10-14 days

    Contraindications include documented hypersensitivity, use of PCN in pregnant patients , and impaired renal function .

    A cure for neurosyphilis does not exist in patients infected with HIV. After treatment for syphilis, PCN fails to produce a biologic cure and relapse is prevented by the immunologic status of the host. In a way, neurosyphilis is considered an opportunistic infection. Prolonged survival despite depleted helper T cells is associated with a recrudescence of syphilis. The course of neurosyphilis is believed by some investigators to be more rapid in patients co-infected with HIV, consistent with a potentiating effect. Others maintain that the course is no more aggressive in HIV-positive patients, nor is it atypical or more refractory to treatment.

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    Stages And Symptoms Of Syphilis

    Syphilis has four stages: primary, secondary, latent, and tertiary. Different signs and symptoms are associated with each.

    • Primary syphilis generally begins with a sore at the original site of infection. These sores, called chancres, are typically found in, on, or around the genitals, anus, rectum, or mouth. These sores are usually firm, round, and painless.
    • Secondary syphilis symptoms occur four to eight weeks later. They typically start with a non-itchy skin rash on one or more parts of the body. Other symptoms can include swollen lymph nodes and fever. The signs and symptoms may disappear, come and go, remain mild, or even go unnoticed.
    • Latent syphilis is the next stage if an infected person goes untreated. Also known as the hidden stage, it can last years and present no visible signs or symptoms, especially early on. This stage still responds rapidly to treatment if identified.
    • Tertiary syphilis is the final stage and is associated with severe medical problems. Symptoms can occur many years after the original infection. It can affect the heart, brain, and other organs of the body. Cardiovascular syphilis can affect the aorta and cause damage to other blood vessels. Neurosyphilis, which occurs when syphilis spreads to the central nervous system, can cause memory problems, headaches, or personality changes, and can even lead to meningitis.

    Am I At Risk For Syphilis


    Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs.

    • All pregnant women should be tested for syphilis at their first prenatal visit.
    • You should get tested regularly for syphilis if you are sexually active and
    • are living with HIV or
    • have partner who have tested positive for syphilis.

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    Tests To Screen For Syphilis

    • One of the oldest blood tests that is used to check for substances that are made by bacteria which can cause syphilis is called the Venereal Disease Research Laboratory test . It measures the antibodies that your body may be producing if you have come in contact with these particular bacteria. The test can be done using either a sample of your spinal fluid or a regular blood sample.
    • Rapid Plasma Regain test this is another screening test for syphilis in which they are looking for antibodies that are in the blood of people who have neurosyphilis. This is similar to the VDRL test.
    • Enzyme Immunoassay test this is a newer blood test and if it is positive it should be checked with either a RPR or VDRL blood test.

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