Before I start my column, I'd like to remind everyone of a survey I'm conducting. I'm starting a research project in my program to increase awareness of the LGBT community in the medical community. These surveys ask you what you wish or would like your primary care physician to know about our community. For a more detailed explanation, please visit the site: https://www.pridesource.com/article.shtml?article=17789. Please e-mail me at the address below and I'll send out the materials. I'd like to thank those of you who have responded. Your help is much appreciated. Now on to this month's column!
So this month, we're going to continue with our series discussing the various STDs along with their symptoms, signs and treatment. For the previous columns on STDs, please visit https://www.pridesource.com.
The STD of the month is syphilis. Syphilis used to be one of the most common STDs and has come down dramatically since the advent of antibiotics (primarily penicillin). There was a resurgence of it in the 80s and 90s and then fell to an all-time low in 2000. However, there is another resurgence with Detroit being the capital of syphilis in the nation. Another number one for the city of Detroit … Yeah!
Syphilis is caused by the bacterium Treponema pallidum. Infection is, of course, transmitted by sexual contact. Transmission occurs when there is direct contact with an infectious lesion (I'll describe this in a bit) during sex. How do we know if we're infected? Well, let's talk about the different stages of syphilis.
After initial contact, it can take up to 3 weeks before any symptoms arise. A small bump in the skin (usually in the genital region) arises that is usually painless and appears at the site of contact. Soon, an ulcer appears that has a raised edge and the person may have some swollen glands in the region. Now, remember that this ulcer may appear anywhere depending on where one got infected – the genital region, hand, foot, mouth. Now these sores usually heal in 3-6 weeks even without treatment but without treatment, there's the increased risk of transmission.
Now let's say that this person still doesn't get treatment. In a few weeks to a few months later, about 25% of infected people develop secondary syphilis (the 2nd stage). A rash usually develops that looks like small zits occurring over the entire torso and extremities (especially on the palms and soles). They are red or reddish-brown and can be as big as 2 centimeters in diameter. Larger lesions that are gray to white in the mouth or genitalia may develop – these are called condyloma lata and are a result of the infection traveling further. Our patient may also develop fever, headache, weight loss, sore throat and muscle aches along with hair loss and swollen lymph nodes throughout the body.
This is just stage 2. These symptoms may disappear still without treatment but it certainly doesn't mean you don't have syphilis. These patients may have no symptoms for up to 25 years but the next stage is definitely something to worry about. Syphilis can affect the main vessel that comes of the heart leading to dilation of the vessel. Blood clots may form or the vessel may burst and that is definitely not a good thing. Syphilis can also affect the nervous system leading to meningitis showing up as facial paralysis, stiff neck, fever and headaches. The blood vessels of the nervous system may also be involved and show up as stroke-like symptoms. Some even become deluded and show signs of dementia and even loss of sensation in the extremities.
As with other STDs, you also have to look out for other infections that this person might have caught. The biggest one, of course, is HIV. HIV infection is pretty common in those who have found to be positive for syphilis. Although there are no major studies proving this, HIV seems to worsen this infection.
How do we treat syphilis? Syphilis can be treated simply with penicillin! This antibiotic is great and easily administered for those who seek treatment early. For those who let the infection stay, hospitalization is often required and usually for a long time. For those who are allergic to penicillin, there are alternatives. Of course, the best way to prevent infection is to play it safe and to know your partners!
And once again, I hit my word limit. I'm definitely too wordy. But as always,
if you have any questions, don't hesitate to ask me or your primary health care provider. Next week, we'll talk about another STD and if you have any particular interest in one, let me know. I hope this column finds all of you in good health and spirits and I'll see you next month!
