Syphilis is caused by an organism named spirocheta pallida,and can be found in all stages:primary,secondary and tertiary.Exist an other classification too,as:early,latent,late and congenital stage.The syphilitic infection presents a risk for doctors and nurses exposed,if there is a break in their skin or mucous membrane.
Ordinarily,however,the entry of the spirochete is determinated by sexual contact whit an infected partner.This is true even when the primary stage is on the breast,in the mouth or on the lips,the last sites being determinated by genito-oal coitus rather than by kissing or by drinking from infected containers-as used to be suggested.
We will talk about syphilitic case as a result of sexual intercourse.
The primary stage is found most commonly on the labia majora,labia minora,clitoris,urethral orifice or cervix,but it may be anywhere on the lower genital tract,even the vaginal wall.The signs appears usually in 10-20 days after exposure but the incubation period can be modified by penicillin therapy for gonorrhea and can be as long as 90 days.
The first manifestation is a small papule which quickly breaks down to form an ulcer,the classical features of which are a sharply defined serpiginous outline and a brownish red colour.
In practice the signs are so slight that can pass unnoticed.Indeed,any sort of discrete relatively painless ulceration on the vulva may be a primary syphilitic sign.
The first form(primary stage) heals spontaneously in 1-8 weeks and soon afterwards the secondary stage of syphilis,which resolts from entry of the spirochaetes into the bloodstream,is manifestated by:general systemic upset with lassitude,anorexia,headache,pustular skin rashes which are typically non-irritant,occasional loss of hair,white mucous patches in the mouth and moist and necrotic warts on the vulva and around the anus.
Sometimes secondary manifestation occur before the primary heals,or they may not occur at all.
The first and second stages can last up to 2 years,and all this time the woman(and the man infected0 is a source of infection.
In untreated syphilis the tertiary stage occupies many years during which the organisms of infection attack bones,joints,eyes,blood vesels,the heart and the central nervous system.Tertiary syphilis is also characterized by the formation of localized granulomas in any part of the body.Granulomas on the genital tract are rare but,when they do occur,are most often found on the vulva.They are not painful unless secondarly infected.this late form are rarely seen nowadays.
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