SÍFILIS

	S
	SÍFILIS
	*SÍFILIS*

SÍFILIS

Sífilis

Chronic disease of sexual transmission caused by the Treponema Pallidum, a espiroqueta, with a complex natural history that happens through three phases.

After the appearance of Penicillin, very effective for its treatment, its presence in the western world diminished, but it returned to resurge with the appearance of marginalized subpopulations and changes in the sexual habits. At the moment in the western world its incidence by the fear has returned to be reduced to the AIDS (the prevention is similar in both cases).

He is more frequent in the groups of between 15 and 34 years.

Causes

Infection through the mucous oral, genital or anal by the Treponema Pallidum.

It is a very contagious organism, having itself established experimentally that the amount of espiroquetas necessary to infect to 50 % of the people is of only 57.

Signs and symptoms

Sífilis classic presents/displays four distinguibles phases affluent:

Primary injury or Chancro (hard).

Secondary Sífilis or Mucocutánea.

Phase of latency.

Tertiary Sífilis or of sequels.

Primary injury (chancro):

Although after the infection the T. Pallidum is scattered quickly by all the organism, the first symptoms, the premises, does not appear until last three weeks (con greater amount of inoculated organisms, faster) and consists of:

Pápula (elevation of the skin) in the zone of inoculation (in heterosexual men most frequent it is in the penis, in the homosexuals in mouth or anus);

the women in cervix and smaller lips), than one becomes a painless ulcer of consistency edges quickly typically lasts, like the cartilage of the ear.

The atípicas initial injuries are not rare, without ulceración.

After one week, approximately, from the appearance of chancro, they are developed to adenopatías (tumefacción of the regional lymphatic gánglios; inguinales or in the neck).

Chancro cures habitually in six weeks, but the adenopatías last much more; until months.

Secondary Sífilis:

Still before the disappearance of chancro, but sometimes after the same one, they appear the injuries of sífilis secondary:

Mucocutáneas (sifílides), located or generalized injuries (they can affect the palms, plants, face and hairy leather).

Spots (spots) pink of between 0.5 to 1 cm.,

Pápulas (bulks in the skin) more ahead, reddish, of so large similar, even

Ulceras, usually coexists several of these forms, and sometimes they are difficult to distinguish.

In broad the humid zones they erode forming condilomas; very contagious.

Adenopatias generalized.

Other frequent symptoms are:

Pain throat,

Fever,

General malaise and

Headache.

Sífilis secondary evolves to buds, less and less manifest, until the cutaneous injuries and the adenopatías disappear, going to

Phase of latency

In this the signs or symptoms of the disease disappear and the patient is not contagious (safe for the fetus; to see underneath sífilis congenital; or by the blood).

This state can indefinitely last during years, giving passage to the following phase or thus remaining.

Delayed or tertiary Sífilis

The infection and consequence fight of the organism against treponema produces injuries that, with the years usually are demonstrated like:

Neurosífilis

Affectation of the central nervous system and its blood vessels that can cause parenquimatosa Sífilis, or affectation of the neurons and its cases, divided as well in two great syndromes or groups of symptoms

General paralysis

Tabs dorsal

Cardiovascular Sífilis

Rubbers

Another form of presentation is the congenital Sífilis, caused by the infection of the fetus, and that presents/displays the following injuries, that appear as of the fourth month of pregnancy (the adapted treatment of the mother before can prevent its appearance):

Retained abortions or dead fetuses

Followed Rinitis of mucous injuries (vejigas, spills of blood under the broad skin and condilomas),

Affectation of the cartilages and the bones, which causes a typical nose, in chair to mount and defects of growth,

Hepática affectation with ictericia,

Adenopatías generalized,

Injuries in the eyes and kidneys.

Factors of risk

Commercial sexual relations,

Sexual promiscuity.

Prevention

To avoid the risk relations.

Protection by means of preservative in the doubtful relations.

Diagnosis and treatment

DIAGNOSIS:

The diagnosis precóz needs the demonstration of the Treponema in the primary injuries.

After a variable period, the tests in the blood are positivizan, of which more frequently used they are the VDRL and the RPR, that are indirect and must be validated by means of direct tests.

TREATMENT:

The TREATMENT IS NECESSARILY MEDICO, BY MEANS OF The ADMINISTRATION OF PENICILLIN To The SUITABLE DOSES. In the allergic to penicillin tetraciclinas and macrólidos patients are useful, but not other antibiotics.

Complications

As it is come off the clinic, sífilis can cause great number of cutaneous and digestive nervous, ocular complications, vasculares.

Prognosis

Sífilis treated quickly cures without leaving sequels, although it can return to be infected.

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