Description

• Syphilis is a sexually transmitted bacterial infection with the spirochete Treponema pallidum
• The disease presents with four distinct, successive clinical stages if left untreated. Primary syphilis manifests with a painless chancre (primary lesion), typically on the genitals
• Secondary syphilis is characterized by a polymorphic, maculopapular rash that appears on the palms and soles also
• The first two stages are followed by an asymptomatic phase (latent syphilis), in which the disease may resolve entirely or progress to tertiary syphilis
• In the tertiary stage, characteristic granulomas (gumma) may appear, which can cause irreversible organ damage, particularly in the cardiovascular system (syphilitic aortic aneurysm) and the CNS (neurosyphilis)

Types

Primary Syphilis

• The primary lesion (chancre) may be single or multiple and is usually located in the labia
• Firm, indurated, painless, and highly infectious ulcer
• Enlarged lymph nodes
• Heals spontaneously in 1-8 weeks leaving behind a scar

Secondary Syphilis

• Systemic symptoms like fever, headache, and sore throat
• Maculopapular skin rashes on palms and soles
• Generalized lymphadenopathy, mucosal ulcers, alopecia
• Condylomalata – wart-like lesion in the vulva

Latent Syphilis

• Quiescence phase
• 2-20 yrs

Tertiary Syphilis

• Reappearance of symptoms
• Damages central nervous, cardiovascular, and musculocutaneous system
• Characterized by ‘Gummatous ulcer’
• Acute meningeal syphilis 
• Argyll Robertson pupil – Bilateral miosis, pupils accommodate but do not react to direct or indirect light

Investigation

• History and clinical picture
• Darkfield microscopy – demonstration of the organism in exudates of lesions
• Serological testing – VDRL, TPHA( Treponema pallidum Haemagglutination test), enzyme immune assay 
• Rapid plasma Reagin – generally the test of choice
• Angiography – aneurysms of the ascending aorta or aortic arch
• Chest CT – Heavily calcified aortic root, Treebark appearance of the aorta

Treatments

• Long-acting penicillin in a single dose IM
• For penicillin-sensitive patients, Doxycycline – 100 mg twice daily for 14 days
• Re-examination after treatment

Ayurvedic Treatment

Internal Medicines

• Aragwadhadi Kashaya
• Punarnavadi Kashaya
• Triphala Guggulu
• Vilwadi gutika
• Chandraprabha Vati
• Punarnavaasava
• Gandhaka rasayana

Procedures

• Yoni Kshalana - Triphala Kashaya
• Avagaha sweda - Triphala Kashaya

Department

Prasoothi & Stree Roga