Syphilis and Gonorrhea

Syphilis is caused by a germ called Treponema pallidum, This disease can be easily missed because a person can carry the germ of syphilis but may look healthy. Complications such as blindness, deafness and heart disease can occur many years after the initial infection and they do not respond to treatment at that stage. In its initial stage of infection, a sore appears in or around the genitalia (sex organs) usually about 2-3 weeks after sexual contact with an infected person. This sore usually heals on its own. The second stage of the disease is characterized by the appearance of some or all of the following features: a skin rash, loss of hair, enlargement of lymph nodes all over the body, sore throat, and a feeling of not being well. The skin rash may not be very obvious in dark skinned people and appears 3-6 months after genital sore appears. These symptoms also disappear gradually and the person goes into a latent or hidden stage, where the infected person feels well and healthy. The disease at this stage can be detected only by a blood test.

After many( usually 7-20 years) years of infection, complications such as blindness, paralysis and dementia occur in about 40% of patients. This stage is called tertiary syphilis. An infected mother may have several abortions and miscarriages. She could also infect the baby and cause congenital syphilis. (i.e. present at birth) The infection spreads through the placenta, from an infected mother to the unborn child. Most of the infected babies look normal at birth. involvement of the bones is common and the babies may develop swelling of the joints at around 6 weeks to 6 months of age; these are extremely painful, and as a result the baby may not move the limbs due to pain. Fever, anemia, failure to thrive, and irritability may be some of the features. Involvement of the nasal (nose) bone, teeth, enlargement of the liver and skin rashes are other later manifestations. The diagnosis is usually made by examining the scrapings from the lesions, and by doing the VDRL test. When a blood test is done a few days after the infection (soon. after the sore appears) the blood test may not be positive. Hence it is important to repeat the test again after 3 months. The VDRL may sometimes be positive in other conditions as well. In such instances other specific tests could be done to confirm the diagnosis. A blood test done during pregnancy helps to detect and treat congenital syphilis in the baby.

Treatment
Although syphilis can be completely cured when adequately treated in its early stages, treatment at the stage when complications set in is of little use. Self prescribed treatment with antibiotics such as tetracycline will suppress the disease but does not give a complete cure. Treatment is a prescribed course of Penicillin injections.

Gonorrhea
Gonorrhea is more prevalent than syphilis and is caused by bacteria Nisseria gonorrhoea (gonococci). The most noteworthy feature of this disease is that females frequently do not show any symptoms of the disease. Thus it is only the males (who get symptoms) that usually turn up for treatment. The larger infected pool of commercial sex workers usually does not seek treatment because they feel and look quite well. Symptoms in the male are burning sensation when passing urine, pus-like (thick and yellow) discharge from the tip of the urethra, and frequency of passing urine. If left untreated, complications can occur, but these are rare at present; these include swelling of joints, abscesses in the genital organs and infertility in women.Infection of the male urethra may lead to strictures (narrowing of the opening), and subsequent difficulty in passing urine. Infection of a pregnant mother may result in infection of baby's eyes, during birth. The eyes become reddened with a discharge. This may result in blindness, if untreated. Gonorrhea cannot be diagnosed by a blood test. The females in particular need to have a genital examination and special swabs taken for diagnosis. Penicillin used to be the drug of choice; however, many patients are now resistant to this drug.