Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum, identifiable by sore lesions. It progresses through stages including primary, secondary, latent, and tertiary, with symptoms ranging from painless sores to severe systemic damage. Diagnosis involves blood tests and treatment primarily consists of penicillin, with alternative medications for those allergic to it.

1. Dr. B.Venkata Subbareddy Pharm.D
Asst.Professor
Sri Lakshmi Venkateswara Pharmaceutical Sciences, Proddatur

3. Syphilis is one of the better-known sexually transmitted infections (STIs), also referred
to as a sexually transmitted disease (STDs). It is caused by the bacterium Treponema
pallidum and can often be recognized by the appearance of an open ulcerative sore,
known as a chancre, on the genitals, mouth, anus, or rectum.

5. Aetiology
 Causative agent- Spirochaete Spicess
 It is a Unicellular organism.
 Which is elongated and tightly coiled and
undergoes reproduction every 30hrs.
 Human being is the only natural host and the
organism can not survive its host.
 Once it gains entry into the body, it can infect any
organ including central nervous system.

6. Mode of Transmission

7. The disease is usually transmitted by having
sexual contact with an infected person.

8. Transmission of human blood and by kissing or
touching active lesions of infected person

9. Sharing food or utensils of infected person or from using tubes ,
pools or toilets used by the infected person.

10. The disease can also be transmitted from mother to
infant during pregnancy.
.

13. Primary Stage
During the first (primary) stage of
syphilis, you may notice a single sore
or multiple sores. The sore is the
location where syphilis entered your
body. Sores are usually (but not
always) firm, round, and painless.
Because the sore is painless, it can
easily go unnoticed. The sore usually
lasts 3 to 6 weeks and heals regardless
of whether or not you receive
treatment. Even after the sore goes
away, you must still receive treatment.
This will stop your infection from
moving to the secondary stage

14. Secondary Stage
During the secondary stage, you may have skin rashes
and or mucous membrane lesions. Mucous membrane
lesions are sores in your mouth, vagina, or anus. This
stage usually starts with a rash on one or more areas of
your body. The rash can show up when your primary
sore is healing or several weeks after the sore has
healed. The rash can look like rough, red, or reddish
brown spots on the palms of your hands and/or the
bottoms of your feet. The rash usually won’t itch and it
is sometimes so faint that you won’t notice it. Other
symptoms you may have can include fever, swollen
lymph glands, sore throat, patchy hair loss, headaches,
weight loss, muscle aches, and fatigue (feeling very
tired). The symptoms from this stage will go away
whether or not you receive treatment. Without the right
treatment, your infection will move to the latent and
possibly tertiary stages of syphilis

15. Tertiary Stage
Most people with untreated syphilis do
not develop tertiary syphilis. However,
when it does happen it can affect many
different organ systems. These include
the heart and blood vessels, and the
brain and nervous system. Tertiary
syphilis is very serious and would
occur 10–30 years after your infection
began. In tertiary syphilis, the disease
damages your internal organs and can
result in death.

16. Neurosyphilis and Ocular Syphilis
Without treatment, syphilis can spread to the brain and
nervous system (neurosyphilis) or to the eye (ocular syphilis).
This can happen during any of the stages described above.
Symptoms of neurosyphilis include:
severe headache;
difficulty coordinating muscle movements;
paralysis (not able to move certain parts of your body);
numbness; and
dementia (mental disorder).
Symptoms of ocular syphilis include:changes in your vision
and even blindness.
Latent syphilis:
If you aren't treated for syphilis, the disease moves from the secondary to the latent (hidden)
stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms
may never return, or the disease may progress to the tertiary (third) stage.

17. Diagnosis
• Syphilis can be diagnosed by testing samples of:
• Blood. Blood tests can confirm the presence of antibodies that
the body produces to fight infection. The antibodies to the
bacteria that cause syphilis remain in your body for years, so
the test can be used to determine a current or past infection.
• Cerebral spinal fluid. If it's suspected that you have nervous
system complications of syphilis, your doctor may also
suggest collecting a sample of cerebrospinal fluid through a
procedure called a lumbar puncture (spinal tap).

18. Diagnostic tests
1.Visual microscopic examination.
a) DFA testing (Dark field antigen)
b) Immunofluoresence
c) Silver staining
2.Non treponemal serological antigen testing.
a)VDRL (Venereal disease research laboratory)
b)RPR (Rapid plasma reagin)
c)TRUST (Toluidine red unheated serum test)
3.Treponemal serological antigen testing
a) FTA-ABS Test (Fluorescent treponemal antibody test)
b) TP-PA Test (Treponema pallidum –particle
agglutination test)

19. Treatment
• Have periodic blood tests and exams to make
sure you're responding to the usual dosage of
penicillin
• Avoid sexual contact until the treatment is
completed and blood tests indicate the
infection has been cured
• Notify your sex partners so that they can be
tested and get treatment if necessary
• Be tested for HIV infection

20. SYPHILIS DRUG DOSAGE AND ROUTE
Syphilis of >1 year
(Primary and secondary
syphilis)
Procaine Penicillin+
Probenecid
A single daily I.M injection of
60,00,000 units+10mg oral
Probenecid given for 10days.
Benzathine penicillin
Two injections given by I.M
each injection of 1.2 mega
units of each.
In case of allergy to
penicillin: Doxycycline
100mg twice a day.
Erythromycin
Oral administration of 500mg
q.i.d for 2 weeks on empty
stomach.
Syphilis of<1 year
(Cardio vascular syphilis)
Procaine Penicillin+
Probenecid
A single daily I.M injection of
60,00,000 units+10mg oral
Probenecid given for 15days,
Benzathine penicillin 2.4 mega unit by I.M given
once a week & Continued for
3 weeks

21. SYPHILIS DOSE DOASAGE AND ROUTE
Nuerosyphilis
Procaine Penicillin+
Probenecid
A singel daily 2-4 million
units+10mg oral Probenecid
for 10days.
PenicillinG Daily dose of 12mega units
for divided doses for about 2
weeks.
Congenital Syphilis Procaine Penicillin G
Aqueous Penicillin G
Daily I.M injection of
1,00,000 units given for
10days.
Two daily divided doses of
50,000 units/kg