This document provides an overview of syphilis, including its causes, transmission, stages, diagnosis, and treatment. It is caused by the Treponema pallidum bacterium, which can be transmitted sexually, from mother to fetus, or through blood transfusions. Syphilis progresses through primary, secondary, latent, and tertiary stages. It is diagnosed through clinical examination, demonstration of spirochetes, and detection of antibodies. Treatment involves benzathine penicillin or alternative antibiotics depending on the stage of syphilis. Prevention involves barrier methods and avoiding contact with infected individuals.

1. NIMS INSTITUTE OF PHARMACY
SYPHILIS
BY- NILESH SHARMA
(Pharm-D 2nd year)

2. WHAT IS SYPHILIS ?
 SYPHILIS IS A SYSTEMIC ,SEXUALLY TRANSMITTED DISEASE (STD) CAUSED BY THE
TREPONEMA PALLIDUM BACTERIUM.
 THE THREE MEANS OF SYPHILIS TRANSMISSION ARE :
PERSON TO PERSON VIA VAGINAL , ANAL OR ORAL SEX THROUGH DIRECT
CONTACT WITH A SYPHILIS CHANCRE.
PERSON TO PERSON DURING FOREPLAY ,EVEN WHEN THERE IS NO PENETRATIVE
SEX (MUCH LESS COMMON ).
PREGNANT MOTHER WITH SYPHILIS TO FETUS.

3. SYPHILIS INTRODUCTION:
 CAUSED BY TREPONEMA PALLIDUM.
 TRANSMISSION : SEXUAL; MATERNAL – FETAL;BLOOD TRANSFUSION AND RARELY
BY OTHER MEANS OF BOTH TRANSMITTING AND GETTING INFECTED WITH HIV.

4. MODE OF TRANSMISSION :
 SEXUAL TRANSMISSION IS MOST COMMON,OCCURS WHEN ABRADED SKIN OR
MUCOUS MEMBRANES COME IN CONTACT WITH OPEN LESION.
 CAN BE TRANSMITTED TO FETUS.
 RARE TRANSMISSION FROM NEEDLE STICK AND BLOOD TRANSFUSION.

5. STAGES OF SYPHILIS :
 PRIMARY
 SECONDARY
 LATENT :
EARLY LATENT
LATE LATENT
 LATE OR TERTIARY : MAY INVOLVE ANY ORGAN,BUT MAIN PARTS ARE-
NEUROSYPHILIS
CARDIOVASCULAR SYPHILIS
LATE BENIGN ( GUMMA)

6. PRIMARY :
 DEVELOPS AT SITE OF CONTACT.
 MULTIPLIES AT THE SITE OF ENTRY, A SMALL PAINLESS PRIMARY LESION CALLED
CHANCRE IS FORMED.
 APPEARS ON EXTERNAL GENITILLA CORONA OF THE PENIS LABIA,VAGINAL
WALL.
 ALSO OCCURS IN CEVIX,PERIANAL AREA,MOUTH,ANAL CANAL.

7. SECONDARY :
 SECONDARY SYPHILIS AT 2-10 WEEKS AFTER PRIMARY LESION –DIFFUSE
SYMPTOMS :
FEVER,HEADACHE,SKIN PUSTULES.
USUALLY DISAPPEARS EVEN WITHOUT TREATMENT.

8. LATENT SYPHILIS :
 AFTER SEVERAL WEEKS,SECONDARY LESIONS DISAPPEAR AND DISEASE BECOMES
LATENT.
 NOT INFECTIOUS AT THIS STAGE.
 EXCEPT FOR TRANSMISSION FROM MOTHER TO FOETUS (CONGENITAL SYPHILIS).

9. TERTIARY SYPHILIS :
 DEVELOPS AFTER MANY YEARS IN PERSONS WITH UNTREATED SECONDARY
SYPHILIS.
 APPEARANCE OF DEGENERATIVE LESIONS CALLED GUMMAS IN SKIN,BONE AND
NERVOUS SYSTEM.

10. DIAGNOSIS :
EVALUTION BASED ON THREE FACTORS :
CLINICAL FINDINGS
DEMONSTRATION OF SPIROCHETES IN CLINICAL SPECIMEN.
PRESENT OF ANTIBODIES IN BLOOD OR CEREBRAL FLUID.
MORE THAN ONE TEST SHOULD BE PERFORMED.

11. LABORATORY TESTING:
 DIRECT EXAMINATION OF CLINICAL SPECIMEN BY DARK –FIELD MICROSCOPY OR
FLUORESCENT ANTIBODY TESTING OF SAMPLE.
 SPECIFIC TREPONEMAL ANTIBODY TESTS ARE USED AS A CONFIRMATORY TEST
FOR A POSITIVE REAGIN TEST.

12. SEROLOGICAL TESTS OF SYPHILIS (
DEPENDING UPON ANTIGEN )
 NON TREPONEAL / STANDARD TESTS :
VDRL
RPR
WASEMANN TESTS
TREPONEMAL TESTS :
FTA-ABS
TPHA

13. PREVENTIONS :
 AVOIDANCE OF SEXUAL CONTACT WITH DISEASED INDIVIDUAL.
 USE PHYSICAL BARRIERS (condom ) AND ANTISEPTICS.

14. TREATMENT :
 EARLY SYPHILIS
BENZATHINE PENICILLIN G ( INTRAMUSCULARLY ONCE )
PROCAINE PENICILIN 600000 UNITS INTRAMUSCULARLY DAILY FOR 10 DAYS.
IF PATEINT IS UNABLE TO TAKEN PENICILLIN ,THEN GIVE TERTRACYCLINE OR
ERYTHROMYCIN 500 MG 4 TIMES A DAY BY MOUTH –OR DOXYCYCLINE 100 MG FOR -
15 DAYS.
CEFTRIAXONE ,IT IS EFFECTIVE SPECIALLY IN NEUROSYPHILIS.

15. THANK YOU