DR. HOOK- No clapping: Syphilis can be life-threatening

Ice cream– just love it! But I don't eat a whole lot of it for health reasons. Skiing– exhilarating! Well, until I tore my ACL and had surgery because a stupid snowman pushed me (I'm sticking with this story). TV– entertaining! Though after a while I feel like my IQ drops 100 points, and I feel like a sloth. 

For every yin there's a yang, for every rainstorm there's a flower, for every Marco there's a Polo– you get the point. With sex there can also be consequences: broken hearts, nasty gossip, and sexually transmitted diseases (STD). 

One particularly nasty STD, syphilis, is on the rise, according to the Virginia Department of Health. Between 2003-2007 in Virginia alone, the number of syphilis cases has increased a whopping 160 percent, in particular in men who have sex with men.

Syphilis is a sexually transmitted disease (with the exception of a pregnant mother infecting her fetus) dating back over 500 years that infected many famous people in history. It's caused by Treponema pallidum– a spiral-shaped, moving bacterium. Left untreated, this bad boy can cause lifelong medical problems.

There are three stages. After exposure to the bacterium, the incubation period is 10-90 days (average is three weeks). In primary syphilis, a chancre (pronounced shan-ker) appears at the site of infection and usually heals in a few weeks. It's a painless ulcer that feels somewhat hardened. 

Most men who find one on their penis run to the doctor faster than Marion Jones on steroids to the finish line. But some dudes don't really pay attention to their body parts, and since it doesn't hurt, they never notice it. Or if they're in denial (like politicians believing no one will ever find out about their visits to ladies of the night), they ignore the chancre. "Nay, it's just a flesh wound" as Monty Python might say.

However, when the chancre occurs in the mouth, throat, vagina, or anus, it can go unnoticed. So I guess you could say syphilis is also a kissing disease because you can get it that way. 

Secondary syphilis, which rears its ugly head weeks to months later, occurs in 25 percent of untreated people. Syphilis is called "the great mimicker" because of the similarity of symptoms to other diseases: rash (especially on the hands and feet), canker sores, swollen lymph nodes, fever, headache, hair loss, just not feeling well, loss of appetite. Hmm, kind of like how I feel about certain American Idol contestants. Left untreated, it can spontaneously go away but then pop up later– up to five years later!

Tertiary syphilis occurs in 25 percent of untreated people, and it can infect any organ: brain, heart, skin, stomach. Neurosyphilis, which can cause dementia, weakness, and sensory problems, can be a challenge to treat. Tertiary syphilis can be deadly.

You can't culture T. pallidum, but it can be seen on dark field microscopy in primary and secondary syphilis. So diagnosis is usually made with a blood test (for neurosyphilis, cerebral spinal fluid is evaluated). However, it can take up to 10 weeks for a positive reading, so what should be done if someone is exposed to syphilis?

A shot of benzathine penicillin G may be effective, although more than one dose might be required depending on certain factors. For those who get help within 90 days of exposure, treatment is recommended by the Health Department. 

Those who are sexually active outside an exclusive sexual relationship, or for those who have just entered a new relationship, had better not throw caution to the wind. It's better to be safe than sorry. Vital info available at cdc.gov/std/treatment/2006/rr5511.pdf

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.


1 comment

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