STD: Syphilis

STD:                         Syphilis
Causative Agent:    Treponema Pallidum
Signs/Symptoms:

• Painless ulcer on vulva or vagina (primary syphilis);
• Hepatic and splenic enlargement, headache, anorexia, and maculopapular rash on the palms of the hands abd soles of the feet (secondary syphilis; occuring about 2 months after initial infection;
• Cardiac, vascular, and central nervous system changes (tertiary syphilis; occuring after an undetermined latent phase);
• Positive venereal disease research laboratory serum test confirmed with positive rapid plasma reagin and fluorescent treponemal antibody absorption tests;
• Dark-field microscopy positive for spirochete.

Treatment:

• Penicillin G Benzathine (Bcillin L-A) Intramascular (single dose)

Special Considerations:

• Possible transmission across placenta after approximately 18 weeks of gestation, leading to spontaneous abortion, preterm labor, stillbirth, or congenital anomalies in the neonate;
• Standard screening for syphillis at the first prenatal visit, screening at 36 weeks of gestation for mother with multiple partners, and possible rescreening at beginning of labor, with neonates tested for congenital syphilis using a sample of cord blood;
• Jarisch-Herxheimer reaction (sudden hypotension, fever, tachycardia, and muscle aches) after medication administration, lasting for about 24 hours, and then fading becaus espirochetes are destroyed.