SYPHILIS

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syphilis

Ques : 1    What is syphilis?

Ans :         This is a chronic infection caused by Treponema Pallidum.

Ques : 2    What is the mode of infection of syphilis?

Ans :         Incubation period 10 to 90 days. Almost 95% cases are transmitted through sexual intercourse. Other modes of infection are-

(1) Indirect – common towels or clothes, common utensils, common spoons, or drinking cups, cigarette sharing, licking pens and pencils, children whistles and toys etc.

(2) Congenital.

(3) Occupational – shoe makers or carpenters lick hails and put them back into common box, doctors spread infection through instruments, blood transfusion etc.

(4) Direct – kissing, bites, licking out foreign body in eye, feeding some one else’s child from breasts etc.

Ques : 3    What are the clinical features of syphilis?

Ans :         Clinical Features : A. Primary Stage –

(1) Local lymph nodes enlarged, hard, painless.

(2) Lesion may also occurs on lips, breast, nipple, fingers, tonsils, anus etc.

(3) Hard chancre (usually single) in the genitalia (occurs in penis in males and labia or cervix in females).

(4) Even without treatment the chancre will heal completely within 4-6 weeks.

(5)  The lesion an eroded papule, and indurated firm and ulcerated, usually painless.

  1. Secondary Stage –

(1) Mucous patches- In the mucous membrane of the mouth painless, slimy, grayish patches are seen (snail track).

(2) Condylomata – these are situated round the mucocutaneous junctions, around the anus and vulva.

(3)  About 3 6 months after healing of primary chancre, generalized infection occurs (malaise, headache, sore throat, fever etc.)

(4) Skin – rash – the rashes are discrete, pleomorphic indurated, symmetrical in nature, mostly situated in flexor surface of limbs, trunk, face, palm, sole (do not itch) the rashes may be macular, pustular or deep ulcers with scabs (rupia). When they heal they leave patches of coppery pigmentation.

(5) Eye lesion-Iritis, photophobia, dimness of vision may be present.

(6)  Lymphadenopathy – generalized enlargement of lymph nodes, are painless, symmetrical, discrete and rubbery feel.

(7) Neurological lesion-Frontal and occipital neuralgia may be present.

(8) Lesions in the bones and joints – intense pain at night due to congestion, also synovitis of knee may be present.

  1. Tertiary Stage – Mostly involves the skin, subcutaneous tissue, bones, tongue, aorta, central nervous system, testes and liver.

Diagnosis:

(1) Late secondary and tertiary stages – W.R., K.T., V.D.R.L. test.

(2)  Primary and early secondary stage – D.G. illumination test.

Ques : 4    What can be the possible treatments for syphilis?

Ans :         Treatment :

(1) Patients should be followed up for 3 year during which V.D.R.L. test should be done initially quarterly and later half-yearly.

(2)  In early stage, Benzathine penicillin (Penidure-LA) 24 lakh units i.m. as single dose, half of which should be injected into each buttock. In case of allergy to Penicillin, Tetracycline 500 mg. 4 times a day may be given for 15 days, of Erythromycin may be given 500 gm. 4 times a day for 15 regular days.

 (3) Homoeopathic remedies-

Ques : 5    Which Homoeopathic medicines work well for syphilis?

Ans :         (1) MERCURIUS IOD. RUB- Hunterian hard chancre; threatened gangrene of glans in paraphimosis; soreness of bones of face; sharp shooting stitches in the end of penis through the glans ; old buboes, discharging for year.

(2) CAUSTICUM – Vesicles under prepuce changing into suppurating ulcers; phagedenic chancre; watery, greenish corroding discharge with jerking pains; buboes secreting an acrid, corrosive ichor, with systemic complications.

(3) PHYTOLACCA- Secondary syphilis ; ulcers in throat and genitals; syphilitic rheumatism and syphilitic eruption; pains shift; joints swollen, red; ulcers with appearance as if punched out, lardaceous bottom; worse at night.

(4) CARBO AN- Constitutional or tertiary syphilis ; coppery-red blotches on skin, induration of glands; bubo is hard as a stone, mostly left side. With lancinating and cutting pains sensitive to tauch when beginning to suppurate.

Ques : 6    Which Biochemic Remedies work for syphilis?

Ans :         Biochemic remedies-

  • SILICEA- Chronic syphilis with suppurations or indurations. Ulcerated cutaneous affections, nodes in tertiary syphilis ; caries & necrosis with discharge of offensive pus.
  • FERRUM PHOS. – Bubo with heat, throbbing or tenderness.
  • KALI MUR – Soft chancre. In bubo for the soft swelling. Mucous patches. Chronic stage of syphilis.
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