Sexually Transmitted Diseases: Syphilis
Syphilis is a sexually transmitted bacterial infection by having sexual intercourses with an infected person. It is caused by a spirochete bacterium called Treponema Pallidum. It can be transmitted through blood transfusions, as well as throughout pregnancy. Another way it can be transmitted is through skin contact especially if there are any breaks in the skin or on the mucous membranes. A person who is not affected can then become infected because of the infection that they just encounter. If this disease is left untreated, syphilis can escalate to sequential stages. The sequential stages of syphilis are primary, secondary, and tertiary. To even further complications in the body that affect the cardiovascular and neurological system as well as causing blindness. If syphilis is catch early, it can be treatable and curable.
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The primary stage is caused by a nonpainful chancre usually consist of one or more lesions. If pregnant then the site of infection will be intravaginally caused by sexual intercourse. Congenital transmission can affect both perinatal and neonatal care. If mother doesn’t take care of the fetus then it will cause neurological and musculoskeletal impairments as well as fetal death. According to Advances in Neonatal Care (2018) states, that most maternal and CS infections were noticed in the Western and Southern States. With a shockingly 42.3% increase in cases of CS (2012-2016) in the West.
However, If the person doesn’t take care of the chancre in the primary stage then it can progress to a secondary stage. In this stage the chancre would develop to a maculopapular rash that will appear on different locations of the body. The body locations are seen in the palms of the hands, soles of the feet, sores in genitals, anus, or mouth. Followed by clinical manifestations for having the maculopapular rash such as fever, malaise, lymphadenopathy, and myalgia. Moving on to the Tertiary stage, the infection will remain dormant for a while with no signs of symptoms. This means the infection can be life threading and lead to multiorgan failure and damage. These life threading comorbidities would be tumors of the skin, bones, and in the liver. According to Advances in Neonatal care (2018) states if appear in the liver this can be lesions caused by an inflammatory response to the treponemes. More Complications in the tertiary are neurological which include meningovascular and parenchymatous damage and neurosyphilis. As signs and symptoms are described as irritation, insomnia, memory loss, as well personality changes. Tertiary stage also affects the cardiovascular system to having aortic aneurysm with aortic regurgitation (Rowe, Newberry & Jnah, 2018, p 440).
Additionally, as mentioned earlier this disease is primarily transmitted through sexual intercourse. Other ways that this can be transmitted is by having multiple sex partners, oral sex, anonymous sex, victim of an abusive relationship, and HIV infection (Caple & Karakashian 2018, p 2). According to the Journal for Nurse Practitioners (2015), Gay men, bisexual men, or heterosexuals (MSM) are categorized to be in the highest risk for having a syphilis infection (Elsevier, 2015, p 49). People in the ages of twenty through twenty-nine rank as the highest to have primary and secondary syphilis (Caple & Karakashian, 2018, p 1). People who have syphilis come from low socioeconomic status, practice unsafe sex, lack treatment during pregnancy, and are uninsured to medical care. Some individuals may not be educated on sexual transmitted diseases and don’t understand how critical it is to wear protection barriers during intercourse. Another issue is lack of insurance to prevent people from seeking or getting treatment.
Furthermore, laboratory findings used as a diagnosis for syphilis are visualization of Treponema Pallidum and a serological test. For the visualization of Treponema Pallidum, a dark-field microscopy is used to detect the disease. As for the serological test Treponema Pallidum antibodies include the fluorescent treponemal antibody absorbed (FTA-ABS) test. The Treponema Pallidum drop of agglutination(TPPA) test is based on serology results being negative with patients with tertiary syphilis (Caple & Karakashian, 2018, p 3). Some alert indications can be detected if a patient has a reaction to Penicillin to cause Jarisch-Herxheimer. Since penicillin is used to treat all the stages of syphilis. Jarisch-Herxheimer causes an acute febrile reaction with symptoms such as chills, myalgia, tachycardia, headache, increased respiratory rate, and hypertension within 24 hours of treatment (Caple & Karakashian, 2018, p 3). This is more common in patients in primary and secondary stages of syphilis.
When treating syphilis patients, one must monitor vital signs, assess all physiological systems, and review laboratory results to identify any changes. If changes due occur notify the physician as well as following the prescribed treatment as indicated. If a person is in primary, secondary, and early tertiary a single of dose of antibiotics can be used to treat the patient (Caple & Karakashian, 2018). If the patient is in tertiary stage, then an increase of antibiotics is given to three weekly doses. However, if a patient is allergic to penicillin, then alteration of medications is given such as doxycycline or tetracycline.
The nurse’s role is to provide emotional support and educate patients on how to practice safe sex. As well as providing screenings for syphilis with patients who start having sexual intercourses and those with multiple partners. With early detections and screenings preventions can then be measured to help if infected. As nurses it is one jobs to educate the patients on getting annual check-ups, getting screenings, and vaccinations. This disease is critical and harmful as mention earlier and if infected with syphilis one must take full action to take care of oneself.
Sexually Transmitted Diseases
Caple, C. L., & Karakashian, A. L. (2018). Sexually Transmitted Diseases. Sexually Transmitted Diseases, 45, 1–4. doi: 10.1097/01.olq.0000544647.98472.4
Syphilis on the Rise: Diagnosis, Treatment and Prevention
Klein, J., Mclaud, M., & Rogers, D. (2015). Syphilis on the Rise: Diagnosis, Treatment, and Prevention. The Journal for Nurse Practitioners, 11(1), 49–55. doi: 10.1016/j.nurpra.2014.10.020
Special series: Congenital Infections
Rowe, C. R., Newberry, D. M., & Jnah, A. J. (2018). Congenital Syphilis. Advances in Neonatal Care, 18(6), 438–445. doi: 10.1097/anc.0000000000000563
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