Syphilis in male

 

Syphilis || Symptoms, Prevention, and Cure

Syphilis (or lue) is a disease caused by a bacterium ( Treponema pallidum ), which causes a chronic progressive infection with potential permanent damage to all organs.

Syphilis in Man

Man contracts this pathology mainly through sexual intercourse not protected by condoms, both genital and oral, with a previously infected person.

The onset of the first symptoms of syphilis in males occurs three to four weeks after infection, with the development of ulcersor rounded wounds at the injection site of the pathogen (i.e. in areas that have come into contact with the infected areas of the other person). Such lesions are typically associated with swelling of the regional lymph nodes.

Often, primary syphilitic lesions are localized in the genital area, in particular at the level of the penis, the foreskin (the portion of skin that covers the glans penis ), or the anus and, if left untreated, tend to evolve towards the secondary stage of the disease.

Secondary syphilis occurs approximately six weeks after the primary lesion (called syphiloma ) disappears with a macular rash on the limbs and trunk, sometimes accompanied by fever, joint pain, fatigue, and hair loss.

In the latent period, the man does not show any symptoms, but he can still transmit the disease. If healing does not occur, syphilis can evolve into the third stage (tertiary syphilis), which can occur even after thirty years from the first infection.

The diagnosis of syphilis in humans is based on clinical and anamnestic data, on the microscopic identification of T. pallidum, and the results of serological investigations. Treatment involves antibiotic therapy, while prevention must be implemented by practicing safe and protected sex to reduce the risk of infection.

Note. Syphilis is one of the most important sexually transmitted diseases. The infection can affect both sexes, but men are more frequently affected by the problem.

Causes and risk factors of Syphilis

Syphilis is caused by Treponema pallidum, a spirochete (a spiral-shaped bacterium) that can spread easily in the body.

This infectious agent can penetrate through intact mucous membranes (genital, rectal, and oropharyngeal) or damaged skin, so it can be easily transmitted through oral contact and unprotected vaginal and anal sexual intercourse.

Without adequate treatment, syphilis evolves within weeks or months: this microorganism migrates through the skin capillaries, then spreads to the lymph nodes, where it multiplies until it reaches levels sufficient to cause clinical disease. Typically, syphilis incubation times extend from 2 to 12 weeks.

In people with the disease, Treponema Pallidum is found in all body fluids, such as semen and vaginal secretions. In addition, the bacterium is found in skin, genital and mucosal lesions, including that of the mouth, which occur in the course of syphilis.

Without a timely diagnosis and therapy, progressive evolution of the disease is possible, which can induce serious permanent damage to multiple organs and systems, such as the skin, heart, brain, and skeleton.

Infection

How can humans get syphilis?

A man usually contracts the disease through unprotected sexual intercourse, both genital (vaginal or anal), and oral with a person suffering from syphilis.

Other possible modes of transmission are petting (ie simple contact between genitals) without protection and the exchange of contaminated sexual tools (eg sex toys).

However, the infection can also be contracted non-sexually, through direct contact with wounds or ulcers of the skin and mucous membranes, which form in the areas where the disease mainly occurs (genital, anus, mouth, throat, or skin surface damaged). In some cases, some of these manifestations are painless or go unnoticed, so the man may not be aware that he is suffering from syphilis, thus risking infecting his partner.

Occasionally, the disease can be transmitted through blood transfusions (now a very rare mode of contagion).

In the case of the congenital form, it is also possible to pass the bacterium transplacental from the infected mother to the child (maternal-fetal transmission).

Syphilis does not confer immunity against subsequent reinfections; this means that the patient recovered from the disease can contract the infection over and over again in the course of life.

Symptoms of Syphilis

The natural course of untreated syphilis follows four developmental stages:

Primary syphilis;

Secondary syphilis;

Latent syphilis;

Tertiary syphilis.

In any case, the disease is complex and, if not properly treated, can lead to various complications, such as heart disease and neurological disorders, up to death.

Primary syphilis in humans

The initial stage of infection occurs approximately 3-4 weeks after contagion, with the appearance of a localized, rosacea, circular and sharp-margin papular lesion ( syphiloma ) at the injection site of Treponema pallidum.

In men, the most frequent localization of syphiloma is the scrotal skin, the balance-preputial sulcus, the outlet of the urethra on the penis and the region around the anus; less often, this lesion can occur on the skin of the hands or inside the oral cavity, then on the lips, gums, pharynx or tongue. Syphiloma does not generally cause pain but is typically associated with an increase in the volume of the regional lymph nodes, which are not, however, painful on palpation.

Within a short time, the surface of the syphiloma tends to ulcerate, exposing a bright red background, from which a serous exudate, containing the treponemes, comes out.

Symptoms of the first stage of syphilis in humans generally persist for between 2 and 6 weeks. Without treatment, syphilis progresses to the secondary stage.

Secondary syphilis in humans

Secondary syphilis begins 3-6 weeks after the onset of syphiloma. This phase is characterized by a diffuse macular rash in one or more areas of the body surface, associated with the swelling of the lymph glands. This manifestation is transient or recurrent and can have a very variable appearance: for example, roundish cracks may appear on the palms of the hands and the soles of the feet or groups of pink spots spread on the trunk and limbs, reminiscent of the measles rash. 

Furthermore, in this stage, the man with syphilis manifests flu-like systemic disorders, due to the proliferation and diffusion of Treponema pallidum through the blood and lymphatics. In particular, the following may appear fever, asthenia, headache, muscle aches, and general malaise. Syphilis in humans can also lead to sore throat, lack of appetite, weight loss, visual disturbances, hearing, and balance changes, bone pain, hair loss

in clumps and the appearance of thickened, gray, or pink skin rashes ( warts ).

In humans, a rarer form of syphilitic manifestation is intense balanoposthitis (inflammation of the glans penis and foreskin), apparently caused by other infectious agents.

Latency period

At the end of the secondary stage, a long latency period begins, which can last for months or even years. This phase is due to the immune control of the disease: the man with syphilis does not present any symptoms, however, the infection persists.  

Tertiary syphilis in humans

After many years (usually after about 10-25 years from the moment of infection), syphilis progresses to the tertiary phase.

At this stage, the disease is characterized by the formation of painless lumps ( gums ) in the skin or brain, bones, and joints, and by severe impairment of the body's internal organs (including the liver, kidneys, lungs, and heart).

Once syphilis enters the third stage, the individual may present with personality changes, gradual blindness, dementia, inability to control muscle movements, and progressive paralysis. In severe cases, syphilis leads to the patient's death.

The evolution of syphilis can be accelerated by one coexisting HIV infection; in these cases, ocular involvement, meningitis, and other nerve complications are more frequent and severe.

Diagnosis of Syphilis

The diagnosis of syphilis in humans can be formulated with the evaluation of the signs and the set of symptoms reported by the patient during a careful medical examination, and through the observation under the microscope of the material taken from the lesions (which allows recognizing the treponemes ).

In support of these investigations, the execution of blood tests is also indicated to detect the possible presence of antibodies against the bacterium already in the early stages of the infection, taking into account that these appear in a period ranging from 2 to 5 weeks.

These analyzes are essentially divided into:

Non-specific tests for Treponema - including the Venereal Disease Research Laboratory ( VDRL ) - aimed at identifying a lipoid antigen deriving from the bacterium or its interaction with the host; these investigations can offer an advantage in disease control.

Treponemal tests, such as the passive agglutination test of treponemal particles (TP-PA) or fluorescence for the search for the absorption of anti-treponemal antibodies (FTA-ABS); these tests make it possible to establish the degree of activity of the infection, then define the most appropriate therapeutic protocol for the case.

If the man is infected, all sexual partners of the previous 3 months (in case of confirmed primary syphilis) or of the previous year (in case of confirmed secondary syphilis) will be evaluated and treated.

Treatment of Syphilis in Humans

Treatment of syphilis in humans involves the parenteral administration of penicillin.

In patients allergic to this active ingredient, other drugs such as doxycycline and tetracycline can be used.

To determine the correct dosage and duration of antibiotic therapy, the doctor will rely on the stage of the disease defined during the diagnostic process. Prompt treatment allows for regression of lesions and prevention of secondary or tertiary syphilis, but any permanent organ damage tends to persist.

During drug treatment, to avoid infecting one's partner, abstinence from any type of sexual intercourse is mandatory, until the lesions caused by syphilis are completely healed. It should always be remembered that wounds and skin ulcers can transmit the infection even during oral sex or any other skin contact with infected areas.

Prevention of Syphilis

Regarding the prevention of syphilis, a good measure is the correct use of condoms, which must be used from the beginning to the end of sexual intercourse (whether vaginal, anal, or oral) and to also protect any objects used. during intimate contact. 

Furthermore, it is possible to avoid exposing oneself to the risk of contagion by refraining from sexual practices with potentially infected people, and by reducing the number of partners.