Primary Syphilis

Syphilis is a chronic systemic STD caused by T. pallidum, mainly sexually transmitted; it can involve almost any organ. Primary syphilis presents as chancre at the inoculation site; secondary as mucocutaneous lesions/lymphadenopathy; tertiary as cardiovascular/neurosyphilis/gummas. It is also transplacental causing congenital syphilis. After a 2-3 week incubation (first incubation), skin lesions (typically hard chancre) appear—this is primary syphilis. Host antibodies then develop. Histologically (rabbit syphilis), mononuclear infiltration appears on day 6, lymphocytes peak at day 13, then macrophages; T cells predominate. Treponemes are seen in intercellular spaces, epithelial invaginations/phagosomes, fibroblasts, plasma cells, capillary endothelium, lymphatics, and regional nodes.

Common Symptoms

Lymphadenopathy; hard chancre; station doctor

Causes and Pathogenesis

Sexual contact is the main route. Untreated patients are most infectious in the first year; infectivity declines, and by 4 years sexual transmission is rare. Pregnant women transmit transplacentally (usually after 4 months); women >4 years untreated usually do not infect sex partners but may still infect fetuses. Non-sexual routes include kissing, breastfeeding, and contact with infectious lesions via clothes/towels/razors/utensils. Syphilitic/carrier serum is infectious via blood transfusion and shared needles.

Treatment

Drug therapy, supportive therapy

Preventive Measures

1. Screen suspects with serology for early treatment. 2. Isolate/treat patients; disinfect clothes/towels/razors/utensils/bedding. 3. Trace and examine all sex contacts; treat as needed; no sex until cured. 4. Treat pregnant suspects to prevent fetal infection; no marriage before cure.

Department to Visit

It is recommended to visit the STD department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.