Syphilis: Nursing

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Syphilis is a sexually transmitted infection or STI, that primarily affects the skin and mucous membrane of the external genitalia, and over time disseminates throughout the body, ultimately causing serious damage to the cardiovascular and nervous systems.

Now, syphilis is caused by a spirochete or spiral-shaped bacteria called Treponema pallidum. This infection is mainly transmitted from person to person during sexual contact through body fluids, such as vaginal secretions, semen, or blood, and it can also be transmitted via contact with skin or mucous membranes, including eyes, mouth, throat, and anus. The main risk factors for contracting syphilis include having vaginal, anal, and oral unprotected sex, as well as having multiple or anonymous sexual partners.

Pregnant clients can also transmit the infection to their fetus, either via the placenta, which may result in spontaneous abortion, fetal death, or poor fetal growth; or during childbirth, causing congenital syphilis.

Now, syphilis has four stages: primary, secondary, latent, and tertiary. The first stage as soon as the client gets infected is called primary syphilis or early localized stage, in which the bacteria start replicating at the contact site, most often the skin and mucous membrane of the external genitalia. After 10 to 90 days from the initial infection, clients typically develop a lesion called chancre, which contains a high number of replicating bacteria and is highly contagious. Now, the chancre typically heals on its own within 3 to 6 weeks, but during this time, the bacteria manage to disseminate to nearby lymph nodes and into the bloodstream.

This leads to the second stage, called secondary syphilis, also called the dissemination stage, which can occur about 2 to 10 weeks after the chancre develops. This dissemination results in a generalized rash that self-resolves within 4 to 12 weeks.

At this point, the disease enters a dormant stage called latent syphilis, which can last from 1 year up to even 20 years! During the latent stage, a small amount of bacteria can be found in the tiny capillaries of various body organs and tissues, so clients are typically asymptomatic, but may still be contagious.

Summary

Syphilis is a sexually transmitted infection (STI) caused by the bacteria Treponema pallidum. It can spread through direct contact with a syphilis sore during vaginal, anal, or oral sex. It can cause disease in three stages. The first is localized primary syphilis, and this produces hard chancres. The second is disseminated secondary syphilis, which produces widespread maculopapular rash, and the third is systemic tertiary syphilis, which affects various organs.

Syphilis can be diagnosed by using serological tests and treated with antibiotics like penicillin. If left untreated, it can lead to severe health complications, including organ damage and even death. Syphilis is primarily treated with intramuscular penicillin G benzathine. The main goals of nursing care include the resolution of their infection, and avoiding the spread of the infection among their sexual contacts. Client teaching is aimed at promoting adherence to treatment and follow-up, as well as disease prevention.

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