Syphilis

The advent of penicillin transformed syphilis from a major scourge into an easily treatable condition. Rates plummeted during the later part of the twentieth century only to see a steady rise in the current millennium. Statistics from 2017 reported slightly more than 100,000 cases of all stages. This includes in excess of 30,000 reports of primary and secondary syphilis, another 34,000 cases of early latent syphilis with slightly more cases of late latent disease. Nearly 1000 babies were born with congenital syphilis.

Since 2013 the rates have risen more than 70% with 70% of diagnoses in the 50 most populous metropolitan areas. An increase in rates occurred in 36 of the 50 states with the highest incidence in Washington, D.C. and Nevada with the lowest in Wyoming. Until recently most cases occurred in the south. This dubious first place award currently belongs to the western states.

In previous times the incidence was similar in men and women. During the recent past an imbalance developed with men affected 10 times more frequently than women. This mostly relates to men having sex with men. African Americans account for 50% of the diagnoses with the rate of disease twice as high as in Hispanics as Caucasians.

Several sequential stages appear however their manifestations may be easily overlooked or mistaken for other conditions. The initial stage appears several weeks after exposure with the infectious bacteria typically entering during vaginal, oral or anal sex. This primary stage or chancre generally appears in the genital or anal area as a small, non-descript, painless ulcer with a clean base.

The chancre ranges from the size of a pencil eraser to slightly less than
an inch in diameter. It may be mistaken for an ingrown hair, trauma from shaving or a scratch. Even without treatment it disappears without a trace in 3-9 weeks.

After a 1-2 month interval without any evidence of the disease, the secondary stage appears. It also lingers for several weeks and manifests itself as a diffuse but otherwise asymptomatic rash reminiscent of a viral infection or an adverse drug reaction. It addition to involving the trunk and extremities it characteristically appears on the palms and soles. Up to 50% of those affected remain unaware of the eruption or its significance. At times an small masses appear about the genitals or anus vaguely reminiscent of venereal warts. Patchy hair loss, fever and swollen lymph nodes occasionally develop.

Ultimately even without treatment the secondary stage resolves. The early latent stage lasts for a year during which time the disease remains contagious but less than in earlier stages. No evidence of its presence can be detected except through blood tests. The late latent stage demonstrates reduced possibility of transmission but persists forever unless treatment or the tertiary stage appear.

Tertiary syphilis complicates the disease in only 1 of 3 untreated individuals. Overall three subtypes exist: gummas, neurological injury and cardiovascular disease. Gummas or benign tertiary syphilis appear anywhere but prefer the skin, bone, liver or brain where they result in local tissue destruction.

Neurological manifestations range from syphilitic meningitis to pupil abnormalities, cranial nerve damage and stroke. Some develop tabes dorsalis causing leg pain, impaired balance and a peculiar gait. Others demonstrate a form of dementia referred to as generalized paresis. Aneurysms of the thoracic ascending aorta occur in about 1 in 10 untreated individuals.

Syphilis represents one of only a few sexually transmitted infections that may result in death. Treatment with penicillin cures all but established tertiary disease.

[jenniferybarra]

You are so easy to watch, and listen to. Thank you.

[mycoffeemyday]

Abstinence, it's ethically legal for everyone. Sex literally isn't important, men need to learn how to control themselves at all times. Diseases don't care about popularity contests, diseases don't care about border walls, diseases don't care about politics, diseases don't care about religious views, diseases don't care about income, diseases don't care about anything.

[dinacharlayne]

cantt cure th e deafness or disease qt thqt level of stage progression us uwuqlly? uw usually the annurism is fatal i n men or something? we felt a spark in our heart n' hqd some pqin before the shocking spark was like not pi]ainful but big then to our e right hqnd it shot n' tingled there. weird. one vi3o sqid this iqs is like qnnurisms but in femlales it may be less big thn males.