A Review on the Diagnosis and Treatment of Syphilis
DOI:
https://doi.org/10.54097/hset.v8i.1206Keywords:
Syphilis, STI, Clinical Manifestations, Diagnosis, Treatment, HIV.Abstract
Syphilis is a multi-phase sexually transmitted disease through contacting with a partner infected by syphilis or from a gravida to her newborn congenitally. The reappearance of syphilis is a severe public health concern, particularly because syphilis lesions would boost the chance of acquiring and spreading human immunodeficiency virus (HIV) infection. A dose of benzathine penicillin G (BPG) through intramuscular injection is the current treatment for syphilis, which is the optimal treatment for all stages of syphilis. Although some alternatives such as doxycycline and ceftriaxone are also evidently effective, the optimal therapy is still BPG, especially in latent syphilis and pregnancy. Because of the clinically significant azithromycin resistance, this second-line medication is no longer used routinely. Currently, macrolide resistance is the only antibiotic resistance with clinical evidence. Even though still no vaccine is published for syphilis, syphilis is a promising disease for vaccine development. The vaccine for syphilis is currently under research. This paper contained information about the pathological process, symptoms, diagnosis of syphilis, and effective treatment using antibiotics. The review also discussed future vaccine directions.
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Health Organization Prevalence and incidence of selected sexually transmitted infections Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis: methods and results used by WHO to generate 2005 estimates. 2011.
Radolf, J. D., Deka, R. K., Anand, A., Šmajs, D., Norgard, M. V., & Yang, X. F. Treponema pallidum, the syphilis spirochete: making a living as a stealth pathogen. Nature reviews. Microbiology, 2016, 14 (12), pp.744–759.
Stoltey, J. E., & Cohen, S. E. Syphilis transmission: a review of the current evidence. Sexual health, 2015, 12 (2), pp.103–109.
Cameron, C. E. & Lukehart, S. A. Current status of syphilis vaccine development: Need, challenges, prospects. Vaccine, 2014, 32 (14), pp.1602-1609.
Stamm, L. V. Syphilis: Re-emergence of an old foe. Microbial Cell, 2016, 3 (9), pp.363-370.
Ghanem, K. G., Ram, S. & Rice, P. A. The Modern Epidemic of Syphilis. New England Journal of Medicine, 2020, 382 (9), pp.845-854.
Public Health England. Tracking the syphilis epidemic in England: 2010 to 2019. London, 2020.
Bond, S. M. & Blain, M. L. Diagnosis and Treatment of Secondary Syphilis in Women. Journal Of Midwifery &Amp; Women's Health, 2021, 66 (3), pp.372-379.
Schmidt, R., Carson, P. J., & Jansen, R. J. Resurgence of Syphilis in the United States: An Assessment of Contributing Factors. Infectious Diseases: Research and Treatment, 2019, 12
Tsimis, M. E., & Sheffield, J. S. Update on syphilis and pregnancy. Birth Defects Research, 2017, 109 (5), pp.347-352.
Tudor ME, Al Aboud AM, Gossman W. Syphilis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
Lithgow, K. V., & Cameron, C. E. Vaccine development for syphilis. Expert review of vaccines, 2017, 16 (1), pp.37–44.
Peeling, R. W., Mabey, D., Kamb, M. L., Chen, X. S., Radolf, J. D., & Benzaken, A. S. Syphilis. Nature reviews. Disease primers, 2017, 3, p.17073.
Nyatsanza, F., & Tipple, C. Syphilis: presentations in general medicine. Clinical medicine (London, England), 2016, 16 (2), pp.184–188.
Kingston, M., French, P., Goh, B., Goold, P., Higgins, S., Sukthankar, A., Stott, C., Turner, A., Tyler, C., & Young, H. UK National Guidelines on the Management of Syphilis 2008. International Journal of STD & AIDS, 2008, 19 (11), pp.729–740.
O'Byrne, P., & MacPherson, P. Syphilis. BMJ, 2019, 365, p.l4159.
Radolf, J.D., Pillay, A., Cox, D.L. Treponema and Brachyspira, human-associated spirochetes. In: Versalovic, J et al. eds. Manual of Clinical Microbiology, 10th ed. Washington, DC, ASM Press, 2011, pp.941–963.
Stamm, L.V. Syphilis: antibiotic treatment and resistance. Epidemiology And Infection, 2014, 143 (8), 1567-1574.
Clement, M.E., Okeke, N.L., & Hicks, C.B. Treatment of Syphilis. JAMA, 2014, 312 (18), p.1905.
Pastuszczak, M., & Wojas-Pelc, A. Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines. Advances in Dermatology and Allergology, 2013, 4, pp.203-210.
Roberts, C.P., Raich, A.R., Stafylis, C., & Klausner, J.D. Alternative Treatments for Syphilis During Pregnancy. Sexually Transmitted Diseases, 2019, 46 (10), pp.637-640.
Cooper, J.M. & Sanchez, P.J. Congenital syphilis. Seminars in Perinatology, 2018, 42 (3), pp.176-184.
Katanami, Y., Hashimoto, T., Takaya, S., Yamamoto, K., Kutsuna, S., Takeshita, N., Hayakawa, K., Kanagawa, S. & Ohmagari, N. Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. Emerging Infectious Diseases, 2017, 23 (5), pp.827-829.
Andrew, M.A., Easterling, T.R., Carr, D.B., Shen, D., Buchanan, M.L., Rutherford, T., Bennett, R., Vicini, P. & Hebert, M.F. Amoxicillin Pharmacokinetics in Pregnant Women: Modeling and Simulations of Dosage Strategies. Clinical Pharmacology & Therapeutics, 2007, 81 (4), pp.547-556.
Katz, K.A., & Klausner, J.D. Azithromycin resistance in Treponema pallidum. Current Opinion in Infectious Diseases, 2008, 21 (1), pp.83-91.
Chen, C., Chi, K., Pillay, A., Nachamkin, E., Su, J.R., & Ballard, R.C. Detection of the A2058G and A2059G 23S rRNA Gene Point Mutations Associated with Azithromycin Resistance in Treponema pallidum by Use of a TaqMan Real-Time Multiplex PCR Assay. Journal of Clinical Microbiology, 2013, 51 (3), pp.908-913.
Khalil G. Ghanem, Richard D. Moore, Anne M. Rompalo, Emily J. Erbelding, Jonathan M. Zenilman, Kelly A. Gebo, Antiretroviral Therapy Is Associated with Reduced Serologic Failure Rates for Syphilis among HIV-Infected Patients, Clinical Infectious Diseases, 2008, 47 (2), pp.258–265.
Yang, C. J., Lee, N. Y., Chen, T. C., Lin, Y. H., Liang, S. H., Lu, P. L., Huang, W. C., Tang, H. J., Lee, C. H., Lin, H. H., Chen, Y. H., Ko, W. C., & Hung, C. C. One Dose versus Three Weekly Doses of Benzathine Penicillin G for Patients Co-Infected with HIV and Early Syphilis: A Multicenter, Prospective Observational Study. PLoS ONE, 2014, 9 (10), e109667.
Xu, M., Xie, Y., Zheng, K., Luo, H., Tan, M., Zhao, F., Zeng, T., & Wu, Y. (2021). Two Potential Syphilis Vaccine Candidates Inhibit Dissemination of Treponema pallidum. Frontiers in Immunology, 2021, 12.
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