E.Wallace APA Shell week 6
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Arts Humanities
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Dec 6, 2023
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Syphilis
Erania Wallace
Aspen University HUM410 – Academic Success: Strengthening Scholarly Writing
Dr. Alicia Hinton
September 11, 2023
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Abstract
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Syphilis
Syphilis is a bacterial infection caused by Treponema pallidum, which is normally spread by sexual contact. Syphilis begins as a painless sore primarily on the genitals, rectum, or mouth of the affected person within 21 days of contact with the bacterium. Syphilis can remain in the human body for decades in an inactive state. The bacterium may return to an active state for many reasons, from stress to a decline in health. Early stages of Syphilis can be treated effectively and quite inexpensively with Penicillin G injections. The dosage and time frame of treatment vary by patient and stage of infection. There has been an increase in cases both in the United States and throughout the world since the early 2000s. Syphilis is both preventable and curable in its initial stages. (Ghanem, Khalil G.; Hook, Edward W. (2020).)
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Literature Review
The rise in Syphilis cases despite the availability of education and treatment is a complex issue that requires review of research information. There are various factors that contribute to increasing numbers of syphilis cases even with availability of education and treatment. The inadequate availability of healthcare access or low healthcare literacy may be a factor to increasing syphilis cases. This could be due to the result of a missed diagnosis during the crucial
stage of the infection, which would be the primary or secondary stages of the disease.
(Ghanem, 2020, Hook, 2020).
During the early stages of the disease diagnoses of the disease can be difficult as the patient can be either pre chancre or post chancre. Usually once the chancre appears within several weeks or months of the initial contact and heals the patient(s) believes the illness is resolved if it was ever a thought there was an illness at hand. (Ghanem, 2020, Hook, 2020).
To explore deeper into this ideology research was assessed utilizing EBSCOhost and Explora databases. There is information that supports misdiagnosis, low health literacy, and lack of protection during sexual encounters as causes for an increase in cases of syphilis although it is preventable and curable. Syphilis, the sexually transmitted or congenital disease is caused by the
bacteria Treponema palladum. The origin of this bacterium is unknown although some believe it
is related to a disease noted in medical history by the name of yaws. Yaws were spread by contamination of objects or skin lesions that were open but not through sexual acts. (Alder, 2022)
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There are four stages of Syphilis, Primary, Secondary, Latent, and Tertiary. Each stage has its own duration, signs, and symptoms of infection. Primary syphilis occurs up to 90 days post exposure and is generally characterized by a chancre on the genitals. Secondary syphilis is post chancre healing, usually 3-6 weeks, but it can be up to several months post exposure. The chancre may resolve without treatment. There is usually an associated rash on trunk of body, palms of hands, and sole of feet. The rash may return off and on for up to two years and may be treated symptomatically for a rash not related to syphilis. Penicillin G is primarily used for treatment. The latent stage of syphilis can begin to cause other health issues such as tumors, paralysis, and blindness. The latent stage can cause nervous system issues, heart, brain damage, or even cause a fatality. (Kaplan,1958)
Although syphilis is curable at all stages with Penicillin G as a first course of antibiotic therapy there are other supporting antibiotics. Though the disease can be cured even in this stage, the damage that occurred within the body is not reversable.
Neurosyphilis, Tabes dorsalis, and damage to blood vessel supply of brain and spinal cord are noted in the Tertiary stage of Syphilis. There are alterations in coordination, memory, and speech. The diagnosis at this stage is a serology test that looks for antibodies against the Trponema pallidum. There can also be a diagnosis made by high leukocytes in cerebral spinal fluid. (Augenbraun M., 2000)
The primarily used treatment for syphilis at all stages is Penicillin G, although for those allergic to penicillin and women that are not pregnant, it is suggested to use Doxycycline 100 mg
twice a day for fourteen days orally. Tetracycline 500 mg by mouth four times a day for fourteen
days or Ceftriaxone one gram intramuscularly or intravenously for 10 days may also be administered. (Center For Disease Control 2021, July 22).
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While neurosyphilis can occur at any stage of syphilis it is the exclusive diagnosis of tertiary syphilis. Neurosyphilis is the infection of the central nervous system in patients with syphilis. In
this stage there are increased chances for blood vessel and bone damage. The diagnosis of neurosyphilis is usually a lumbar tap or puncture to retrieve cerebral spinal fluid and test for antibodies against Treponema pallidum.
Due to the Covid 19 Pandemic there was a decrease in available information due to the stay in
place and social distancing. It is thought there may be a higher incidence of cases of syphilis due
to inability to be tested. There was also a decrease in medical visits, possibly decreasing availability of the patient population to get access to contraceptives that would prevent syphilis. This can be evidenced by an influx of emergency department cases of syphilis duration unknown
or tertiary stage. (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases, 1999)
Syphilis is a bacterial based sexually transmitted disease while HIV/AIDS is viral. Both diseases affect your immune system. While syphilis has a chancre visible post exposure if the chancre is not in a visible place or painful it can be missed. Respectively, HIV/Aids can go undiagnosed as the symptoms mimic other illnesses. Both diseases in the early stages are easily dismissed as not serious as it pertains to signs and symptoms. Syphilis can increase susceptibility to HIV/ Aids due to the chancre sore post exposure. (Pfizer, 2021)
Discussion
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Conclusion
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References
Augenbraun M. (2000). Treatment of latent and tertiary syphilis. Hospital practice
(1995), 35(4), 89–96. https://doi.org/10.3810/hp.2000.04.195 Augenbraun M. (2000)
Center For Disease Control. (2021, July 22). Sexually Transmitted Infection Treatment Guidelines, 2021. Centers for Disease Control and Prevention. Retrieved August 20, 2023, from https://www.cdc.gov/std/treatment-guidelines/default.htm.
Ghanem, Khalil G.; Hook, Edward W. (2020). "303. Syphilis". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 1983–1989. ISBN 978-0-323-55087-1.
Hutto B. (2001). Syphilis in clinical psychiatry: a review. Psychosomatics, 42(6), 453–460. https://doi.org/10.1176/appi.psy.42.6.453
KAPLAN BI, RYAN J, THOMAS E, CUTLER JC, JENKINS KH. Results of therapy of latent and asymptomatic syphilis in a prison population. I. Clinical outcome with reference to cardiovascular and central nervous system syphilis and related to a nonsyphilitic control population. J Chronic Dis. 1958 Apr;7(4):300-11. doi: 10.1016/0021-9681(58)90087-0. PMID: 13539142.
National guideline for the management of late syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). (1999). Sexually transmitted infections, 75 Suppl 1, S34–S37.
Pfizer (2021, September 20). Learn More About Syphilis | Signs of A Syphilis Infection.
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Syphilis is Back. Retrieved August 20, 2023, from https://www.syphilisisback.com/what?
gclid=a4521d66dae41b1a0b4a79850645a1ab&gclsrc=3p.ds&#rise?
gclid=a4521d66dae41b1a0b4a79850645a1ab&gclsrc=3p.ds&
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Annotated Bibliography
KAPLAN BI, RYAN J, THOMAS E, CUTLER JC, JENKINS KH. Results of therapy of latent and asymptomatic syphilis in a prison population. I. Clinical outcome with reference to cardiovascular and central nervous system syphilis and related to a nonsyphilitic control population. J Chronic Dis. 1958 Apr;7(4):300-11. doi: 10.1016/0021-9681(58)90087-0. PMID: 13539142.
There are four stages of Syphilis. The initial stage is the primary stage, there is a secondary stage, a latent stage, and the final stage is tertiary. The stage defines the dosage
of medication although there is not a definitive dosage.
National guideline for the management of late syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). (1999). Sexually transmitted infections, 75 Suppl 1, S34–S37.
Penicillin G can cure syphilis in its early stage. Primary, secondary, or latent syphilis can be cured with three doses of long-acting Penicillin G dosed weekly. All sexually active partners need to be treated.
Augenbraun M. (2000). Treatment of latent and tertiary syphilis. Hospital practice (1995)
, 35
(4),
89–96. https://doi.org/10.3810/hp.2000.04.195
Augenbraun M. (2000) Patients may experience a late latent stage of syphilis in which the infection occurred over 12 months prior. The latent stage of syphilis can be due to an unknown duration. The latent stage of syphilis can last for years.
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Hutto B. (2001). Syphilis in clinical psychiatry: a review. Psychosomatics, 42(6), 453–460. https://doi.org/10.1176/appi.psy.42.6.453
Neurosyphilis was once thought to plague the psychiatric population more than the general public. Testing proved this to be incorrect and the medical field has not made a concise population that should be tested. Neurosyphilis is associated with other diseases as well as syphilis.
C. F. D. C. (2021, July 22). Sexually Transmitted Infection Treatment Guidelines, 2021. Centers for Disease Control and Prevention. Retrieved August 20, 2023, from https://www.cdc.gov/std/treatment-guidelines/default.htm
.
Covid decreased the ability of the patient to acquire both testing and treatment for Syphilis. The patient and community also saw a decrease in ability to participate in studies. This inability to participate in studies will provide a false positive result in determining statistics.
Pfizer (2021, September 20). Learn More About Syphilis | Signs Of A Syphilis Infection. Syphilis is Back. Retrieved August 20, 2023, from https://www.syphilisisback.com/what?
gclid=a4521d66dae41b1a0b4a79850645a1ab&gclsrc=3p.ds&#rise?
gclid=a4521d66dae41b1a0b4a79850645a1ab&gclsrc=3p.ds&
Syphilis is harder to diagnosis once infected. The patient is educated for signs and symptoms to look for. There is a relationship between syphilis and HIV/Aids.