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Syphilis. False shame and fear may destroy your future : Have your blood tested. Poster for treatment of syphilis, showing a man and a woman bowing their heads in shame. Created/Published: Rochester, N.Y.: WPA Federal Art Project, between 1936 and 1938. Creator: Hans Erik Krause, born 1899, "Syphilis is a dangerous disease, but it can be cured." Poster for treatment of syphilis, showing text and design of an anchor and a cross. Created/Published: Rochester, N.Y.: WPA Federal Art Project, between 1936 and 1938. Creator: Hans Erik Krause, born 1899, artist. Syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero.
The signs and symptoms of syphilis are numerous; before the advent of serological testing, precise diagnosis was very difficult. In fact, the disease was dubbed the "Great Imitator" because it was often confused with other diseases, particularly in its tertiary stage.
Syphilis can generally be treated with antibiotics, including penicillin. If left untreated, syphilis can damage the heart, aorta, brain, eyes, and bones. In some cases these effects can be fatal. In 1998, the complete genetic sequence of T. pallidum was published, which may aid understanding of the pathogenesis of syphilis. In 1906, the first effective test for syphilis, the Wassermann test, was developed. Although it had some false positive results, it was a major advance in the prevention of syphilis. By allowing testing before the acute symptoms of the disease had developed, this test allowed the prevention of transmission of syphilis to others, even though it did not provide a cure for those infected. In the 1930s the Hinton test, developed by William Augustus Hinton, and based on flocculation, was shown to have fewer false positive reactions than the Wassermann test. Both of these early tests have been superseded by newer analytical methods. The study began in 1932, when syphilis was a widespread problem, especially in poor communities, and when there was no effective treatment or cure. Study researchers recruited a group of 600 black male sharecroppers in the rural area of Tuskegee, Alabama. Of these 600, 399 of the men had the disease in the latent, asymptomatic stage. 201 men were uninfected control patients. The PHS intended to study the progress of the disease and the effects of current treatments at different stages. Available treatments had such severe side effects that doctors questioned whether treatment provided the best outcome for the patient, or whether a man might do as well with no treatment. Patients were misled about the diagnosis of their disease, and about aspects of treatment, such as a painful lumbar puncture for evaluation. During the crisis of the Great Depression, in a segregated state with underfunded services for blacks, patients were recruited in exchange for physical exams, free health care of minor illnesses, free meals and transportation the day of exams, and a $50 death benefit. The study was designed to measure the progression of untreated syphilis. It also was to determine whether syphilis caused cardiovascular damage more often than neurological damage, as untreated disease led to effects in numerous body systems. Researchers hoped to determine whether the natural course of the disease was different in black men versus white men; historically, researchers had by then accumulated more information on the disease in white men. For patients diagnosed with neurosyphilis including ocular or auditory syphilis with or without positive CSF results, aqueous crystalline penicillin G is the treatment of choice. The recommended regimen is intravenous treatment every 4 hours or continuously for 10–14 days. If intravenous administration is not possible, then procaine penicillin is an alternative (administered daily with probenecid for two weeks). Procaine injections are painful, however, and patient compliance may be difficult to ensure. To approximate the 21-day course of therapy for late latent disease and to address concerns about slowly dividing treponemes, most experts now recommend 3 weekly doses of benzathine penicillin G after the completion of a 14-day course of aqueous crystalline or aqueous procaine penicillin G for neurosyphilis. No oral antibiotic alternatives are recommended for the treatment of neurosyphilis. The only alternative that has been studied and shown to be effective is intramuscular ceftriaxone daily for 14 days. Description Source Wikipedia