Syphilis - the perfect disguiser

Symptoms can progress and change in the same patient and can be easily confused with other diseases, so syphilis is known as the "perfect disguiser".

On October 3, Dr. Nguyen Thi Ha Vinh, General Planning Department, STIs Clinic, Central Dermatology Hospital, said that syphilis is a sexually transmitted disease caused by syphilis spirochetes. The incidence of this disease in the world as well as in Vietnam is increasing, related to the trend of homosexual sex, early and unsafe sex among adolescents.

Syphilis has diverse and complex manifestations, not only in the skin and mucous membranes but also in other organs such as the ears, eyes, musculoskeletal system, cardiovascular system, and nervous system. The signs of the disease change in the same patient and are easily confused with other diseases, so scientists call it "the great imitator".

In addition, in the "closed" syphilis group, the patient has no clinical symptoms until tested. Therefore, people with a history of exposure, unsafe sex or symptoms of suspected sexually transmitted diseases should see a dermatologist.

If syphilis is not diagnosed and treated promptly, it can lead to complications in other organs such as the musculoskeletal system, nervous system, cardiovascular system, etc. In particular, pregnant women with syphilis can transmit it to their children, leading to the risk of miscarriage, stillbirth, premature birth, low birth weight or congenital syphilis.

In particular, Dr. Vinh noted that patients with genital skin lesions should not self-medicate with topical or oral medications. There are many causes of genital ulcers, and patients need to be examined carefully for an accurate diagnosis. Self-medication without knowing the cause can alter initial symptoms, distort test results, and delay proper diagnosis and treatment.

As in the case of a 54-year-old man, the disease started 10 days before going to the doctor with symptoms of burning and redness in the glans penis. The lesion then progressed into an ulcer that gradually spread, accompanied by a fever of 39 degrees. Three days after going to the doctor, the patient washed his genitals with iodine alcohol and applied powdered medicine (unknown ingredients), but the wound became more severe, so he went to the Central Dermatology Hospital for examination.

The doctor examined and found a deep ulcer in the glans penis, the ulcer base was hard, painless, and not itchy; there were many inguinal lymph nodes on the right side. Taking the medical history, 2 months before the genital lesions appeared, the patient had unsafe sex. He was tested for syphilis serology and tested for cytology of the lesion fluid at the ulcer, the results were positive.

"We diagnosed the disease in this case as stage I syphilis or primary syphilis. The patient was treated with Benzathin penicillin G, injected into the buttocks, a single dose, and was scheduled for a follow-up visit after one month," said Dr. Vinh, adding that this person's sexual partner was also at risk of infection and needed to come to the hospital for examination.

According to Dr. Vinh, the current and previous sexual partners of a person with syphilis should be examined, tested, and treated if present. If the sexual partner is not diagnosed and treated, the patient is at risk of reinfection when having sex again.

Le Nga

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