Sífilis (primária, secundária e terciária) - Conceitos, diagnóstico e tratamento - SanarFlix

Summary

This video covers the essential aspects of syphilis, a sexually transmitted disease caused by the bacterium *Treponema pallidum*. It explains the stages of the disease—primary, secondary, tertiary, and latent—along with diagnostic methods and treatment options. Key points include how syphilis is transmitted, its symptoms, and the relationship between syphilis and HIV. The video emphasizes the importance of early diagnosis through specific tests like VDRL and FTA-ABS, and highlights how the disease can evolve, including complications such as cardiovascular syphilis and neurosyphilis. The treatment mainly involves penicillin, with dosages depending on the disease stage.

Takeaways

• 😀 Syphilis is a sexually transmitted infection (STI) caused by the bacterium *Treponema pallidum*, which is spiral-shaped and spread primarily through sexual contact, but also through vertical transmission (mother to child) and, rarely, through blood transfusion or tattoos.
• 😀 The disease progresses through several stages: primary, secondary, tertiary, and latent. Each phase has distinct symptoms and diagnostic challenges.
• 😀 Primary syphilis is marked by a painless lesion (chancre) that typically appears around three weeks after infection. This lesion can be found in genital, oral, or anal areas.
• 😀 Secondary syphilis develops after the primary lesion heals, typically 6-8 weeks later, and involves skin rashes, mucous membrane lesions, and flu-like symptoms. It may be mistaken for other viral or bacterial infections.
• 😀 Tertiary syphilis can occur many years after the initial infection and can cause severe damage to vital organs like the heart and nervous system, leading to complications such as cardiovascular issues and neuro-syphilis.
• 😀 Latent syphilis is a stage where the disease remains in the body without symptoms, but the bacteria are still present and can potentially be passed on to others if not treated.
• 😀 Syphilis can co-occur with HIV, as the sores caused by syphilis facilitate the entry of the HIV virus. People with syphilis may progress to AIDS more rapidly if co-infected with HIV.
• 😀 Syphilis can be diagnosed using blood tests (VDRL, FTABS) and direct observation of *Treponema pallidum* in samples from lesions. The VDRL test is more effective in secondary syphilis, while FTABS is used for primary or latent syphilis.
• 😀 Penicillin is the primary treatment for syphilis. The dosage and administration depend on the stage of the disease: a single dose for primary syphilis, higher doses for secondary or latent stages, and different treatment for neurosyphilis.
• 😀 Syphilis can be passed from mother to child during pregnancy, which is why it's crucial for pregnant women to undergo regular prenatal testing. Untreated syphilis in pregnancy can result in miscarriage, stillbirth, or congenital syphilis in the newborn.
• 😀 It's important to understand that having syphilis does not provide immunity, so individuals can get reinfected if exposed again. Regular testing and safe sexual practices are essential for prevention.

Q & A

What is syphilis and how is it transmitted?

Syphilis is an infectious disease caused by the bacterium *Treponema pallidum*, which has a spiral shape. It is primarily transmitted through sexual contact, specifically through abrasions or small lesions during sexual intercourse. There are also less common transmission methods, such as vertical transmission (from mother to child) and through blood transfusions or tattoos.

What are the main stages of syphilis?

Syphilis progresses through four stages: primary, secondary, latent, and tertiary. The primary stage involves a painless lesion at the site of infection. In the secondary stage, the infection spreads through the bloodstream, causing skin rashes and flu-like symptoms. The latent stage occurs when symptoms disappear, but the bacteria remain in the body. The tertiary stage can occur years later, potentially affecting organs like the heart and nervous system.

What is the primary stage of syphilis characterized by?

The primary stage is marked by the appearance of a painless lesion, known as a 'chancre', which is usually located on the genitals, anus, or mouth. This lesion is hard, smooth, and indolent, and it typically heals on its own after 3 to 6 weeks without leaving any scarring.

How does syphilis affect the body during the secondary stage?

During the secondary stage, the *Treponema pallidum* bacteria spread through the bloodstream and affect multiple organs, especially the skin. Symptoms include skin rashes, especially on the palms of the hands and soles of the feet, along with flu-like symptoms such as fever, sore throat, headache, and muscle pain.

What happens in the latent stage of syphilis?

In the latent stage, the symptoms of syphilis disappear, and the disease enters a dormant period. Although there are no active symptoms, the bacteria remain in the body. This stage can last for years, and in some cases, the disease may resolve spontaneously. However, some individuals may progress to the tertiary stage.

What is tertiary syphilis and how does it affect the body?

Tertiary syphilis occurs many years after the initial infection and can cause severe damage to organs. It is categorized into cardiovascular syphilis and neurosyphilis. Cardiovascular syphilis can lead to aneurysms and heart valve damage, while neurosyphilis affects the nervous system, causing symptoms such as paralysis, dementia, and difficulty with coordination.

Can syphilis be transmitted during pregnancy, and what are the risks?

Yes, syphilis can be transmitted from a mother to her fetus during pregnancy. The risk of transmission is highest during the early stages of syphilis. Infected infants may be born with congenital syphilis, leading to developmental issues, hearing loss, or even stillbirth.

How is syphilis diagnosed?

Syphilis is diagnosed through a combination of clinical history, physical examination, and laboratory tests. The primary tests are serological tests, such as the VDRL (Venereal Disease Research Laboratory) test and FTA-ABS (Fluorescent Treponemal Antibody Absorption) test. Direct tests, such as dark-field microscopy, can also detect the *Treponema pallidum* bacteria in lesions.

What is the treatment for syphilis?

The primary treatment for syphilis is penicillin, specifically benzathine penicillin. The dosage varies depending on the stage of the disease: a single dose is sufficient for primary syphilis, while multiple doses are required for secondary and tertiary stages. For neurosyphilis, intravenous crystalline penicillin is used as it can cross the blood-brain barrier.

Can someone get syphilis multiple times?

Yes, having syphilis does not provide immunity. A person who has been treated for syphilis can contract the disease again if exposed to the bacteria. It is important to practice safe sex to reduce the risk of reinfection.