Overview
Non-sexually transmitted syphilis (endemic syphilis) is an endemic disease caused by a spirochete that is not sexually transmitted. Human-to-human transmission occurs primarily through mucosal contact with pathogen-contaminated utensils, drinking glasses, or felt products. The most common is stage II oral mucosal plaque. Untreated stage II endemic syphilis may resolve spontaneously in 6 to 9 months. Stage III damage is gelatinous ulcers of the skin, nasopharynx, and bone. Single-dose benzylpenicillin is effective in treating nonsexually transmitted syphilis and its contacts.
Etiology
The causative agent of the disease is the local subspecies of the pallidum spirochete also known as the endemic syphilis spirochete.
Between people, mainly through mucosal contact, contaminated by the pathogen tableware, drink cups or felt products and be infected, subtypes of endemic spirochetes multiply in the body, the primary lesions are rare, likely to occur in the oropharyngeal mucosa and not easy to detect, the most common is the second stage of oral mucous membrane plaque, without treatment of the second stage of endemic syphilis can be self-healing in 6 to 9 months, the third stage of the damage to skin, nasopharyngeal and bone of the gelatinous ulcers.
Symptoms
The clinical presentation of nonsexual syphilis is quite similar to that of sexually transmitted syphilis. In the first stage, oral lesions are not easily detected; in the second stage, the damage is manifested as mucous membrane spots in the oropharynx, fissured papules at the corners of the mouth, warts, periostitis and localized lymph node enlargement, etc. Hyperkeratosis is often found on the palms of the hands and the soles of the feet. Stage III clinical symptoms are more prominent, including dendritic damage to the skin, nasopharynx, bone, etc., and this destructive damage is called disfiguring nasopharyngitis is often more common than yaws. Breast gummosis is also seen in mothers feeding infected infants.
Examination
1. Microscopic examination
Based on the skin or mucous membrane specimens directly dark field microscopy to find positive spirochetes
2. Serologic testing
Presence of appropriate antibodies.
Diagnosis
Endemic syphilis should be suspected in patients with chronic skin and bone damage living in endemic areas. Diagnosis is based on direct dark-field microscopy of skin or mucous membrane specimens to look for positive spirochetes, and serologic testing for the presence of corresponding antibodies. Since the three subspecies of Spirochaetes pallidum are basically the same in morphology, antigenic structure and even DNA homology, it is impossible to distinguish them from each other. Therefore, the diagnosis must be made in conjunction with clinical manifestations and epidemiologic data.
Treatment
A single dose of benzylpenicillin, intramuscularly, is effective in the treatment of the disease and its contacts. Ceftriaxone, intramuscularly or intravenously administered for 10 days. Doxycycline, tetracycline hydrochloride, and erythromycin are available for those allergic to penicillin.
Prevention
Prevention of nonsexual syphilis must be carried out in endemic areas to treat patients on a large scale and eliminate the source of infection, and at the same time, public health conditions should be improved and socio-economic level should be raised in order to effectively control the epidemic of nonsexual syphilis.