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[Syphilis in the third millenium]
A Machovcová1, R Konkolová, R Schmiedbergerová
1Dermatovenerologická klinika 2. LF UK a FNM, Praha. alena.machovcova@fnmotol.cz
Background:
For several decades the clinical picture of all stages of syphilis has been assumed to be immutable. The aim of the study was to describe the real spectrum of cutaneous and mucosal manifestations and organ changes and to ascertain whether the incidence of the disease has an increasing trend.
Methods And Results:
The studied group included 92 patients (44 males, 48 females, average was 31.3 years) diagnosed in years 1992 to 1998 at our clinics. The diagnose was confirmed by a microscopic and/or serologic examination. Number of patients with the primary syphilis increased more than twice (1992 versus 1997), incidence of newly registered manifestations of the secondary syphilis has also increased (1996 to 1998), number of hospitalised patients in the stadium of syphilis latens increased at least twice (1992 versus 1996). Higher was the number of proven cases in pregnant patients: number of dead births increased twice, inborn forms of syphilis were three times more frequent. Among the newly described clinical forms the specific gastritis and specific uveitis were diagnosed. In immunosuppressed patients forms of lues maligna and the blue toes syndrome were identified. However, those forms were not diagnosed among our group of studied patients.
Conclusions:
During the last 10 years a significant increase of incidence of syphilis was reported in the population of Czech Republic. Such dangerous and almost explosive rise of new cases has been accompanied with increased number of inborn forms and with the occurrence of new clinical manifestations, namely in immunosuppressed patients.
Insights
Syphilis incidence is rising, with more congenital cases and new clinical forms, particularly in immunosuppressed individuals. This trend highlights evolving disease presentation and public health concerns.
Area of Science:
- Infectious Diseases
- Dermatology and Venereology
- Public Health
Context:
- Syphilis clinical presentation was historically considered static.
- Recent observations suggest a potential shift in disease patterns.
- The study investigates trends in syphilis incidence and manifestations.
Purpose:
- To describe the spectrum of cutaneous, mucosal, and organ changes in syphilis.
- To determine if syphilis incidence is increasing.
- To identify new clinical manifestations and their association with patient groups.
Summary:
- A study of 92 patients (1992-1998) revealed a more than twofold increase in primary syphilis and rising secondary syphilis and latent syphilis cases.
- Congenital syphilis and stillbirths significantly increased in pregnant patients.
- New clinical forms like specific gastritis and uveitis were noted, alongside potential severe forms in immunosuppressed patients.
Impact:
- Highlights a significant increase in syphilis incidence in the Czech Republic over the last decade.
- Indicates an alarming rise in congenital syphilis and novel clinical presentations.
- Underscores the need for vigilance, especially regarding syphilis in immunosuppressed populations.