Syphilis Today

Sifilis je spolno prenosiva zarazna bolest uzrokovana spirohetom Treponema pallidum. Prenosi se ponajprije spolnim putem, a u rijetkim slučajevima moguć je i transplacentarni prijenos. Bolest zahvaća različita tkiva i organske sustave, u prvom redu kožu, kardiovaskularni, koštani i središnji živčani sustav. Sifilis danas nije jedan od vodećih javnozdravstvenih problema, međutim, prisutan je, a posljednjih godina zamijećen je i blagi porast zaraženih "de novo", kao i udruženost s drugim spolno prenosivim infekcijama (klamidije, HIV). Ovaj porast bilježi se i u nama susjednim zemljama u kojima se broj oboljelih povećava tijekom posljednja dva desetljeća. Prema trajanju bolesti sifilis se dijeli na rani i kasni sifilis, a na temelju kliničke slike bolest se dijeli u tri stadija. Sifilis je prozvan "velikim imitatorom" ubrzo nakon njegova otkrića zbog raznolikosti kliničkih slika kojima se očituje. Stoga je poznavanje različitosti kliničkih slika u raznim stadijima sifilisa važno, kako u okviru rane dijagnostike sifilisa tako i u diferencijalnoj dijagnostici različitih bolesti, osobito onih koje se pojavljuju na koži. Dijagnoza sifilisa temelji se na anamnezi, kliničkoj slici te laboratorijskim testovima. Lijek izbora za terapiju sifilisa je penicilin koji se u različitim stadijima i fazama bolesti primjenjuje u različitoj dozi. U slučaju preosjetljivosti na penicilin terapija se može provesti doksiciklinom ili azitromicinom. Nakon provedene terapije nužno je redovito kontrolirati bolesnika te na taj način utvrditi je li terapija uspješno provedena.Syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum. The route of transmission of syphilis is almost always through sexual contact. Transplacental transmission has been also recorded although rarely. This disease affects various tissues and organ systems, primarily skin, and cardiovascular, skeletal and central nervous systems. Although syphilis does not represent a major public health problem, it is still present and it has even recorded a mild increase over the last years and has occurred in combination with other sexually transmitted infections (chlamydiae, HIV). This increase has been also recorded in neighboring countries over the last two decades. According to its duration, syphilis can be either early or late. On the basis of its clinical picture, it can be divided into three stages. The disease was dubbed the "Great Imitator" soon after its discovery due to the diversity in its clinical picture. Therefore, the knowledge of its clinical picture in early stages of the disease is important both for its diagnosis and for the differential diagnosis of various diseases, particularly skin diseases. The diagnosis of syphilis is based on anamnesis, clinical picture and laboratory tests. The drug of choice for the treatment of syphilis is penicillin, which is given in different doses in different stages of the disease. In hypersensitivity to penicillin, doxycycline or azithromycin may be used. Follow-up is necessary to verify whether the therapy has been successful