Syphillis in the Third Century

Overview

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 changesand 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 age was 31.3 years)diagnosed in years 1992 to 1998 at our clinics. The diagnose was confirmed by a microscopic and/or serologicexamination. Number of patients with the primary syphilis increased more than twice (1992 versus 1997), incidenceof newly registered manifestations of the secondary syphilis has also increased (1996 to 1998), number of hospitalisedpatients in the stadium of syphilis latens increased at least twice (1992 versus 1996). Higher was the number ofproven cases in pregnant patients: number of dead births increased twice, inborn forms of syphilis were three timesmore 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, thoseforms 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 populationof Czech Republic. Such dangerous and almost explosive rise of new cases has been accompanied with increasednumber of inborn forms and with the occurrence of new clinical manifestations, namely in immunosuppressedpatients.

Key words:
syphilis, sexually transmissible diseases, transplacental transmission, dead birth, dispensary, immunodeficiency.