Sexually transmitted infections (STIs) are a significant public health issue that negatively impact the quality of life and result in substantial deaths and morbidity worldwide. One such illness brought on by Treponema pallidum is syphilis. The fact that malaria-induced fevers were used to treat neurosyphilis from the 1920s until the 1950s, before the invention of penicillin, should be emphasized. Therefore, this article provides an overview of what syphilis is, why malaria therapy was used to treat it, and how it is actually addressed.
What exactly is syphilis?
Syphilis can be spread through blood transfusions, sexual contact with infectious lesions on the mucous membranes or rubbed skin, or transplacentally from an expecting mother to her developing baby. The illness has different stages and lasts for many years if untreated.
In contrast to late syphilis, which consists of late latent syphilis and tertiary syphilis, early syphilis includes primary, secondary, and early latent syphilis. Any stage of the syphilis infection, including the initial few months, can result in neurosyphilis. Meningitis, stroke, cranial nerve dysfunction, acute changes in mental status, and abnormalities of the eyes, ears, or nose are examples of early neurological manifestations.
Why was syphilis treated with malaria therapy?
Syphilis was a widespread sexually transmitted infection up until the end of the Second World War. Mental deterioration, paralysis, and ultimately death were the results of this stigmatising infectious disease. Due to ‘malaria therapy’, which was used in patients with paralytic dementia after the First World War, the history of syphilis was brought to the public’s attention. This is due to the fact that the malaria-induced fever spikes killed the syphilitic infection-causing bacteria.
The Austrian physician Julius Wagner-Jauregg discovered the curative properties of malaria therapy in 1917, but once penicillin became widely available, this treatment was no longer effective.
What is the most effective way to treat syphilis?
According to the World Health Organization, penicillin, specifically the variety known as penicillin G benzathine, is used to treat syphilis. This is due to the fact that penicillin can kill Treponema pallidum, the bacteria that causes syphilis.
Keep in mind that syphilis is easily treatable if detected and treated at an early stage. A single injection of penicillin G benzathine can also stop the spread of syphilis in people who have had the disease for less than a year.
However, one might require additional doses if the condition progresses for more than a year. Even tertiary, or late-stage, syphilis is treatable, though penicillin cannot repair any organ damage brought on by syphilis.
If neurosyphilis, or syphilis that affects the brain or spinal cord, is identified, an intensive penicillin regimen lasting 10 to 14 days is required, and in some cases, it may need to be repeated. While penicillin is the preferred treatment for syphilis, other antibiotics may be used in non-pregnant people who are allergic to penicillin. The CDC advises treating patients with penicillin allergies with doxycycline, tetracycline, and azithromycin.
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