What is syphilis?

Syphilis is a bacterial infection that usually transmits through sexual contact. The disease begins as a painful infection that usually spreads to the genitals, rectum, or mouth. Syphilis spreads from person to person through contact with the mucous membrane of these sores.

When infected, the syphilis bacteria can remain dormant in your body for years before becoming active again. Syphilis can be treated when detected early, sometimes with a single dose (injection) of penicillin. Syphilis can seriously damage your heart, brain, or other organs, and it can be life-threatening if left without treatment. Syphilis can also be transmitted from mothers to their unborn babies.

What are the symptoms of syphilis?

Syphilis develops in stages, so symptoms vary with each stage. But the stages can overlap, and symptoms do not always appear in the same order. A person may develop syphilis and not notice any symptoms for years.

Primary syphilis. The first indication of syphilis is the appearance of a small sore. The sore appears where the bacteria entered your body. While most people with syphilis develop a single sore, others develop multiple sores. Many people with syphilis do not notice this sore; Because it is usually painless, it may be hidden inside the vagina or rectum. The sore heals on its own within three to six weeks.

Secondary syphilis. Within a few weeks of the sore healing, you may experience a rash that first appears on your torso and then spreads to cover your entire body to the palms of your hands and the soles of your feet. This rash is not usually itchy, but it may be accompanied by wart-like sores in the mouth or genitals. Also, some people may develop symptoms such as hair loss, muscle pain, fever, sore throat, and swollen lymph nodes. These signs and symptoms may disappear without treatment within a few weeks and may appear and disappear repeatedly over a year.

Latent syphilis. If you are not treated for syphilis, the disease progresses from the second stage to the latent stage when you will not have any symptoms. The latent stage can last for years. Signs and symptoms of the disease may never return, or the disease may progress to the third stage.

Tertiary syphilis. About 15% to 30% of people with syphilis who do not receive treatment will develop a complication known as late (tertiary) syphilis. The disease may damage the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints in its late stage. 

Neurosyphilis. Syphilis can spread at any stage and cause, among other things, damage to the brain and nervous system (neurosyphilis) and the eyes (ophthalmic syphilis).

Congenital syphilis. Babies born to mothers with syphilis can become infected via the placenta or during childbirth. Most newborns with congenital syphilis have no symptoms, although some may develop a rash on the palms of their hands and the soles of their feet. Other signs and symptoms that appear in later stages may include deafness, dental deformities, and a saddle nose – where the bridge of the nose collapses. However, children with syphilis can also be born early, stillborn, or die after birth.

What is the cause of syphilis?

Syphilis is caused by a bacterium called Treponema pallidum. The most common way to transmit the disease is through contact with a person who has sores during sexual activity. The bacteria enter the body through small cuts or abrasions on your skin or mucous membranes. Syphilis is contagious during the primary, secondary, and sometimes early stages.

What are the risk factors of syphilis?

  • Having unprotected sex
  • Having more than one sexual partner
  • A previous infection of gonorrhea or another sexually transmitted infection

What are the complications of syphilis?

Syphilis can damage all parts of the body if left without treatment and can increase the risk of contracting HIV infection and can cause problems during pregnancy. Treatment helps prevent future damage but does not repair or reverse the damage that has occurred before.

How to diagnose syphilis?

Syphilis can be diagnosed by testing samples from:

  • Blood. Blood tests are necessary to confirm the presence of antibodies produced by the body to fight infection. These antibodies to the bacteria that cause syphilis remain in the body for years. So, the test can be used to detect the presence of a current infection or a previous infection.
  • Cerebrospinal fluid. If your doctor suspects you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a process called a lumbar puncture.

How to treat syphilis?

Syphilis is easier to treat when it is diagnosed and treated in its early stages. Penicillin is the preferred treatment at all stages, which is an antibiotic drug that can kill the organism that causes syphilis. If you are allergic to penicillin, your doctor may suggest another antibiotic or recommend desensitization to the penicillin.

If you are diagnosed with primary, secondary, or early latent syphilis (by definition, less than a year), the recommended treatment is one injection of penicillin. However, if you have had syphilis for more than a year, you may need additional doses.

Penicillin is the only treatment recommended for pregnant women who have syphilis. Women who are allergic to penicillin can undergo a desensitization procedure, which allows them to take penicillin. Even if you are treated for syphilis during pregnancy, your new-born baby will be tested for congenital syphilis and will receive antibiotic treatment if infected.

On the first day of treatment, you may have what is known as the Jarisch-Hexheimer reaction. Signs and symptoms include fever, chills, nausea, pain, and headache. This reaction usually lasts no more than a day.

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