Syphilis

Written by Shannon Johnson | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What Is Syphilis?

Syphilis is a sexually transmitted infection. It is caused by a type of bacteria known as Treponema pallidum. According to the Centers for Disease Control and Prevention, in 2006, more than 36,000 cases of syphilis were reported in the United States (CDC). According to statistics from the Mayo Clinic, the rate of syphilis among homosexual men has been rising consistently since 2000 (Mayo).

The first sign of syphilis is a small, painless sore. It can appear on your sexual organs, rectum, or inside your mouth. This sore is called a chancre. Often, people fail to notice it right away.

Syphilis can be tricky to diagnose. An infected person can go years without showing any symptoms. However, the earlier you discover the infection, the better it is. Syphilis that remains untreated for a long period can cause major damage to important organs, like the heart and brain.

Syphilis is only spread through intimate contact. It cannot be transmitted by (for example) sharing a toilet with another person, wearing their clothes, or using their eating utensils.

Stages of Syphilis Infection

Syphilis has four stages: primary, secondary, latent, and tertiary. It is most infectious in the first two stages. When syphilis is in the hidden or latent stage, the disease remains active but often with no symptoms and is not contagious to others. Tertiary syphilis is most dangerous for your health.

Primary Syphilis

The primary stage of syphilis occurs shortly after you are infected with the bacteria. It begins with a small and painless, but highly infectious, round sore called a chancre. This sore may appear on or inside your mouth or genitals, wherever the bacteria entered your body.

On average, the sore shows up around three weeks after infection, but it can take between 10 and 90 days. The sore remains for anywhere between two and six weeks.

Syphilis is transmitted by direct contact with a sore. This usually occurs during sexual activity.

Secondary Syphilis

During the second stage of syphilis, you may experience skin rashes and a sore throat. The rash will not itch and is usually found on your palms and soles. Some people do not notice the rash before it goes away.

Other symptoms of secondary syphilis may include:

  • headaches
  • swollen lymph glands
  • fatigue
  • fever
  • weight loss
  • hair loss
  • aching joints

These symptoms will go away whether or not you receive treatment. However, without treatment you will still be infected.

Secondary syphilis is often mistaken for another condition.

Latent Syphilis

The third stage of syphilis is the latent or hidden stage.  The primary and secondary symptoms disappear and you will not have any noticeable symptoms at this stage. However, you will still be infected with syphilis. The secondary symptoms could reappear. You could also remain in this stage for years before progressing to tertiary syphilis.

Tertiary Syphilis

The last stage of infection is tertiary syphilis. One-third of people who do not receive treatment for syphilis will enter this stage. Tertiary syphilis can occur years or decades after you are infected, and it is very serious. Some potential outcomes of tertiary syphilis include:

  • blindness
  • deafness
  • mental illness
  • memory loss
  • destruction of soft tissue and bone
  • neurological disorders (e.g., stroke and meningitis)
  • heart disease
  • neurosyphilis (brain or spinal cord infection)
  • death

How Is Syphilis Diagnosed?

If you think you might have syphilis, go to your doctor as soon as possible. The doctor will take a blood or urine sample to run tests. If a sore is present, your doctor will take a sample from the sore to determine if the syphilis bacteria are present.

If a doctor suspects that you are having nervous system problems because of tertiary syphilis, you may need a spinal tap. During this procedure, your spinal fluid is collected so that your doctor can test for bacteria.

Since the bacteria can be in your body without you knowing it, doctors will often screen pregnant women for syphilis. This is to prevent the fetus from being infected with congenital syphilis. Congenital syphilis can cause severe damage in a newborn. It can even be fatal.

Treating and Curing Syphilis

Primary and secondary syphilis are easy to treat with a penicillin injection. Penicillin is one of the most widely used antibiotics. It is usually effective in treating syphilis. People that are allergic to penicillin will be treated with a different oral antibiotic, such as tetracycline.

Neurosyphilis sufferers will get daily doses of IV administered penicillin. This will often require a brief hospital stay. Unfortunately, the damage caused by late syphilis cannot be reversed. The bacteria can be killed, but treatment will most likely focus on easing pain and discomfort.

During your treatment, make sure to avoid all sexual contact until all sores on your body are healed and your doctor tells you it is safe to resume sex. If you are sexually active, your partner should be treated as well. You should not resume sexual activity until both of your treatments are complete.

How to Prevent Syphilis

The best way to prevent syphilis is to practice safe sex. Using condoms during any type of sexual contact is a good idea. In addition, it is helpful to:

  • avoid having sex with multiple partners
  • use a dental dam (square piece of latex) or condoms during oral sex
  • avoid sharing sex toys
  • get screened for sexually transmitted infections and talk to your partners about their results

Syphilis can also be transmitted through shared needles. Avoid sharing needles if you are going to use drugs.

Drinking too much or doing recreational drugs can cause you to make unsafe sexual decisions.

Risks and Complications Associated With Syphilis

Pregnant Mothers and Newborns

Mothers infected with syphilis are at risk for miscarriages, still births, or premature births. There is also is a risk that an infected mother will pass the disease on to her fetus. This is known as congenital syphilis.

Babies born with congenital syphilis can suffer from the following:

  • death
  • deformities
  • developmental delays
  • seizures
  • rash
  • fever
  • swollen liver/spleen
  • anemia
  • jaundice
  • infectious sores

If congenital syphilis goes undetected, then a baby could develop late stage syphilis. This could lead to major damage in their bones, teeth, eyes, ears, and brains.

HIV/AIDS

People with syphilis have a significantly increased chance of getting HIV. The sores the disease causes makes it easier for HIV to enter the body.

It is also important to note that those with HIV may experience different syphilis symptoms than those who do not have HIV. If you do have HIV, talk to your doctor about how to recognize syphilis symptoms.

When Should I Test for Syphilis?

The first stage of syphilis can easily go undetected, and the second stage symptoms are common to other illnesses. This means that if you fall into any of the following categories, you should probably be tested for syphilis. It does not matter if you have ever had any symptoms. Get tested if you:

  • have had unprotected sex with someone that might have had syphilis
  • are pregnant
  • are a sex worker
  • have exchanged sex for drugs
  • are in prison
  • have had unprotected sex with multiple people, or have a partner who has done so
  • are a man who has sex with men

If your test comes back positive, it is important to complete your full treatment. Make certain to finish your antibiotics even if your symptoms disappear. You should also avoid all sexual activity until your doctor tells you that it’s safe. You might also consider being tested for HIV.

People who have tested positive for syphilis should notify all of their recent sexual partners so that they can also get tested and receive treatment.

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