What is Syphilis?

Syphilis

Syphilis is a common bacterial infection that’s spread through sex. Syphilis is easily cured with antibiotic medicine, but it can cause permanent damage if you don’t get treated. Typically on the genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores. You can catch syphilis more than once, even if you have been treated for it before.

What causes Syphilis?

Syphilis is an infection that develops due to T. pallidum bacteria. These bacteria can spread between people through direct contact with a syphilitic sore.

How is syphilis spread?

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can spread from an infected mother to her unborn baby.

Syphilis isn’t spread through casual contact, so you CAN’T get it from sharing food or drinks, hugging, holding hands, coughing, sneezing, sharing towels, or sitting on toilet seats.

The main ways people get syphilis are from having vaginal sex and anal sex. It’s less common to get it from having oral sex, but it can happen. Syphilis is very easy to give to other people in the beginning, when there are sores. But lots of people don’t even know they have syphilis because they don’t notice the sores. Using condoms every time you have sex is one of the best ways to help prevent syphilis — even if you and your partner seem totally healthy.

A mother can also pass syphilis to a baby during pregnancy and childbirth, which can be dangerous. This is called congenital syphilis.

How can I reduce my risk of getting syphilis?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis;
• Using latex condoms the right way every time you have sex.
• Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Am I at risk for syphilis?

Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs.

• All pregnant women should be tested for syphilis at their first prenatal visit.
• You should get tested regularly for syphilis if you are sexually active and
• are a man who has sex with men;
• are living with HIV; or
• have partner(s) who have tested positive for syphilis.

When should I test for syphilis?

The first stage of syphilis can easily go undetected. The symptoms in the second stage are also common symptoms of other illnesses. This means that if any of the following applies to you, consider getting tested for syphilis. It doesn’t matter if you’ve ever had any symptoms. Get tested if you:

have had condomless sex with someone who might have had syphilis

• are pregnant
• are a sex worker
• are in prison
• have had condomless sex with multiple people
• have a partner who has had condomless sex with multiple people
• are a man who has sex with men

If the test comes back positive, it’s important to complete the full treatment. Make sure to finish the full course of antibiotics, even if symptoms disappear. Also avoid all sexual activity until your doctor tells you that it’s safe. Consider getting tested for HIV as well.

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.

What are the signs and symptoms of syphilis?

Doctors categorize the stage of syphilis as either primary, secondary, latent, or tertiary. A variety of symptoms define each stage.

The disease can be contagious during the primary and secondary stages and, occasionally, the early latent phase. Tertiary syphilis is not contagious, but it has the most severe symptoms.

Primary symptoms

The symptoms of primary syphilis include one or more painless, firm, and round syphilitic sores, or chancres. These appear 10 days to 3 months after the bacteria enter the body. Chancres resolve within 2–6 weeks. However, without treatment, the disease may remain in the body and progress to the next phase.

Secondary symptoms

Secondary syphilis symptoms include:

• sores that resemble oral, anal, and genital warts
• a non itchy, rough, red or red-brown rash that starts on the trunk and spreads to the entire body, including the palms and soles
• muscle aches
• fever
• a sore throat
• swollen lymph nodes
• patchy hair loss
• headaches
• unexplained weight loss
• fatigue

These symptoms may resolve a few weeks after they first appear. They might also return several times over a longer period. Without treatment, secondary syphilis can progress to the latent and tertiary stages.

Latent syphilis

The latent phase can last for several years. During this time, the body will harbor the disease without symptoms. However, the T. pallidum bacteria remain dormant in the body, and there is always a risk of recurrence. Doctors still recommend treating syphilis at this stage, even if symptoms do not occur. After the latent phase, tertiary syphilis may develop.

Tertiary syphilis, or late syphilis

Tertiary syphilis can occur 10–30 years Trusted Source after the onset of the infection, usually after a period of latency during which there are no symptoms.

At this stage, syphilis damages the following organs and systems:

• heart
• blood vessels
• liver
• bones
• joints
• Gummas may also develop. These are soft tissue swellings that can occur anywhere on the body.
• Organ damage means that tertiary syphilis can often lead to death. Treating syphilis before it reaches this stage is, therefore, critical.

Neurosyphilis

Neurosyphilis is a condition that develops when T. pallidum bacteria have spread to the nervous system. It often has links to latent and tertiary syphilis. However, it can occur at any time after the primary stage.

A person with neurosyphilis may be asymptomatic for a long time. Alternatively, symptoms might develop gradually.

Symptoms includeTrusted Source:

• dementia or altered mental status
• abnormal gait
• numbness in the extremities
• problems with concentration
• confusion
• headache or seizures
• vision problems or vision loss
• weakness

Congenital syphilis

Congenital syphilis is severe and frequently life threatening. T. pallidum bacteria can transfer from a pregnant woman to a fetus through the placenta and during the birth process.

Data suggest that without screening and treatment, about 70% of women with syphilis will have an adverse outcome in pregnancy.

Adverse outcomes include early fetal or neonatal death, preterm birth or low birth weight, and infection in infants.

Symptoms in newborns include:

• saddle nose, in which the bridge of the nose is missing
• fever
• difficulty gaining weight
• a rash of the genitals, anus, and mouth
• small blisters on the hands and feet that change to a copper colored rash, which may be bumpy or flat, and spread to the face
• watery nasal fluid

Older infants and young children may experience:

• Hutchinson teeth, or abnormal, peg shaped teeth
• bone pain
• vision loss
• hearing loss
• joint swelling
• saber shins, a bone problem in the lower legs
• scarring of the skin around the genitals, anus, and mouth
• gray patches around the outer vagina and anus

When to see a doctor

Call your doctor if you or your child experiences any unusual discharge, sore or rash — particularly if it occurs in the groin area.

How is syphilis diagnosed?

• If you think you might have syphilis, go to your doctor as soon as possible. They’ll take a blood sample to run tests, and they’ll also conduct a thorough physical examination. If a sore is present, your doctor may take a sample from the sore to determine if the syphilis bacteria are present.
• If your doctor suspects that you’re having nervous system problems because of tertiary syphilis, you may need a lumbar puncture, or spinal tap. During this procedure, spinal fluid is collected so that your doctor can test for syphilis bacteria.
• If you’re pregnant, your doctor might screen you for syphilis because the bacteria can be in your body without you knowing it. This is to prevent the fetus from being infected with congenital syphilis. Congenital syphilis can cause severe damage in a newborn and can even be fatal.

How is Syphilis treated?

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

• Doxycycline
• Azithromycin
• Ceftriaxone

If you have neurosyphilis, you’ll get daily doses of penicillin intravenously. This will often require a brief hospital stay. Unfortunately, the damage caused by late syphilis can’t be reversed. The bacteria can be killed, but treatment will most likely focus on easing pain and discomfort.

During treatment, make sure to avoid sexual contact until all sores on your body are healed and your doctor tells you it’s safe to resume sex. If you’re sexually active, your partner should be treated as well. Don’t resume sexual activity until you and your partner have completed treatment.

Can syphilis be cured?

Yes, syphilis can be cured with the right antibiotics from your healthcare provider. However, treatment might not undo any damage that the infection has already done.

I’ve been treated. Can I get syphilis again?

Having syphilis once does not protect you from getting it again. Even after you’ve been successfully treated, you can still be re-infected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is recommended to make sure that your treatment was successful.

It may not be obvious that a sex partner has syphilis. This is because syphilis sores can be hidden in the vagina, anus, under the foreskin of the penis, or in the mouth. Unless you know that your sex partner(s) has been tested and treated, you may be at risk of getting syphilis again from an infected sex partner.

How to prevent syphilis

preventive measures to decrease the risk of syphilis include:

• abstaining from sex
• maintaining long term mutual monogamy with a partner who does not have syphilis
• using a condom, although these only protect against genital sores and not those that develop elsewhere on the body
• using a dental dam, or plastic square, during oral sex
• avoiding sharing sex toys
• refraining from alcohol and drugs that could potentially lead to unsafe sexual practices
• syphilis can also be transmitted through shared needles. Avoid sharing needles if using injected drugs.
• having syphilis once does not mean that a person has protection from it going forward. Even after treatment has successfully removed syphilis from a person’s body, it is possible for them to contract it again.

Partner notification and preventive treatment

If tests show that you have syphilis, your sex partners — including current partners and any other partners you’ve had over the last three months to one year — need to be informed so that they can get tested. If they’re infected, they can then be treated.

Official, confidential partner notification can help limit the spread of syphilis. The practice also steers those at risk toward counseling and the right treatment. And since you can contract syphilis more than once, partner notification reduces your risk of getting reinfected.

Screening for pregnant women

People can be infected with syphilis and not know it. In light of the often deadly effects syphilis can have on unborn children, health officials recommend that all pregnant women be screened for the disease.

References

Syphilis – CDC Fact Sheet https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
What to know about syphilis https://www.medicalnewstoday.com/articles/186656#prevention
Syphilis https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756
Syphilis https://www.healthline.com/health/std/syphilis#diagnosis