What To Know About Syphilis

Syphilis, often considered a relic of the past, remains a relevant and concerning public health issue today. Despite advances in medicine, this sexually transmitted infection is making a comeback, with increasing rates reported in recent years.

What is Syphilis?

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. It is both preventable and curable, but if left untreated, it can progress through several stages, each with its own set of symptoms and potential complications.

Syphilis is primarily transmitted through sexual contact, including oral, vaginal, and anal sex. However, it can also be spread through sharing needles for drug use. Pregnant women with syphilis can pass the infection to their infants during childbirth, leading to congenital syphilis.

Stages of Syphilis

Syphilis is classified into four main stages:

• Primary Syphilis

  The first stage occurs immediately following exposure to the infection and typically lasts for about three weeks. The primary symptom is a single, painless sore that usually appears near the point of entry of the bacteria. This sore, known as a chancre, can manifest on or around the genitals, anus, or other areas. Since it is painless, it often goes unnoticed, but it disappears on its own within a few weeks. If untreated, syphilis will progress to the next stage.

• Secondary Syphilis

  The second stage of syphilis is characterized by a reddish rash on the palms and soles of the feet. This rash is not typically itchy but can be accompanied by flu-like symptoms such as fever, headache, weight loss, and muscle aches. White or gray lesions may also appear in moist areas like the mouth and genital regions. If untreated, the symptoms of this stage will resolve on their own, but the infection will eventually progress.

• Latent Stage

  Between the secondary and tertiary stages, there is a latent stage of syphilis. This phase is categorized as "early latent" if the infection occurred less than a year prior and "late latent" if it's been over a year. During this period, the infection remains hidden or dormant, displaying no noticeable signs or symptoms.

• Tertiary Syphilis

  The final and most severe stage of syphilis is the tertiary stage. It is relatively rare, typically appearing 5 to 30 years after untreated infection. At this stage, the infection can cause irreversible damage to the brain and heart. If left untreated, tertiary syphilis may lead to death.

Diagnosis and Treatment

Diagnosing syphilis is relatively straightforward. A blood sample is typically taken to test for the presence of syphilis antibodies. Testing can reveal whether a person has an active infection or has been exposed to syphilis in the past.

Treatment for syphilis typically involves the use of antibiotics. The choice of antibiotic and the treatment duration depend on the stage of the infection. Primary, secondary, and latent syphilis are often treated with benzathine penicillin G as an injection. Tertiary syphilis may require crystalline penicillin G administered intravenously for a more extended period. It's important to start treatment as early as possible to achieve the best outcomes.

For individuals allergic to penicillin, alternative treatments are available. Options include antibiotics like doxycycline, ceftriaxone, azithromycin, and erythromycin, depending on the specific circumstances and stage of the infection. Consultation with an allergist may also be considered in some cases.

Complications

Many of the most serious and severe complications of syphilis tend to occur in the third stage, known as tertiary syphilis. Tertiary syphilis is characterized by the involvement of various organs and systems in the body and typically appears 5 to 30 years after the initial infection, if left untreated. This stage can lead to severe and potentially life-threatening complications, including:

• Neurosyphilis
  Tertiary syphilis can cause neurosyphilis, which affects the nervous system and can lead to symptoms like headaches, confusion, behavioral changes, and, in extreme cases, stroke or dementia.
• Cardiovascular Syphilis
  The infection can damage the cardiovascular system, potentially leading to aortic aneurysms or aortic insufficiency, which can be life-threatening.
• Gummatous Syphilis
  Tertiary syphilis can cause the formation of destructive lesions known as gummas on various body parts, including the skin, bones, and organs. Gummas can result in significant tissue damage, deformities, and organ dysfunction.
• Organ Damage
  As the disease progresses to its later stages, tertiary syphilis can affect multiple organs, such as the liver, kidneys, and bones, potentially causing irreversible damage.

It's important to note that while the most severe complications are associated with tertiary syphilis, complications can also occur in the secondary stage of the disease, which follows the initial primary stage. During secondary syphilis, individuals may experience symptoms like rashes, lesions, and flu-like symptoms. These symptoms can affect various body systems, and if left untreated, they can lead to complications.

Preventing Syphilis

Preventing syphilis involves practicing safe sex, getting regular sexual health check-ups, and using barrier methods like condoms. Education and awareness are essential in combating the resurgence of this sexually transmitted infection.

If you think you may have syphilis or have been sexually active but haven’t had sexual health testing recently, it’s important to speak with a healthcare provider to get tested.