What Is Syphilis?
It is a bacterial infection that can spread via sexual activities. Syphilis is causing bacteria known as Treponema pallidum. Syphilis is considered an “imitate disease” as it mimics several diseases; for this reason, it can be challenging to diagnose.
Symptoms may vary depending on a patient’s exposure to infection. Some show signs like syphilis chancre or nose syphilis, syphilis rashes specifically on genital parts, but others have no symptoms. A timely diagnosis of Syphilis is crucial. If left untreated for an extended period, Syphilis can cause significant damage to the heart and brain, and other body systems.
Four stages of Syphilis
In Syphilis diagnosis, it’s essential to recognize the stages and progression of the disease. Likewise, for other STIs, the syphilis symptoms vary with the passage of the stage.
If the primary stage shows up with syphilis chancre, the latter may develop Syphilis in one month or another. In addition, each of the four steps has its severity and complications primarily alike, but some are highly contagious.
The first two stages of Syphilis are highly infectious, but tertiary Syphilis is the most dangerous.
Following are the four stages of Syphilis:
- Primary Syphilis
- Secondary Syphilis
- Latent Syphilis
- Tertiary Syphilis
Let us have a look at the four stages of Syphilis:
Primary Syphilis is the very first stage of syphilis infection. After exposure to the bacteria, it takes 3 to 4 weeks to develop symptoms of the preliminary stage.
The first symptom of this stage is the appearance of syphilis chancre, a painless small round sore. Syphilis chancre may appear at sites where bacteria get into the body. This painless sore can be on or inside the genitals, mouth, or rectum; it mostly remains unnoticed due to its easy existence, but its highly contagious.
The chancer can heal up on its own within three to six weeks. The duration of the sore is for two to six weeks, approx. Besides, having chancre, sometimes swollen lymph nodes is the only symptom of Syphilis at this stage.
At this stage, the disease is curable and treatable with the help of medicine but can still be transmitted.
Secondary Syphilis commonly shows nonpresent symptoms, such as itchy skin rashes in the sole and palm region but may also appear on other bodily organs. They are primarily non-itchy and painless, so they will remain unnoticed until the rash disappears. Secondary-stage symptoms appear 2-24 weeks after the body gets infected by Pallidum.
The signs and symptoms associated with the second stage include:
- Patchy alopecia
- Early Neurosyphilis
- Swollen lymph nodes
- Effortless weight loss
- Aching in joints
These symptoms will be treated with proper medical treatment and may disappear. If patients remain untreated, the progression to the next stage of Syphilis will occur.
As Syphilis is referred to as mimicking various infection symptoms, in the case of secondary Syphilis, it can be confused with some similar medical conditions, including:
- Pityriasis rosea
- Lichen planus
Latent Syphilis is the static phase of the infection. At this stage, patients may not experience any syphilis symptoms like syphilis rash, chancre, or ingrown hair and remain asymptomatic. However, the condition is still ruining the body system in a silent mode.
Syphilis stage three is called ongoing Sero reactivity but no clinical appearance of symptoms. The latent phase is subdivided into two early latent Syphilis (acquired during the preceding year) and late latent Syphilis (disease acquired for more than a year or unknown duration). The patient may carry latent Syphilis for many years or throughout his life. In some cases, remaining untreated may lead to tertiary Syphilis most dangerous stage.
If you have experienced the first or second stage before and, for the time being, your body is not showing any sign of infection, talk to a doctor to get a latent syphilis diagnosis and treatment.
Tertiary Syphilis is a phrase that comes up after latent Syphilis. It is not wrong to say that it is the most potent yet destructive stage of human health. This stage involves complications like psychiatric disorders, gummas, cardiovascular manifestations, and late neurosyphilis. Approx—14 to 40 people experience the late stage of syphilis infection. Tertiary Syphilis can be life-threatening and appear due to progression in the initial infection stages.
Tertiary Syphilis shows some potential signs, including:
- Blurry vision or Blindness
- Impaired hearing ability
- Forgetfulness or Dementia
- Impairment of soft tissue and bone
- Neurological disorders (stroke or meningitis)
- Cardiovascular manifestations
- Brain or spinal cord infection (neurosyphilis)
The primary complications reported in syphilis-infected patients are Neurosyphilis, Ocular Syphilis, Otosyphilis, and Oral and maxillofacial Syphilis. Syphilis can infect any organ or organ system at any stage of infection:
- Neuro-syphilis (Nervous system)
- Ocular Syphilis (Visual system)
- Otosyphilis (The auditory or vestibular system)
- Oral and maxillofacial Syphilis (Syphilis of mouth, lips, tongue)
It is a complication that occurs when Pallidum invades the nervous system. Neurosyphilis results from Treponema’s invasion of the central nervous system; this complication may occur at the stage of Syphilis.
Here are some common symptoms:
- Migraine or severe Headache
- Impaired muscular movement
- Paralysis or muscle weakness or (not able to move certain parts of the body)
- Change in personality (trouble focusing, experiencing confusion)
- Dementia or forgetfulness
One can expect the onset of ocular Syphilis at any stage of Syphilis. Ocular Syphilis is an invasion of vision or sight by bacteria. Manifestations of Syphilis of the eye may include interstitial keratitis, posterior and anterior uveitis, retinal vasculitis, and optic neuropathy.
Signs and symptoms of ocular Syphilis can include:
- Floating spots in the field of vision
- Eye pain or redness of the eye
- Vision impairment (blurry vision or even Blindness).
Otosyphilis occurs when bacteria invade the auditory or cochleovestibular system with T. pallidum, and its typical name is sensorineural hearing loss or tinnitus.
Signs and symptoms of otosyphilis may include:
- Impaired hearing ability
- Hissing in the ears
- Imbalance problem
- Vertigo or dizziness
Oral and Maxillofacial Syphilis
Oral Syphilis, or Syphilis of the mouth, is a type of infection due to Treponema within the mouth. Primary Syphilis mouth symptom is the presence of syphilis mouth sores inside or on the mouth surface.
In the case of Secondary oral Syphilis, mouth lesions or rashes become worse, and the appearance of soreness, ulcer, and white patches on the tongue (Syphilis white tongue), chancre tongue, syphilis chlamydia bumps on tongue gums or inner lining of mouth and lips. Maxillofacial Syphilis includes rashes and sores on the skin.
Oral Syphilis includes:
- Syphilis on the tongue
- Syphilis on lips
- Syphilis on gums
- Syphilis of the month inside and out
Common symptoms observed in this type of Syphilis are:
- Muscle aches
- Hair loss
- Weight loss
Causes of Syphilis
The primary cause of Syphilis is Pallidum invasion in a person’s body. In the case of oral Syphilis, oral sex is the most significant causative factor if sexual activity like kissing done with an already infected person will indeed cause infection.
How is Syphilis transmitted?
Likewise, with other STDs, Syphilis’s primary transmission mode is sexual contact.
The standard mode of Transmission, Syphilis can spread by:
- Sexual contact with an infected partner
- Direct touch on the chancer during sex or an accidental touch
- Transfusion of infected blood or exposure to an infected needle
- Non-sexual exposure to infected skin or syphilis chancre or rash
- Transmission from mother to fetus during birth
Who is most at risk of Syphilis?
Certain factors, however, may boost your risk of contracting an infection. Syphilis is more likely to affect the following groups:
- An individual partnered with syphilis-infected people
- Individuals have sexual activity without protection, like a condom
- An individual having sexual relationships with multiple partners
- Individuals involved in homosexual or bisexual activities · HIV patients
- A fetus of a syphilis-infected mother
The listed group of individuals is more prone to have syphilis infection.
Complications in Syphilis
Complications associated with Syphilis may get congenital if they remain untreated for an extended period.
- Gummas are most common in the liver. They can also occur in the brain, heart, skin, bones, eyes, and testis
- hearing loss
- brain damage
- heart valve damage
- aortitis (inflammatory aortic disease)
Syphilis and Pregnancy
Regarding the severity of infection, Pregnant women are on the borderline. During pregnancy, syphilis symptoms in female is a big red flag for the fetus’s health. To avoid disease spreading from mother to fetus, all pregnant females should get screening for Syphilis on their first visit to a gynecologist.
The number of screening tests varies on patients’ symptoms; some need a syphilis test in their third trimester, but others may need it on the spot at delivery time.
Here an expert opinion is necessary. Our expert doctors are here to help you get healthy pregnancy.
Risk Factors During Pregnancy
Here are some risk factors that may lead to Syphilis during pregnancy:
- Having multiple sex partners
- No protection uses
- Having transactional sex
- You are not seeing your doctor on time, i.e., late entry to prenatal care or no prenatal care.
- Use of drugs like heroin and methamphetamine
- Imprisonment of pregnant women or their partner
- Not having a safe household or homelessness
Despite watching the above list of risky behaviors, rectifying the hidden risk factors associated with your sex partners is essential.
Doctors recommend syphilis screening for those who deliver a stillborn infant after 20 weeks. Pregnant people with Syphilis may have a higher risk of stillbirth, depending on how long they have had the disease. There is also a possibility that the fetus will die soon after birth.
Approximately 40 percent of infants not treated for Syphilis die during pregnancy.
In some cases, infected mothers deliver babies that remain safe and alive with no symptoms of Syphilis. However, such asymptomatic infants should get immediate treatment, too, as symptoms appear after a few weeks and may worsen due to a lack of timely medical aid.
An infant may experience complications like developmental delay and seizures or reach death if not getting treatment when required. Syphilis-positive pregnant women should get screening and examination for congenital Syphilis during pregnancy.
Syphilis and HIV
Recent outbreaks have shown that around 20% to 70% of cases appeared in men infected with HIV. During Syphilis, sores are commonly present on the genitals (vagina and pinus ) that facilitate acquire and transmit HIV infection sexually.
Syphilis and HIV are STIs; their standard transmission mode is sexual contact. Therefore, the risk of having HIV hikes up to two- to five-fold when Syphilis is already present.
Diagnosis needs a careful examination of symptoms. In the case of Syphilis, diagnosis is a bit tricky due to common similarities. It may mistake for other conditions.
If you notice any signs of Syphilis, like skin rashes, chlamydia bumps on the tongue, white-colored spotted tongue, or the symptoms mentioned earlier, it is the right time to consult a doctor.
To see your case precisely, your doctor may examine and interlink your symptoms. If a medical officer notices an Impairment in the nervous system, he may get the link to tertiary Syphilis.
However, to ensure diagnosis patient has to be screening a blood test and lumbar puncture, or a spinal tap may be required during this procedure. In this case, the cerebrospinal fluid sample is necessary for testing syphilis bacteria presence.
Syphilis Can be tested at home.
A testing kit for Syphilis is a blessing as it can help proceed with early diagnosis and treatment. Get a proper diagnostic test if you feel like having symptoms of Syphilis. In case of positive results, getting doctors’ appointments for follow-up sessions is crucial.
Getting yourself tested daily is recommended if you are at risk of Syphilis due to your partner’s medical history or any other reason.
How to prevent Syphilis
Prevention is better than cure is the most common phrase in disease studies. We may avoid several chronic conditions if we implement them in our lives.
In the case of STIs, prevention is almost similar to all infectious diseases but also has specific preventive measures.
Syphilis can be prevented by doing the following modifications:
- Ensure safe sexual activity (avoid oral sex)
- Use of condoms during sex
- Be aware of your partner’s medical history
- Should stop Homosexual activities
- Avoid physical relationship with an infected person · Avoid the significant modes of transmission.
You can protect yourself against Syphilis by getting a complete guide from a doctor.
Treatment of Syphilis
Syphilis is a curable disease with the help of antibiotics.
The two commonly prescribed antibiotics are
Both of these medications belong to the beta-lactam group of antibiotics but fall into different subclasses. Ceftriaxone is a cyclosporine beta-lactam antibiotic, and Doxycycline is a penicillin G. Both medications are considered to treat Syphilis.
In the case of penicillin, therapy should use to treat Syphilis and prevent passing it to the baby. Treatment with penicillin is highly effective (success rate of 98%) in preventing transmission to the baby.
Penicillin dosage is administered intravenous route if there is neurosyphilis. Patients may have a short hospital stay. The progression of late Syphilis can be dispersed by killing the bacteria, but previously caused damage cannot be repaired. Although it is a bactericidal treatment, easing pain and discomfort is the primary aim.
During the treatment of Syphilis, the body shows some immune reactions known as the Jarisch-Herxheimer reaction (JHR).
Within 24 hours of treatment, less than 30 percent of people with primary or secondary Syphilis may experience it.
JHR immune system reactions include a range from mild to more severe symptoms, including:
- Skin rash
- Chills and Fever
- GI symptoms, such as nausea and vomiting,
- Joint or muscle pain
JHR symptoms may leave the patient within several hours.
It is crucial to talk about some preventive measures to make treatment successful. The patient and his partner should continue their sexual activities until the doctor gets a green safety signal. Otherwise, it is recommended to hold sexual activity until treatment is accomplished.
Talk to a doctor about penicillin allergy to get better alternatives. To get assistance with appropriate dosage forms and no of doses medical prescription by a doctor is necessary.
Right Time to Consult Doctor For Syphilis?
The right time to see the doctor is when you start getting any of the symptoms of Syphilis. You should visit your doctor even though you have an infected partner, or there are chances of getting exposure to the disease.
FAQs on Syphilis Answered by Your Doctors Online Team
Yes, Syphilis can cause infertility. If you don’t treat it timely, the disease can get worse.
Syphilis on the tongue may appear as white patches, rashes, syphilis sores, or syphilis chancre.
Initially, Syphilis may show symptoms like sores on your lips, the tip of your tongue, gums, or the back of your mouth. Syphilis may appear as tiny red patches and grow into larger, open sores that can be red, yellow, or gray.
Yes, Syphilis can spread by kissing in the case of oral Syphilis. If your partner has syphilis chancer or sores in the mouth, their transmission can occur.
Manifestation of oral Syphilis typically appears around 21 days after bacterial exposure, although it may appear between 10-90 days. The syphilis oral lesions are painless and tend to heal independently in 3-6 weeks, but infection remains at the site. Antibiotic treatment is the only cure for Syphilis.