Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria known as treponema pallidum.
Syphilis can be challenging to diagnose. Someone can have it without showing any symptoms for years. However, the earlier syphilis is discovered, the better. Syphilis that remains untreated for a long time can cause major damage to important organs, like the heart and brain.
Syphilis is only spread through direct contact with syphilitic chancres (sores). It can’t be transmitted by sharing a toilet with another person, wearing another person’s clothing, or using another person’s eating utensils.
There are four stages to syphilis with each stage presenting different symptoms. The four stages are:
The first sign of syphilis is a small, painless sore called a chancre. The chancre can appear on the sexual organs, rectum, or inside the mouth. It’s painless but highly infectious. People often fail to notice it right away.
Syphilis is transmitted by direct contact with the chancre – usually during sexual activity, including oral sex.
Skin rashes and a sore throat may develop during the second stage of syphilis. The rash won’t itch and is usually found on the palms and soles of the feet, but it may occur anywhere on the body. Some people don’t notice the rash before it goes away.
Other symptoms of secondary syphilis may include:
These symptoms will go away whether or not treatment is received. However, without treatment, a person still has syphilis.
Secondary syphilis is often mistaken for another condition.
The third stage of syphilis is the latent, or hidden, stage. The primary and secondary symptoms disappear, and there won’t be any noticeable symptoms at this stage. However, the bacteria remain in the body. This stage could last for years before progressing to tertiary syphilis.
The last (and most damaging) stage of syphilis is tertiary syphilis. According to the Mayo Clinic, approximately 15 to 30 percent of people who don’t receive treatment for syphilis will enter this stage. Tertiary syphilis can occur years or decades after the initial infection. Tertiary syphilis can be life-threatening. Some other potential outcomes of tertiary syphilis include:
Syphilis is most infectious during the Primary and Secondary stages.
If untreated, syphilis can cause serious complications down the line.
Mothers infected with syphilis are at risk for miscarriages, still births, or premature births. There’s also a risk that a mother with syphilis will pass the disease on to her fetus. This is known as congenital syphilis.
Congenital syphilis can be life-threatening. Babies born with congenital syphilis can also have the following:
If a baby has congenital syphilis and it isn’t detected, the baby can develop late stage syphilis. This can cause damage to their:
People with syphilis have a significantly increased chance of contracting HIV. The sores the disease cause make it easier for HIV to enter the body.
It’s also important to note that those with HIV may experience different syphilis symptoms than those who don’t have HIV. If you have HIV, talk to your doctor about how to recognize syphilis symptoms.
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The best way to prevent syphilis is to practice safe sex. Use condoms during any type of sexual contact. In addition, it may be helpful to:
Syphilis can also be transmitted through shared needles. Avoid sharing needles if using injected drugs.
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 or ceftriaxone.
If you have neurosyphilis (when syphilis infects the brain or spinal cord), 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.
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.
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