Overview
Syphilis is a sexually transmitted infection caused by a bacterium called Treponema pallidum. It is extremely contagious and transmitted through contact with syphilitic sores called chancres which develop in, on, or around the mouth, penis, vagina, rectum, or anus.
It is an infection with a well-extended latent period characterized by little or no visible symptoms. If left untreated, it may progress with time to affect different organs and systems of the body, producing a lethal outcome.
The disease is curable and further damage can be deterred using prescribed antibiotics.
Key Facts
- Syphilis is a bacterial infection spread through sexual activity. It spreads during oral, anal, and vaginal sex.
- Chancres in the mouth, anus, or genitals may be difficult to recognize.
- Unprotected sex, multiple sexual partners, HIV, homosexuality, and bisexuality increase a person’s chances of contracting the infection.
- Since the bacteria cannot live outside the human body, syphilis cannot be transmitted through contact with bathtubs and toilet seats or by sharing clothing.
- The disease has four clinical stages: primary, secondary, latent, and tertiary. It is transmissible during the primary and secondary stages and life-threatening with severe complications during the tertiary stage.
- Infection does not resolve without proper treatment.
- The disease can be cured with antibiotics prescribed by a healthcare provider. However, damage to the body as a result of the disease cannot be reversed by antibiotics.
- Laboratory tests are the only confirmatory tests for the disease.
- Previous infection does not prevent a recurrence of infection.
Stages of Syphilis Infection
According to the Mayo Clinic, syphilis develops in four stages, including:
- Primary syphilis: This phase occurs one month after Treponema pallidum enters the body. Painless sores (chancres) appear in or on the mouth, genitals, or anus, marking the point of entry of the bacteria into the body. The sores are highly infectious and are responsible for the spread of syphilis during sexual activity. They disappear completely after 3-6 weeks, even without treatment.
- Secondary syphilis: When treatment is ignored in the primary stage, the disease progresses to the secondary stage, with intense symptoms. Non-itchy skin rash and sore throat are some well-known symptoms of this phase. The symptoms vanish even without treatment. However, the lack of treatment makes the infection worse.
- Latent syphilis: This phase is also known as the “silent stage” of the infection. The patient shows no symptoms during this stage, and it can last for 1-20 years. In addition, the infection cannot be transmitted during this period as the bacteria become inactive.
- Tertiary syphilis: This is the fatal stage of the disease that occurs years after the initial infection. Consequently, the brain, nerves, heart, and other organs are affected. Severe symptoms and deadly complications are found in this phase.
Symptoms and Diagnosis
Symptoms
Syphilis symptoms are closely related to each phase and become severe with the progression of infection.
The primary and secondary symptoms of the condition include:
- One or more painless sores are called chancres.
- Non-itchy rash, mostly on the palm and sole.
- Fever
- Muscle ache
- Sore throat
- Hair loss
- Weight loss
- Swollen lymph nodes
- Fatigue
The tertiary complications include:
- Gummas – small destructive bumps that grow on the skin, bones, or organs
- Heart disease
- Blindness
- Hearing loss
- Mental loss
- Neurosyphilis – an infection of the brain and spinal cord
Diagnosis
Samples of blood and cerebrospinal fluid are mainly used to test for syphilis. Blood tests show the presence of antibodies produced by the body against infection. Similarly, the cerebrospinal fluid is examined when the nervous system’s complications are evident.
The most specific diagnostic technique is dark-field microscopy, where the subject’s bodily fluid is examined under a dark-field microscope, and the bacteria are identified by their characteristics.
The different tests for syphilis can be grouped into:
Nontreponemal tests:
There are three types of nontreponemal tests: the rapid plasma reagin (RPR), the Venereal Disease Research Laboratory (VDRL) test, and the toluidine red unheated serum test.
The results of these tests display the infection activity by detecting the reaction of non-specific antibodies produced by the body against the bacteria.
Treponemal-specific tests:
These tests detect specific antibodies produced against Treponema pallidum. They are confirmatory tests for the presence of syphilis.
Causes and Prevention
Causes
The bacterium Treponema pallidum is the causative organism of this sexually transmitted disease. It enters the body through cuts in the skin, and transmission occurs through contact with infectious sores during sexual activity.
Some risk factors for contracting the disease include:
- Unprotected sexual activities involving contact with the mouth, genitals, or anus.
- Multiple sexual partners
- Homosexuality (gay men)
- HIV infection
Syphilis cannot be contracted through contact with objects, such as:
- Toilet seats
- Bathtubs
- Doorknobs
- Clothing and utensils
Prevention
Since there is no vaccine for syphilis, certain measures that prevent disease transmission are important.
You can avoid contracting syphilis by:
- Abstaining from multiple sexual relationships: Maintaining a single sexual partner at a time is a great way to avoid syphilis. Thus, you should have a faithful sexual relationship with a single partner who does not have syphilis.
- Using a condom: Use a condom if you must engage in sexual relationships with individuals with unknown syphilis status. However, a condom may not completely cover penile or vaginal sores and may fail to protect against sores found in other body parts. Hence, you can contract syphilis even with the use of condoms.
- Avoiding alcohol and drug misuse: Alcohol and drug abuse may provoke unrestrained sexual practices. Hence, avoid excess alcohol consumption and drug misuse.
Typical Treatments
With the right diagnosis and early treatment, syphilis can be cured. Proper treatment can only cure the infection but will not rectify the damages that the disease left.
A single dose of Benzathine penicillin G can cure primary and secondary syphilis. Additional doses and a longer duration of treatment are required for the latent and tertiary stages.
Three doses of long-acting Benzathine penicillin G administered weekly are used for the late stages of infection.
Reinfection can still occur even after treatment. Therefore, people treated for syphilis should avoid sexual contact with infected persons. They should also encourage their partners to get tested and treated.
Conclusion
Syphilis is a bacterial infection transmitted during sexual activity involving genital, oral, and anal sex.
The initial and latent phases of infection are always without visible symptoms. It is most contagious in the early stages when pores called chancres to appear in or around the mouth, anus, and genitals.
Treatment prevents the further spread of infection, although the resulting damages can never be reversed.
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