Syphilis can cause long-term complications if not adequately treated

What is syphilis?

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema Pallidum. Syphilis can cause wide range of long-term complications in an individual if not adequately treated.

 How do people get syphilis?

Syphilis is transmitted from person to person by direct contact with a syphilictic sore, known as a chancre. Chancroids mainly occur on the external genitals, vagina, anus or in the rectum. They can also occur on the lips and in the mouth. Syphilis spreads during vaginal, oral or anal sexual activities. Pregnant women with the disease can transmit it to their unborn child.

 How quickly do symptoms appear after infection?

The average time between exposure and the infection to occur is 21 days, but can range from 10 to 90 days.

 What are the signs and symptoms in adults?

Primary stage

The appearance of a single chancre marks the primary stage of syphilis symptoms. The chancre is usually firm, round, and painless. It appears at the location where syphilis has entered the body like penis, vagina or anus. This would last 3 to 6 weeks and heals regardless of whether a person is treated or not. But if the person is not treated adequately then the infection progresses to the secondary stage.

 Secondary stage

Skin rashes and or mucous membrane lesions like sores in mouth, vagina or anus mark the second stage of symptoms. The rash usually doesn’t cause itching. They may appear as rough, red or brownish spots both on palm of hands and soles of feet. 

Rash can appear with different looks on mouth underarm or groin. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss muscle aches and fatigue. These symptoms would be eradicated with or without treatment, but without the treatment the infection will progress to the latent and late stages.

 Latent and late stages

The latent stage begins when primary and secondary symptoms disappear in an individual when no treatment is taken. Latent syphilis occurs after 12 months of infection and can last for years. 

The late stages of syphilis can develop in about 15pc of people who have not been treated for syphilis and can appear 10 - 20 years after infection was first acquired. At this stage the disease can damage multiple organs of the body and can lead to death as well.

 Neurosyphilis

Syphilis can affect nervous system at any stage of infection, and cause a wide range of symptoms varying from no symptoms at all to headache, altered behaviour, muscular dystrophy, vision problem etc.

 What is the effect of syphilis on pregnant woman and her baby?

A pregnant woman with syphilis can have a stillbirth (a baby born dead) depending on how long she had been infected for. 

An infected baby born alive may not have any signs or symptoms of disease. However if not treated immediately, the baby may develop serious problem. Untreated babies may become developmentally delayed, have seizures or fail to thrive.

 How is syphilis diagnosed?

Clinically syphilis can be diagnosed by taking detailed personal history of the patient. In the laboratory blood sample are checked for (a) Nontreponemal Test and (b) Treponemal Test for determining syphilis.

 What is the link between Syphilis and HIV/AIDS?

Genital sores caused by syphilis make it easier to transmit and acquire HIV infection through sexual activities. The chance of getting infected with HIV in these patients rises 3 to 5 folds.

 What is the treatment for syphilis?

Syphilis is easy to cure in its early stages. A single intramuscular injection of long acting Benzathine Penicillin G (2. 4 million units) will cure a person who has primary, secondary or early latent syphilis. Three doses of the same injection in weekly intervals is recommended for individuals with late-latent or latent syphilis. Treatment will kill the bacterium and prevent further damage, but it will not repair damage already done. 

Who should be tested for syphilis? 

Any person with signs or symptoms of primary, secondary, neurological, or tertiary infection should be tested for syphilis. 

Healthcare providers should routinely test persons who

 * are pregnant; 

 * are members of high-risk communities; 

 * have HIV infection; 

 * have partners who have tested positive for syphilis; 

 * are sexually active and live in areas with high syphilis morbidity. 

 Will syphilis recur? 

Syphilis does not recur. But people can be reinfected even after complete cure of previous infection.

 How can be syphilis prevented? 

Only using latex condom during sex can reduce the genital syphilis. But still remain chances of sores in other sites. 

The surest way to prevent syphilis and other STDs is to abstain from sexual contact or to be in a long-term mutually monogamous relationship.  

For more information and consultation contact Dr. Nawsher Labib, with 16 years of experience and is currently at Middle East Medical Center-Hidd Tel: 17464848.