SYPHILIS
Do you know Syphilis is a reportable infection?
That is, it must be reported to public health authorities for assistance in identifying and treating potentially infected sexual partners. Notify your health care provider if you develop signs or symptoms of syphilis -you will need to undergo a careful medical evaluation-.
If you have had intimate contact with a person who has syphilis or any other STD --sexual transmitted disease-- or have engaged in any high-risk sexual practices including having multiple or unknown partners, or using intravenous drugs, you should contact your doctor.
Prompt treatment and monitoring for response to treatment for syphilis can cure the disease. Once late complications develop -tertiary syphilis-, long-term health problems are likely despite therapy.
Syphilis is one of the more frequently diagnosed and reported sexually transmitted diseases. A chancre is the typical sore of primary syphilis.
Syphilis is a sexually transmitted disease and has several stages like: primary syphilis, secondary syphilis, and tertiary syphilis.
Causes and risk factors
Syphilis is an infectious disease caused by the bacterium Treponema pallidum. This organism causes infection when it penetrates broken or abraded skin or mucous membranes, usually of the genitals. Transmission occurs most frequently by sexual contact.
Syphilis occurs worldwide. In the United States, about 10,000 cases occur annually. The rate of syphilis is higher in urban, rather than rural areas, and the disease occurs most frequently in the Southern states.
Because people may be unaware that they are infected with syphilis, many states require tests for syphilis prior to marriage. All pregnant women who receive prenatal care are screened for syphilis to prevent congenital syphilis, which is syphilis infection transmitted from the mother to the newborn.
Syphilis has three commonly recognized stages:
Primary syphilis, first shows as a small, painless open sore or ulcer -chancre-. This ulcer typically appears 2 to 3 weeks after exposure. The ulcer that appears on the penis is easily visible. However, ulcers that occur on the labia, cervix, anal area, or in the mouth may go unnoticed because they are painless and not easily visible.
The classic-appearing ulcer or chancre is shallow with sharply defined borders and slightly raised edges. It is typically painless and is firm to the touch. Any ulcer appearing on the genitalia should be evaluated by a doctor.
If left untreated, the chancre typically heals spontaneously within 3 to 6 weeks. It may leave behind a thin, slightly depressed scar. This is the end of the primary stage.
Secondary syphilis, this usually occurs at about 2 to 8 weeks after the appearance of the original chancre. Secondary syphilis is the stage where the bacteria have spread in the bloodstream and have reached their highest numbers.
The most common symptoms include skin rash, yet frequently involves the palms and soles, in addition to lesions in the mouth, vagina, penis, swollen lymph nodes, and fever. This stage is the most contagious stage of syphilis. It usually resolves within weeks to a year. A latent phase follows which may last for years and is characterized by the absence of symptoms.
Tertiary syphilis, is the final stage of syphilis and is characterized by brain or central nervous system involvement -neurosyphilis-, cardiovascular involvement with inflammation of the aorta -aortitis or aneurysms-, and gummatous syphilis -destructive lesions of the skin and bones-.
Symptoms
The symptoms of syphilis depend on the stage of the disease:
Primary syphilis:
- chancres -- painless sores on genitals, rectum, or mouth
- enlarged lymph nodes in the area adjacent to the chancre
Secondary syphilis:
- skin rash -- with both flat and raised patches which may involve the palms and soles of the feet.
- extensive lymph node enlargement
- mucous patches -- painless ulcerations, seen mostly in the mouth and on the genitals.
- condyloma lata -- papules in folds such as groin, genital areas, axilla, and under the breasts
- hair loss -- alopecia
- general symptoms such as fever, fatigue, loss of appetite, and aches and pains in bones
Tertiary syphilis:
- infiltrative, destructive lesions of skin, bones, or liver - gummatous syphilis -
- cardiovascular syphilis, which leads to inflammation of the aorta - aortitis - and can be associated with aortic aneurysms
- central nervous system disorders with involvement of the meninges, brain, spinal cord, eye, or auditory system.
Signs and tests
The proper diagnostic tests for syphilis depend on the stage of the disease and may include:
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dark field examination of primary lesion -in primary syphilis-
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blood tests such as VDRL or RPR and FTA-ABS.
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in the case of neurosyphilis, a spinal tap is required to make the diagnosis and may be sent for VDRL and/or FTA-ABS.
Treatment
The mainstay of therapy for syphilis is proper antibiotic treatment. Duration of treatment depends on the extent of the syphilis and the overall health of the patient.
Antibiotic is given either intramuscularly or intravenously depending on the stage of syphilis. After appropriate antibiotic treatment is given for syphilis, follow up blood tests are usually performed to assess the adequacy of treatment.
Several hours following the treatment of early stages of syphilis, individuals may undergo a reaction. Symptoms of this reaction include:
- fever
- chills
- headache
- nausea
- general feeling of being ill - malaise -
- joint aches
- muscle aches
These symptoms usually disappear within 24 hours.
Follow-up blood tests must be done at 3, 6, 12, and 24 months to ensure the infection has been eliminated. There must be abstinence from sexual contact until two follow-up tests have indicated that the infection has been cured. The sexual partner should also be treated. Syphilis is extremely contagious in the primary and secondary stages.
Prevention
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Safer sexual practices and consistent condom use are important measures in the prevention of syphilis. In addition, early diagnosis and treatment is needed to prevent ongoing transmission of this disease.
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Screening of all pregnant women for syphilis is another measure to decrease the risk that the disease will be passed on to the fetus.
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People with multiple sex partners, unknown partners, or sex partners involved in any high-risk sexual practices are at risk for acquiring sexually transmitted diseases.
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A person who recognizes that he or she is at risk has taken the first step toward prevention.
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Ideally, monogamous sex with a healthy partner remains, short of total abstinence, the safest type of sexual relation.
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Protected sex --that in which condoms are used-- is the next most reliable method of preventing STDs. Condoms act as a barrier to the transmission of infectious organisms -pathogens-, and should be used in any and all situations which would be considered risky or high risk.
Syphilis is a reportable disease as required by law --reportable diseases are diseases considered to be of great public health importance--. The infection must be reported by the health care provider to public health authorities. Information acquired from reporting helps the public health investigators identify, locate, and treat infected sexual contacts. This function helps prevent the continued spread of infection.
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Trusted Health Information for You
A service of the U.S. National Library of Medicine and the National Institutes of Health
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