Syphilis

Syphilis Overview

Syphilis is sometimes referred to as "the great imitator" because many of its early signs and symptoms mimic those of other diseases.

Syphilis is caused by a bacteria, Treponema pallidum, that can be passed from person to person through direct contact with a syphilis sore during vaginal, anal and oral sex. Sores can occur on the penis, vagina, anus or rectum, or on the lips and inside the mouth. It's also possible for a mother to pass syphilis to her baby during pregnancy or delivery, potentially causing miscarriage or stillbirth, or seizures and developmental delays in the baby.

The good news is that syphilis, in its early stages, is easily treated and curable with antibiotics most commonly, penicillin. Left untreated, however, syphilis can lead to serious health problems down the road — including brain, cardiovascular and organ damage — and increases your risk of getting other STDs, like HIV.

Syphilis is most infectious during the primary and secondary stages of infection. The earlier syphilis is diagnosed, the more successfully it can be treated and cured.

Syphilis Symptoms

While syphilis can be silent for years, its symptoms typically occur in the following three stages, with symptoms and complications becoming more serious over time. Caught early, syphilis can be cured. That's why getting tested is so important.

 

Primary stage syphilis symptoms (within 2-3 weeks after exposure)

Common
  • No obvious symptoms (a painless sore could be small or hidden)
  • A single sore (or chancre) that's round, firm and painless and can appear wherever the body was first infected (vagina, penis, anus, rectum or the mouth area). The sore may be internal — inside your throat or anal canal — so you may not know you have it.

Note: The sore may seem to heal without treatment. But, without treatment, the infection will advance to the more serious secondary stage.

 

Uncommon
  • Swollen lymph glands (groin, armpit or neck)
  • Multiple round, firm and painless sores
  • Skin rash (rough, red or reddish-brown spots, usually on the soles of feet or palms of hands)

 

Secondary stage syphilis symptoms (within 2-12 weeks after primary stage symptoms)

People who don't get treated for syphilis in its primary stage generally stay infected with the secondary stage for up to one year. As in the primary stage, secondary stage sores may go away without treatment, but the syphilis infection will continue to advance and spread through the bloodstream.

 

Common
  • Swollen lymph glands (groin, armpit or neck)
  • Headaches and fatigue
  • Sore throat
  • Skin rash

 

Uncommon
  • Sores on the vulva, vagina, penis, anus, rectum or mouth area
  • Moist, wart-like patches in skin folds or on the genitals (condylomata lata)
  • Loss of appetite and unintended weight loss
  • Fever and chills
  • Muscle aches
  • Hair loss

 

Latent stage syphilis symptoms (symptoms may be hidden for up to 30 years)

Common
  • No obvious symptoms

 

Uncommon
  • Swollen lymph glands (groin, armpit or neck)
  • Headaches and fatigue
  • Sore throat
  • Sores on the vulva, vagina, penis, anus, rectum or mouth area
  • Moist, wart-like patches in skin folds or on the genitals (condylomata lata)
  • Loss of appetite and unintended weight loss
  • Fever and chills
  • Muscle aches
  • Hair loss

 

Rare
  • Muscle weakness and lack of coordination (walking can become difficult)
  • Problems with internal organs (brain, heart, kidney or liver functions)
  • Bone or joint deformities
  • Numbness or paralysis
  • Blindness
  • Impaired speech
  • Dementia (memory loss, difficulty concentrating, impaired judgment

 

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Syphilis Risks & Complications

How do people get infected with syphilis?

Anyone can get syphilis, usually through direct contact with an infectious lesion during sexual activity, including kissing or touching a person who has lesions in or around the genitals, on the lips or inside the mouth.

 

What are some ways that syphilis cannot be spread?

You cannot get syphilis from door knobs, eating utensils, bath tubs, hot tubs, or swimming pools.

 

If I get syphilis once, is it possible to get it again?

Even if you've been treated for syphilis, you're not immune. You can be re-infected. That's why sexual partners should be tested and appropriately treated at the same time so that an untreated partner still carrying the bacteria doesn't re-infect the treated partner.

 

What if syphilis is untreated?

Left undiagnosed and untreated, the first three stages of syphilis evolve into its final, most serious stage, often decades after the initial exposure. In this tertiary stage, internal lesions and other long-term complications from the bacteria can result in damage to the nerves and arteries, heart problems, seizures or paralysis, speech and hearing impairment, blindness, dementia and other serious illnesses, even death. That's why getting tested is so important.

 

Syphilis and HIV

According to the Centers for Disease Control and Prevention (CDC), people with syphilis are two to five times more likely to get HIV, the virus that causes AIDS and anyone with syphilis should be also be tested for HIV.

In general, someone who has one STD is at greater risk for infection with other STDs, including HIV. That's because STDs that cause ulcers, sores, or otherwise break the skin or mucous membranes make carriers more susceptible to infection. Also, people with one or more STDs may have a weakened immune system that makes them more vulnerable to other diseases.

 

Syphilis and pregnancy

In the latent stage of syphilis, there's a risk that a mother infected by the bacteria can transmit it to her baby (congenital syphilis) which can cause physical deformity and neurological complications in the baby, or stillbirth. According to the CDC, untreated syphilis in pregnant women results in infant death in up to 40% of cases. But complications from syphilis in pregnancy can be greatly reduced by early testing and treatment with antibiotics.

If you're pregnant and concerned about syphilis, be sure to consult your OB/gynecologist.

Syphilis Testing & Treatment

How do I get tested for syphilis?

We make getting testing for syphilis simple. Take control of your health with a discreet at-home testing kit for syphilis. Once you order the kit, it should arrive at your door in 3-5 business days.

 

What syphilis test results mean

A positive test result means that you may have either a past or current syphilis infection. A negative test result doesn't necessarily mean that you are free of the bacteria. Sometimes the infection, or signs of the infection, don't show up right away.

If you test positive, we're here to help. You'll have the opportunity to consult with a doctor on the phone right away. We'll answer your questions and explain the next steps.

 

When to test for syphilis

A “testing window” is the period of time between when you contract a disease and when the test is positive.  For example, if you had unprotected sex last night and became infected with syphilis, the test might not yet be positive. It could take up to three months to test positive, though often it shows up much earlier. Our doctors recommend testing 3 weeks after exposure, and 3 months after.

 

Is there a cure or treatment for syphilis?

Yes. Once you've been tested and diagnosed with syphilis, it can be easily and effectively treated and cured with antibiotics. Penicillin, administered via injection, is the most common treatment. In rare cases, an intravenous infusion may be necessary.

Six months after you've been treated, you'll need to be tested again to verify that the penicillin treatment worked. This is called a “test of cure”.

 

Syphilis can recur

Once you've been treated for syphilis, you're not immune. You can be re-infected. That's why sexual partners should be tested and appropriately treated at the same time so that an untreated partner still carrying the bacteria doesn't re-infect the treated partner. You'll want to avoid sexual contact altogether until treatment has been completed.

Be sure to continue to use latex condoms to minimize the risk of reinfection.

 

Pregnancy and antibiotics

In general, syphilis can be cured during pregnancy with antibiotics. Consult your OB/gynecologist to discuss the best treatment for you and your baby.

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