Overview – What is it?
Syphilis is a sexually transmitted infection that is caused by bacteria. It is transmitted through having sexual intercourse with an infected person or from an infected mother to her baby during birth or during pregnancy.
Some symptoms of this disease are painless, firm and rounded syphilitic sores, non-itchy rash, muscle aches and fever.
It can be diagnosed through laboratory tests like a blood test, and through testing of other bodily fluids. In the early stages, syphilis is treated using penicillin. Antibiotics can also be used in the treatment of syphilis.
To prevent this condition, one should use protection when having sex or abstain from sex and limit the number of sexual partners, among other prevention measures.
Causes – What causes it?
Syphilis is caused by a bacterium (Treponema pallidum) which can be transmitted:
through sexual intercourse with an infected person,
from mother to foetus during pregnancy, or
from mother to infant during birth.
Syphilis passed from mother to child is known as congenital syphilis and it can have adverse effects on a child, such as abnormalities or death.
The risk factors for this disease are:
- Being HIV positive
- Having unprotected sex
- Having numerous sexual partners
Symptoms – What do you feel?
The symptoms for syphilis depend of the stage of the disease even though they may not occur in the same order. A person can be infected and not be aware for years. The symptoms in each stage are as follows:
This is the first stage of syphilis and in this stage the first sign is a small painless sore called a chancre. It appears on the spot through which the syphilis – causing bacteria entered the body. The chancre may appear 3 weeks after infection and in some people, there can be more than one chancre. It can heal on its own within 3-6 weeks during which it can go unnoticed due to its painless nature. The disease can also progress to the next stage without treatment.
This occurs a few weeks after the chancre has healed. The symptoms in this phase are:
- Non-itchy rash starting from the trunk to the entire body including on the soles of the feet and palms. The rash may be rough red or reddish-brown.
- Muscle aches
- Oral, genital or anal sores
- Sore throat
- Patchy hair loss
- Weight loss
- Swollen lymph nodes
If untreated, secondary syphilis can progress to latent and late stages.
This phase can last for years especially because it may not show symptoms. The disease may not re-occur and if it does, it may progress to the tertiary stage.
In this stage, which is also known as the late stage, the following symptoms may be present:
- Soft tissue swelling anywhere on the body
- Damage to the heart, liver, joints, blood vessels and bones
It may take 10-30 years before syphilis reaches this phase.
This occurs when the T. pallidum bacteria spreads to the nervous system. Though it is associated with latent and tertiary syphilis, it can appear in the primary stage. It may appear gradually or be asymptomatic. The symptoms for this syphilis include:
- Abnormal gait
- Dementia or altered mental status
- Headache or seizures
- Numbness in the extremities
- Concentration problems
- Problem with vision or vision loss
This is usually severe and life-threatening. It is usually transmitted from a mother to foetus through the placenta or during birth. Even though no symptoms may appear, some children may experience a rash on the palms or feet soles. Other symptoms include:
- Rash on the genitals, mouth or anus
- Watery nasal fluid
- Saddle nose where the bridge of the nose collapses
- Weight gain difficulty
- Small blisters on the hands and feet that change colour and spread to the face
Older infants may experience:
- Bone pain
- Loss of vision
- Loss of hearing
- Abnormal peg-shaped teeth
- Swelling of the joints
- Bone problem in the lower legs
- Grey patches around the vagina and anus
- Scarring of skin around the mouth, anus and genitals
Diagnosis – How do you diagnose it?
You cannot diagnose syphilis just by looking at the physical manifestations of the disease such as chancre. Therefore, the following tests can be carried out:
- Blood test: This is done to confirm the presence of antibodies produced by the body to fight infection. The antibodies the body produces to fight syphilis remain in the body for years and they can be tested to determine current or past infections.
- Cerebral spinal fluid: This is used to determine whether the bacteria have entered into the nervous system by testing spinal fluid collected through lumbar puncture (spinal tap).
- Bodily fluid: It involves testing fluid collected from chancre for syphilis.
Treatment – How do you treat it?
The treatment depends on what stage the syphilis has reached and the symptoms present.
- Primary and secondary syphilis are treated using penicillin and people who are allergic to penicillin can use other drugs like ceftriaxone and doxycline.
- Neurosyphilis is treated using daily doses of penicillin through injection.
- In tertiary or late stage syphilis, the damage is irreversible and therefore treatment focuses on easing pain discomfort.
It is important to abstain from any sexual contact during treatment until treatment is completed.
Prevention – How do you prevent it?
To prevent yourself from getting infected with syphilis or infecting someone else, you should do the following:
- Abstain from sex if you are infected
- Use protection when engaging in sexual intercourse
- Get tested regularly together with your partner
- Limit the number of sexual partners
- Do not share sex toys
- Use a dental dam or plastic square during sex
- Avoid excessive alcohol intake and use of other drugs that could cloud your judgement and lead to unsafe sexual practices