Syphilis

An Overview

Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on the genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores. Syphilis was once a major public health threat. It can cause serious long-term problems such as arthritis, brain damage, and blindness. There wasn’t an effective treatment until the late 1940s, when the antibiotic penicillinwas developed. After the initial infection, the syphilis bacteria can remain inactive in the body for decades before becoming active again. Early syphilis can be cured, sometimes with a single shot (injection) of penicillin.
Without treatment, syphilis can severely damage the heart, brain or other organs, and can be life-threatening. Syphilis can also be passed from mothers to unborn children.

Primary syphilis

The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them.
The chancre usually develops about three weeks after exposure. Many people who have syphilis don’t notice the chancre because it’s usually painless, and it may be hidden within the vagina or rectum. The chancre will heal on its own within three to six weeks.

Secondary syphilis

Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet.
Tertiary syphilis. If the infection isn’t treated, it may move on to a stage marked by severe problems with your heart, brain, and nerves. You could become paralyzed, blind, or deaf, or get dementia or impotence. It can even be deadly.

Other types of syphilis include:

• Latent syphilis. The infection doesn’t have any noticeable symptoms but is still in your body.
• Congenital syphilis. Pregnant women with the disease can spread it to their baby. It can harm the baby and even cause death.
• Neurosyphilis. The infection can spread to your brain or spinal cord. You might get headaches, dementia, or numbness or become paralyzed. You could have a hard time controlling your muscles.
• Fever.
• Pain during sex.
• Lower abdominal pain.
• Rashes over the trunk, hands or feet.
• Painful or burning urination.
• Discharge from the penis.
• Unusual vaginal bleeding.
• Sores or bumps on the genitals or in the oral or rectal area.

Causes of Syphilis

Syphilis is caused by the bacteriaTreponema pallidum. You get it through direct contact with a syphilis sore on someone else’s body. This usually happens during sexual activity, but the bacteria can also get into your body through cuts on your skin or through your mucous membranes.
Syphilis can’t be spread by toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.
Less commonly, syphilis may spread through direct contact with an active lesion, such as during kissing. It can also be passed from mothers to their babies during pregnancy or childbirth.
Syphilis can’t be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs.
Once cured, syphilis doesn’t return on its own. However, you can become reinfected if you have contact with someone’s syphilis sore.
Syphilis could be caused by
1. Having HIV.
2. Having unsafe sex or unprotected sex (Not using condoms)
3. Having sex with partners who have many sex partners.
4. Having a sex partner who is infected by the syphilis bacteria.

Syphilis Diagnosis and Tests

Your doctor will need to do a physical exam. They might give you tests including:
• Blood tests. A quick test at your doctor’s office or a public health clinic can diagnose syphilis.
• Cerebrospinal fluid tests. If your doctor thinks you might have neurosyphilis, they’ll test fluid taken from around your spinal cord.
• Darkfield microscopy. Syphilis bacteria are visible through a microscope in fluid taken from a skin sore or lymph node.

Syphilis Treatment

Syphilis is curable with quick diagnosis and treatment. But if it’s treated too late, it can permanently damage your heart and brain even after the infection is gone.
Medication
When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you’re allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin desensitization.
The recommended treatment for primary, secondary or early-stage latent syphilis — which refers to an infection within the last year — is a single injection of penicillin. If you’ve had syphilis for longer than a year, you may need additional doses.

If you’ve had syphilis for less than a year, one dose of penicillin is usually enough to kill the infection. If you’re allergic to penicillin, you might get another antibiotic instead, like doxycycline. If you’re in a later stage of the disease, you’ll need more doses.

Prevention

There is no vaccine for syphilis. To help prevent the spread of syphilis, follow these suggestions:
• Abstain or be monogamous. The only certain way to avoid syphilis is to avoid (abstain from) having sex. The next-best option is to have mutually monogamous sex in which both partners have sex only with each other and neither partner is infected.
• Use a latex condom. Condoms can reduce your risk of contracting syphilis, but only if the condom covers the syphilis sores.
• Avoid recreational drugs. Misuse of alcohol or other drugs can inhibit your judgment and lead to unsafe sexual practices.
Some people with syphilis have an immune system reaction called a Jarisch-Herxheimer reaction several hours after their first treatment. This might include fever, chills, headache, upset stomach, rash, or joint and muscle pain. These problems usually go away within 24 hours.

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