What Is Syphilis? Symptoms, Diagnosis & Treatment You Need to Know

Syphilis is an STI that is preventable and treatable with antibiotics, but if left untreated, it can cause serious health problems. 

Many people with syphilis do not have symptoms that they can see or recognize, or the symptoms may not be recognized by a healthcare provider.
Transmission occurs by oral, vaginal, and anal sexual exposure and by vertical transmission in utero or through blood transfusions. In pregnant women, syphilis causes stillbirth, neonatal death, or congenital syphilis in the newborn.
The proper use of condoms during sexual intercourse prevents the transmission of the disease.
Several rapid tests are available for syphilis testing that yield results in minutes and offer opportunities for immediate treatment at the same visit.

Symptoms

Many people with syphilis do not have any symptoms, or the symptoms may be so mild they are overlooked. If left untreated, syphilis can last for decades and go through stages.

Primary syphilis (first stage):

• Lasts about 21 days.

• A painless, round, hard sore called a chancre appears at the site of infection. The chancre can appear on the genitals, anus, or mouth.

• The sore is often unnoticed and usually heals after 3–10 days, but the infection will progress to the secondary stage if untreated.

Secondary syphilis:

• A rash, often not itchy, especially in the palms of the hands or soles of the feet.

• Mucous membrane lesions may appear in the mouth or, less commonly, in the genital area or anus.

• These symptoms may disappear on their own.

Latent syphilis:

• Generally asymptomatic.

• Latent syphilis, if not treated, could progress to tertiary syphilis in years, which affects any organ of the body.

Tertiary syphilis:

• Serious complications, such as diseases of the brain and heart.

Symptoms in babies born with syphilis include:

1. Rashes

1. Anemia

1. Bone and joint problems

1. Neurological problems, like blindness, deafness, or meningitis

1. Developmental delays and seizures

Some symptoms may appear later in life.

Diagnosis

Clinical presentation, history of sexual exposure, physical examination, and laboratory tests diagnose syphilis. Without testing, syphilis cannot be diagnosed because symptoms are often not present.
Syphilis is an infection caused by the bacterium Treponema pallidum. Laboratory tests for syphilis detect the bacteria directly by microscopy or indirectly by blood tests. Rapid tests are also available that can give quick results, which can allow for immediate treatment.
Identification of asymptomatic cases through laboratory testing and early treatment will prevent transmission, complications, and adverse pregnancy outcomes, such as congenital syphilis.

Congenital Syphilis

Currently, there are no specific tests for congenital syphilis. All infants born to mothers with syphilis, whether live or stillborn, should be examined for signs of the infection. For live infants, clinical exams, radiology (if available), and laboratory tests at birth, followed by follow-up tests, will guide treatment.

Treatment

Syphilis is treatable and curable. If you suspect you have syphilis, see a health professional.
Early stage treatment generally consists of a single dose of benzathine penicillin (BPG). The BPG is the drug of choice, and it is the only one recommended for pregnant clients. Other antibiotics may include doxycycline, ceftriaxone, or azithromycin.
In late stages of the disease, the injection has to be repeated three times at one-week intervals. When the stage of infection is not sure, this treatment schedule is commonly followed.

BPG treats syphilis and prevents congenital syphilis in infants. It must be given to the baby immediately after birth if there is any suspicion of syphilis in the baby or in case the mother was untreated.

Transmission

Syphilis is usually spread by sexual contact with infectious sores  called chancres on the lips, vagina, anus, or other areas. It is passed from an infected mother to a baby during pregnancy. Syphilis is very contagious during the early stages, up to two years after infection.

Possible Complications

Syphilis and HIV:

Syphilis increases the risk of acquiring HIV infection by approximately twofold and can also increase susceptibility to other STIs including gonorrhoea, chlamydia, and genital herpes.

Severe Disease:

If left untreated, syphilis can, many decades later, have serious complications. Tertiary syphilis may manifest in nearly every organ and system, including the brain, heart, eyes, liver, blood vessels, and joints. The disease may be fatal.

• Neurosyphilis, Ocular Syphilis, and Otosyphilis.

• Neurosyphilis: severe headaches, muscle problems, and mental health issues such as dementia.

• Ocular syphilis: the consequences are related to vision: painful eyes, blurred vision, sensitivity to light, and even blindness.

• Otosyphilis: Consequences include impairment of auditory and vestibular functions.

Congenital Syphilis:

Untreated syphilis in pregnant women usually leads to serious health outcomes such as stillbirth, prematurity, low birth weight, and lifelong health problems for the offspring.

Prevention

Syphilis can be prevented. The surest way to avoid syphilis and many other STIs is to practice abstinence or to always use latex condoms correctly during sexual activity. However, syphilis sores can occur in areas that are not covered by a condom, such as the anus, vagina, or mouth.

Those who are at greater risk should get tested for syphilis at least once a year.
Testing for syphilis should be done for pregnant women during the first prenatal visit, and if found positive, they should be treated immediately. Prevention of congenital syphilis depends on the diagnosis and treatment of the mother with penicillin.
Any person diagnosed with syphilis should inform his or her sexual partners to get themselves tested and treated to prevent further infections. Syphilis is an easily preventable and curable bacterial STI; however, it can lead to serious health consequences if not treated.
Most of the time, many persons with syphilis will not have noticeable symptoms or those symptoms may be ignored by the patient and/or health professional.
It is transmitted by oral, vaginal, and anal sex, and through pregnancy and blood transfusion. Congenital syphilis  will result when a pregnant woman is suffering from the infection.
The use of condoms correctly and consistently during sexual intercourse prevents the acquisition of syphilis infection.