Syphilis is a bacterial infection which is transmitted by sex. It is treatable in the early stages but can lead to illness, neurological disorders, and even death without treatment.
Syphilis is caused by the bacteria Treponema pallidum (T. pallidum). The disease is in four stages: major, secondary, latent, and tertiary.
In 2018, the Centers for Disease Control and Prevention (CDC) reported that 64 percent of the lectures on syphilis included people having sex with men. Nevertheless, the number of cases is also growing among heterosexual men and women.
Syphilis is antibiotic treatable, particularly in the early types. It doesn’t heal without treatment.
We explain the different stages of syphilis in this article and whether it is curable, as well as how to identify and treat it.
What is syphilis?
Syphilis is an infection created by T. Bacteria with a pallidum. These bacteria can spread through direct contact with a syphilitic sore between humans.
Those sores that grow on the vagina, anus, rectum, lips, or mouth’s skin or mucous membranes.
Syphilis tends to spread most during oral, anal, or vaginal sexual activity. People rarely move by rubbing the bacteria on.
The first symptom is a painless sore either on the vagina, rectum, lips, or elsewhere in the skin. Many citizens do not feel the sore, because it is not causing pain.
Those sores heal themselves. If a person receives no medication, however, the bacteria remain in the body. Upon reactivating and destroying organs, including the brain, they can remain dormant in the body for decades.
The physicians categorize the syphilis stage as either major, secondary, latent or tertiary. Each stage is defined by a diversity of symptoms.
During the primary and secondary stages, the disease can be infectious, and rarely, the early latent stage. Tertiary syphilis is not infectious, but the most severe symptoms do occur.
The symptoms of primary syphilis include one or more painless, firm, and round syphilitic sores, or chancres. These appear 10 days to 3 months after the bacteria enter the body.
Chancres resolve within 2–6 weeks. However, without treatment, the disease may remain in the body and progress to the next phase.
Secondary syphilis symptoms include:
- sores that resemble oral, anal, and genital warts
- a nonitchy, rough, red or red-brown rash that starts on the trunk and spreads to the entire body, including the palms and soles
- muscle aches
- a sore throat
- swollen lymph nodes
- patchy hair loss
- unexplained weight loss
Such symptoms can resolve a couple of weeks after first appearance. They might also come back several times over a longer period of time.
The secondary syphilis will advance to the latent and tertiary stages without treatment.
The latent period could last many years. The body will retain the disease during this period with no symptoms.
However, the T. Pallidum bacteria remain dormant in the body, and the chance of recurrence is always high. At this point, doctors still recommend treating syphilis, even if there are no symptoms.
Tertiary syphilis can develop following the latent phase.
Tertiary syphilis, or late syphilis
Tertiary syphilis can occur 10–30 years after the onset of the infection, usually after a latency period during which symptoms do not appear.
Syphilis is destroying the following organs and systems at this stage:
- blood vessels
Similarly, rubber can grow. Those are swellings of soft tissue that can occur anywhere on the body.
Damage to the organs also means tertiary syphilis can lead to death. It is therefore important to treat syphilis before it reaches this level.
Neurosyphilis is a disease that happens as T grows. The pallidum bacteria spread through the nervous system. It often has associations with latent and tertiary syphilis. It can however occur after the primary stage at any time.
A person with neurosyphilis can have long been asymptomatic. Alternatively, symptoms can slowly develop.
Symptoms vary from:
- dementia or altered mental status
- abnormal gait
- numbness in the extremities
- problems with concentration
- headache or seizures
- vision problems or vision loss
Congenital syphilis is a debilitating and often life threatening condition. T. Pallidum bacteria may move through the placenta and during the birth process from a pregnant woman to a fetus.
Data suggest that nearly 70 percent of women with syphilis will have an adverse outcome during pregnancy without screening and treatment.
Adverse effects in children include early fetal or neonatal death, premature birth or low birth weight, and infection.
In newborns the signs include:
- saddle nose, in which the bridge of the nose is missing
- difficulty gaining weight
- a rash of the genitals, anus, and mouth
- small blisters on the hands and feet that change to a copper colored rash, which may be bumpy or flat, and spread to the face
- watery nasal fluid
Older infants and young children may experience:
- Hutchinson teeth, or abnormal, peg shaped teeth
- bone pain
- vision loss
- hearing loss
- joint swelling
- saber shins, a bone problem in the lower legs
- scarring of the skin around the genitals, anus, and mouth
- gray patches around the outer vagina and anus
In 2015, the World Health Organization (WHO) recognized Cuba as the world’s first country to have eradicated congenital syphilis entirely.
Is it curable?
Anyone who is afraid they may have syphilis or another sexually transmitted infection (STI) should talk to a doctor as soon as possible, as it can be healed by timely care.
It is important to treat penicillin early, as the disease can lead to life-threatening long-term consequences.
Syphilis remains curable, at a later stage. A person may however need a longer penicillin course.
When nerve or organ damage occurs during the later syphilis stages, it won’t be healed by treatment. Nevertheless, caution can prevent further damage by removing the bacteria from a person’s body.
Syphilis treatment can be effective especially in the early stages.
The strategy for treatment would depend on the symptoms and how long a person has been harboring the bacteria. However, people with syphilis will typically get an intramuscular injection of penicillin G benzathine during the primary, secondary, or tertiary stage.
Tertiary syphilis can require multiple weekly injections.
Neurosyphilis requires penicillin intravenous (IV) every 4 hours during 2 weeks in order to remove the bacteria from the central nervous system.
Curing the infection can prevent further damage to the body, and may restore healthy sexual practices. Nevertheless, surgery can not undo the damage that has already taken place.
Patients with a penicillin allergy may in the early stages sometimes use an alternative medication. Nonetheless, anyone with an allergy must undergo penicillin desensitization during pregnancy and in tertiary stages to allow for safe care.
Newborn babies with syphilis will receive antibiotic treatment following birth.
The first day of care can include chills, fatigue, nausea, achy pain and headache. Doctors call these effects a result to Jarisch-Herxheimer’s. It does not mean a person should discontinue treatment.
When is it safe to have sex?
Individuals with syphilis have to avoid sexual intercourse until all diagnosis has been completed and blood test results have been obtained confirming the disease has healed.
Blood tests can take several months to prove syphilis has decreased to an appropriate level. Low levels are enough to ensure adequate treatment.
Tests and diagnosis
Before doing clinical tests to confirm syphilis, a doctor will do a physical examination and inquire about a person’s sexual background.
- Blood tests: These can detect a current or past infection, as antibodies to the syphilis bacteria will be present for many years.
- Bodily fluid: A doctor can evaluate fluid from a chancre during the primary or secondary stage.
- Cerebrospinal fluid: A doctor may collect this fluid through a spinal tap and examine it to monitor the disease’s effects on the nervous system.
If a person is diagnosed with syphilis, he or she must tell all sexual partners. The partners should also be tested.
Community services are available to warn sexual partners of possible syphilis exposure, allow for testing and, where appropriate, prescribing care.
Healthcare professionals are also to support HIV tests.
When to receive testing
Many people with an STI will not be aware of it. Therefore, it is a good idea to talk to a doctor or request a test in the following situations:
- after having unprotected sex
- having a new sex partner
- having multiple sex partners
- a sexual partner receiving a diagnosis of syphilis
- a man having sex with different men
- symptoms of syphilis being present
Syphilis occurs in the case of T. Shift of pallidum from one person to another during intercourse.
During pregnancy, the infection can pass from a woman to a child, or during delivery to an infant. This type is called syphilis congénitale.
Syphilis can not spread by direct contact with items such as doorbuttons, utensils dining, and seats in the toilet.
Those who are sexually active are at risk of contracting syphilis. Those at greatest risk include:
- people who have unprotected sex
- men who have sex with men
- people living with HIV
- individuals with more than one sexual partner
Syphilitic sores also increase the risk of contracting HIV.
Preventive measures to decrease the risk of syphilis include:
- abstaining from sex
- maintaining long term mutual monogamy with a partner who does not have syphilis
- using a condom, although these only protect against genital sores and not those that develop elsewhere on the body
- using a dental dam, or plastic square, during oral sex
- avoiding sharing sex toys
- refraining from alcohol and drugs that could potentially lead to unsafe sexual practices
When having syphilis doesn’t mean a individual is safe from it going forward. Even after therapy effectively clears syphilis from a person’s body, they will contract it again.
Is syphilis the most dangerous STI?
While syphilis can indeed cause dangerous complications, it is important to remember that many STIs can lead to potentially serious health consequences if you do not receive treatment. For example:
- STIs such as gonorrhea or chlamydia can lead to problems getting pregnant.
- Human papillomavirus (HPV), the virus that causes genital warts, can lead to the development of cervical cancer.
- HIV can be fatal without treatment. Additionally, having an untreated STI can increase your risk of getting HIV.
Safe sex practice and knowledge of your STI status are important ways to help prevent the spread of those infections. Be sure to undergo testing if you have a new sexual partner, have multiple sexual partners, or are concerned that you may have an STI.
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.