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Syphilis

Basic Information

Syphilis is a sexually transmitted disease (STD) caused by the bacteria Treponema Pallidium. The disease causes tissue destruction at the point of entry. If left untreated it will damage the central nervous system as well as the cardiac valves and damage the heart muscle.

Syphilis is divided into three stages: primary, secondary and tertiary. Tertiary syphilis has two phases: the early latent stage and the late latent stage. It is during the primary and secondary stages that syphilis is considered highly contagious. Any contact with the chancre or the blood or blood products of an infected person are modes of transmission. It is also most communicable in early latent stage through contact with the skin lesions of an infected person. This is especially true during the first four years of the late stage. It is estimated that 7% to 12% of all of sexually transmitted diseases transmitted through lesions are due to syphilis. It is a fact that HIV transmission is increased when syphilis lesions are present. This is due to the availability of virus and the decrease in the skins wall integrity as a defense barrier.

Unfortunately, this disease continues to be widespread in the U.S. with an estimated 90,000 new cases each year. This is a communicable and reportable disease. In 1992 cases reported to public health officials represented a 20% increase over cases reported only twelve years earlier in 1980. Syphilis is most likely to affect urban dwellers in their twenties and thirties.

Syphilitic Infection can be transmitted during unprotected oral, vaginal and/or anal intercourse with a partner who is infected with primary- or secondary-stage syphilis. Donated blood is always screened for syphilis. It is highly unlikely but still a possibility that you might contract syphilis via a transfusion. You may be at risk for contracting syphilis if you or your partner are sexually active outside of a monogamous relationship. Even a one time incident can put you at risk . If this is the case, the proper use of latex condoms will substantially reduce your risk factor for infection.

But the condom is not a guarantee especially if the chancre is in a location where the condom does not cover it.

If you are diagnosed with this disease it is important that you notify your sexual partners so that they may seek treatment. Left untreated, syphilis can cause extremely serious long-term health complications. Close medical follow up for up to a year is very important to establish that syphilis has been adequately treated. Among the serious complications that can result if syphilis is not detected or left untreated are:

  • cardiac disease
  • blindness
  • mental illness
  • skin lesions
  • joint and bone destruction

Be certain you do not engage in further sexual activity until you have followed up with your health care provider to determine that you are no longer infectious. This is critical.

Symptoms

PRIMARY STAGE

The chancre sore appearing on the penile shaft, the labia, the lips of the mouth and/or the anus is known as the classic ulceration or lesion in the diagnosis of syphilis. It is seen approximately 7 days to 3 months after initial exposure to syphilis.

The syphilitic lesion appears to be an elevated area that has rolled edges with a flat base on the inner surface. At times, the lymph nodes nearest the syphilitic infection site become enlarged, but do not hurt. The only time there is discomfort is if there is another type of infection in the same area.

The chancre sore or lesion is usually painless and often heals on its own within 1 to 5 weeks.

[PENIS CHANCROID]

Secondary Stage

This stage begins 2--8 weeks after the primary infection and can include multiple manifestations of symptoms.

A fine rash with small red, scaly bumps may appear on the trunk, face, extremities or just on the genital area. 60--80% of those infected have this rash on their soles and palms. Generally it is not itchy but in can be in persons of color.

Swollen lymph glands, also known as lymphadeonopathy, can occur throughout the body, most usually in the groin, neck or armpit. The liver can become infected as well as the kidneys and neurological system. There can be a flu-like illness with general malaise, a dull headache, nausea and a low grade to moderate fever. Also there is a risk for developing meningitis during this stage.

The lesions usually resolve on their own within 2--6 weeks, yet relapses sometimes occur within the first 1--2 years.

Late Or Tertiery Syphilis

This stage is divided into two types--the early latent and late latent.

The early latent period is the general phase beginning one year after infection and often no symptoms are present. However in both early latent and late latent stages lesions called gummas may appear which cause scarring and ulceration's and may or may not be painful. These are rarely seen in the developed world.

The effects of late latent syphilis, which can last from 1--40 years, can be devastating, leaving those still infected with arthritis and/or cardiovascular and neurological symptoms that are irreversible.

For this reason, if you feel you may have been exposed to syphilis, you should contact your health care provider promptly for diagnosis. Untreated, debilitating tissue destruction--and even death--can occur in those infected.

In addition--although syphilis is spread primarily through sexual intercourse with an infected partner--an infected mother can also transmit syphilis to her newborn. This is called congenital syphilis and can be a catastrophic event in the lives of both mother and newborn.

Diagnosis/Treatment

Syphilis can be diagnosed in the primary stage by a lab examination of fluid from the lesion. More often syphilis can be detected by a blood test. If diagnosed at this stage it is curable with the proper treatment.

Specific antibiotics by injection are the chosen drugs for treatment, but if the patient is allergic to this drug, other medications can be taken orally, usually for a 2--5 week period. The treatment guidelines are standard and can vary from patient to patient, depending on the length of time and co-existing diseases. Treatment guidelines also demand follow up and partner notification.

If it is a complicated case or if HIV is diagnosed then specific treatments must be employed.

Do not attempt to cure yourself with homeopathy or over the counter medications. Syphilitic treatment must be administered with conventional medications by your health care provider. Also if you have had syphilis in the past but have not had a checkup within the last year it is strongly suggested that you discuss a follow-up test with your health care provider. Be aware that 50% of patients diagnosed with secondary syphilis will experience a reaction after the treatment. The patient may have nausea, headaches and/or fever in response to the poisonous substances (toxins) being released from the dying organisms.

A case of syphilis in a child is due to sexual abuse by an infected adult. Often it is a relative of the child's. The child diagnosed with syphilis must be further investigated for the presence of other STDs (sexually transmitted diseases). As well all of the siblings of the child should be carefully examined for signs of sexual abuse.

It takes several tests to confirm the presence of syphilis. Once treated the person may always be positive on one or more tests for the rest of his/her life. As well there are several other disease states that can give an incorrect diagnosis. So often further specialized testing is needed to confirm the diagnosis. An expert diagnostician must interpret the results corresponding with the person's history and treatment background to eliminate the possibility of re-infection. The public health laws insist on follow up and partner notification.

It is important that you be honest with your health care provider with regard to your sexual history.

If you are diagnosed with syphilis, your health care provider is obligated to check for the presence of other sexually transmitted diseases such as gonorrhea, chlamydia, Hepatitis B, HPV and herpes.

Also, if you are diagnosed with syphilis, a discussion about HIV testing and counseling is very important and indicated. When a person has at least one sexually transmitted disease, studies have shown that the risk for HIV transmission is much more likely. This is thought to be due to the body's altered defense mechanism when it is infected with an STD. In fact it has been recently discovered that the presence of a syphilitic chancre--or any genital lesion such as herpes infection or chancroid disease-significantly increases the risk for HIV transmission.

Should you even suspect that you are infected with a sexually transmitted disease please see your health care provider without delay.

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