Syphilis

What is Syphilis?
Syphilis is a sexually transmitted bacterial infection caused by the bacterium Treponema Pallidum. It has often been called "the great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases. Syphilis is passed from person to person through direct contact with a syphilis sore. Transmission of the bacterium can occur during vaginal, anal, or oral sex.

What are Symptoms?
There are 3 stages of syphilis, all of which are characterized by certain symptoms. Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated

Primary Stage
The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre is usually firm, round, small, and painless. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

Secondary Stage
A skin rash and second chancre sore characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching and is characteristic of rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. However, rashes with a different appearance may occur on other parts of the body. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Other symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease.

Late and Latent Stages
The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms. This latent stage can last for years.
The late stage of syphilis can appear 10 - 20 years after infection was first acquired. In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

Other Complications of Untreated Infection
Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.
Also, genital sores (chancres) caused by syphilis make it easier to transmit and acquire HIV infection because those sores cause breaks in the skin, which disrupts the barrier that helps protect against transmission of HIV.

How is syphilis transmitted?
Syphilis transmission most often occurs through direct contact with a syphilis sore or a rash associated with syphilis. The sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores can also occur on the lips and in the mouth. The most common ways syphilis is transmitted is during vaginal, anal, or oral sex.
Transmission of syphilis usually occurs from persons with sores who are in the primary or secondary stage. Many of these sores are unrecognized. Thus, most syphilis transmission occurs from persons who are unaware of their infection.
Transmission of the disease can also occur in the early latent phase of syphilis, although, it is less common.

Testing
The Rapid Plasma Reagin (RPR) is a simple blood test used to determine whether someone has syphilis. This test detects antibodies produced by the body shortly after the infection occurs. The earliest the RPR should be taken is 10 days. The antibodies are most commonly detectable by 3 weeks. If the RPR is positive, an FTA confirmation test is ordered to verify the result.

Treatment
There is a cure for syphilis. Treatment is in the form of penicillin given by injection. If it is suspected that the bacteria has been in the body 1 year or less, usually only one shot of penicillin will be administered. If it is suspected that the bacteria has been in the body longer than 1 year, several shots of penicillin may be needed to clear the bacteria. There are other antibiotics that can be used to treat syphilis when a person is allergic to penicillin.