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Syphilis

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jul 5th 2016

Syphilis is caused by a bacteria called Treponema Pallidum. Like similar bacterially caused STDs, it is spread from person to person via body fluids, most commonly via unprotected sexual activity, but occasionally when infected sores come into contact with open cuts or scrapes.

A Syphilis infection passes through three identifiable stages with each stage having a recognizable profile of symptoms. The first stage of infection is characterized by the presence of painless ulcers (moist breaks in the skin) known as "chancres". The chancres heal on their own. Within several weeks to months 25% of infected people go on to develop symptoms characteristic of the secondary stage of syphilis infection, while the other 75% of infected people will have a silent (symptom-free) but continuing infection. When secondary stage syphilis symptoms are present, they include rash, fever, headache, swollen lymph nodes, loss of appetite, and tiredness. When a rash occurs, it is generally found on the palms of the hands and the soles of the feet.

Whether secondary symptoms are present or not, people infected with syphilis are likely to go on to experience a third stage of symptoms, sometimes referred to as "late syphilis". Third stage syphilis is a very serious medical condition, which can develop anytime between one and thirty years after initial infection. Third stage syphilis affects the nervous system, the heart, the skin and the bones, and can lead to destruction of important organs, such as the liver and brain. In the brain, third stage syphilis can lead to memory problems, mood changes and dementia, resulting in the need for nursing home care. Third stage syphilis can even cause death by affecting the vital organs.

If you suspect you may have syphilis, it is vitally important that you see your doctor as soon as possible for testing and treatment. Doctors can do a blood test to detect the presence of the syphilis bacteria. They can treat syphilis with antibiotics. The earlier the disease is caught, the easier it is to treat (later stage syphilis is difficult to treat). A single dose of penicillin (an antibiotic drug) can treat syphilis when it is at the first "chancre" stage. Alternative antibiotics are available for patients who are allergic to penicillin. Your doctor may retest your blood to make sure it is free of syphilis bacteria once the antibiotic treatments are completed. Needless to say, people with active chancres or other symptoms of syphilis should not have sex until they have been treated for the disease and cleared by their doctor.

Because of the hidden and lethal dangers that syphilis poses for untreated infected persons, it is vital that you contact your recent sex partners, tell them of your syphilis infection, and urge them to see their doctor for testing and treatment. You may be saving your partner's lives by doing so. It is possible that one or more of your partners has had syphilis for years and has never shown recognizable symptoms.

As with other STDs, you can reduce your chances of becoming infected with syphilis by taking precautions with your sexuality. Abstain from sexual contact entirely, or only have sex with one partner. If you must have sex with more than one partner, make sure you use barrier method contraception such as a latex condom. Note that condoms may not protect you from syphilis infection as syphilis chancres can occur in the general pubic region and not be covered by the condom. You could catch the disease if you rubbed against another person's chancres.

 

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