Syphilis

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KEY POINTS

• Syphilis is a sexually transmitted disease or infection, which if not treated, can lead to permanent brain, nerve, and tissue damage.
• You will be treated with antibiotic medicine. Your infection will be reported to the local health department, so your sexual partners can be told confidentially that they have had contact with someone who has a sexually transmitted infection.
• To prevent syphilis and other STDs, always use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.

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What is syphilis?

Syphilis is a sexually transmitted disease or infection (also called an STD or STI). If it is not treated, syphilis can lead to permanent brain, nerve, and tissue damage.

What is the cause?

The infection is caused by bacteria called Treponema pallidum. It is usually passed from person to person during oral, vaginal, or anal sex. The bacteria can also get into your body through a cut or break in the skin or through blood transfusions in countries that don’t check for syphilis in donor blood.

During the early stages of syphilis, sores form on the body, usually near the genitals. These sores are not tender or painful, so you may not notice them. However, the bacteria causing syphilis can spread to others if they touch the sores, especially if the bacteria get near any moist area of the body (such as the vagina, mouth, or rectum) or on any cuts or breaks in the skin. Once inside the body, the bacteria can spread quickly to other parts of the body through the bloodstream.

The infection can be passed from a pregnant woman to her baby before or during birth. It can cause serious problems for the baby, such as vision problems, deafness, and sometimes death.

What are the symptoms?

The symptoms depend on the stage of the disease.

First stage

A smooth, pale or red, painless sore appears at the place where the bacteria entered your body, usually near your genitals. There is usually just one sore, but there may be more than one and they can be anywhere on your body. The sore may appear 10 days to 3 months after contact with an infected person. Because the sore is usually painless and may be inside the vagina or rectum, you may not even know you have been infected. The sore lasts 3 to 6 weeks with or without treatment.

Second stage

If you do not get treatment, the disease will go into the second stage. Sometimes the symptoms of the second stage are so mild that you may not know you need treatment. Symptoms may include:

• A pink or red, bumpy, scaling skin rash that does not itch and may come and go, anywhere on your body
• Brown sores about the size of a penny on the palms of your hands and soles of your feet
• Swollen and tender lumps in the neck, armpits, or groin
• Fever, body aches, sore throat, headache, tiredness, and loss of appetite
• Hair loss in clumps, causing patchy baldness
• Gray or pink growths of soft, fleshy skin in your mouth, armpits, or groin

You can easily infect other people if they have contact with the sores.

The second stage starts 6 to 12 weeks after contact with an infected person and may last as long as a year. The symptoms of second-stage syphilis will then go away, with or without treatment. But the bacteria stay in your body if you’re not treated.

Third stage

The third stage starts anywhere from 2 to 30 or more years after the second stage. During this stage, syphilis can damage your blood vessels, heart, brain, and other organs. It can lead to severe heart disease, brain damage, paralysis, and death.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and sexual and medical history and examine you. Tests may include:

• Tests of the sores
• Blood tests

How is it treated?

If syphilis is treated with antibiotics during the first or second stage, the disease is easily cured. During the third stage of syphilis, antibiotics can still be used to kill the bacteria. However, any damage already done to the blood vessels, brain, or heart will not go away.

Be sure to tell your healthcare provider if you are or may be pregnant. Your provider will prescribe an antibiotic to treat your infection and to keep your baby from getting infected. Your provider will choose an antibiotic that is safe for your unborn baby.

You will be asked about your sexual partner(s). Your infection will be reported to the local health department and your sexual partner(s) will be told that they have had contact with someone who has a sexually transmitted infection. (Your name will not be given.) This will help them get prompt treatment for the infection. It can also help prevent new infections.

Syphilis does not progress to later stages or come back once it is treated, but you can be reinfected if you have sex with someone who has untreated syphilis.

How can I take care of myself?

• Follow your healthcare provider's instructions and take all of your medicine as prescribed. Be sure to tell your provider if you are allergic to penicillin or other medicines.
• Don’t have sex until both you and your partner have finished all of the medicine and your provider says it's OK.
• Ask your healthcare provider:
  • How and when you will get your test results
  • What other STDs you should be tested for
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to normal activities
  • When it is safe to have sex again
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I help prevent syphilis?

To avoid getting syphilis or giving it to someone else if you have it:

• Wash your hands before and after you use the toilet and before you touch any food, dishes, or utensils, and before and after having sex.
• Tell everyone with whom you have had sex in the last 3 months about your infection. Or you can ask the clinic staff to tell them without using your name. Your sexual contacts need to be treated even if they don’t have any symptoms.
• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex. However, condoms are not 100% effective because they do not cover all areas that can have the sores. Talk with your provider about this.
• Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for syphilis and other infections.
• If you had sex and are worried that you may be infected, see your healthcare provider even if you don’t have any symptoms.
• If you have been sexually assaulted, you may need to be treated to prevent sexually transmitted infections. You should have an exam within a few hours of the assault (and before showering or bathing) even if you don’t want to press charges. Women can also ask about being protected from pregnancy.