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Syphilis

  • Secondary syphilis rash
  • Syphilis ulcer

Definition

Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum, a type of bacterium known as a spirochete.

What is going on in the body?

A person can develop syphilis 10 to 90 days after contact with thebacteria. Most people develop symptoms about 3 weeks after contact. This initial infection is known as primary syphilis.
If thebacteria are not effectively killed at this time, the person may develop secondary syphilis. This stage of the infection may show up right after the initial infection clears, or it may be delayed for several weeks.
If the syphilis is not treated effectively, the bacteria remain in the body after the symptoms of secondary syphilis have disappeared. This period is known as latent syphilis.
Treponema pallidum bacteria travel to many vital organs, sometimes infecting the brain, heart, eyes, nerves, and bones. Many years later, the person may develop tertiary syphilis.

Risks

What are the causes and risks of the infection?

Treponema pallidum is the cause of syphilis. The organism is spread from one person to another through direct contact with a syphilis chancre. These sores are usually seen on the genitals or anus, but can also be found on the lips and inside the mouth. Therefore, syphilis can be spread by vaginal, anal, or oral sex.
Syphilis can also be passed from a pregnant woman to her unborn child. Rarely, a case of syphilis results from other types of direct contact with blood, such as a puncture wound to the hand during surgery. Blood collected for transfusion is screened for syphilis, to prevent transmission by this route.

Prevention

What can be done to prevent the infection?

Safer sex practices can reduce, but not eliminate, the risk of syphilis. Male and female condoms provide some degree of protection against infection. Anyone diagnosed with syphilis should encourage his or her recent sexual partners to be screened and treated.
People with HIV (the AIDS virus), or with other sexually transmitted infections should be tested for syphilis. Pregnant women should be screened for syphilis and treated promptly if positive.

Diagnosed

How is the infection diagnosed?

The medical history is important for finding out who the person's sexual partners have been, the timing of the sexual exposures, and the types and timing of symptoms of syphilis. On physical exam, the healthcare professional can look for a syphilis chancre at the sites of sexual exposure, and for symptoms of secondary syphilis.
The diagnosis of syphilis, however, depends primarily on antibody tests made on a blood specimen. One type of test is used to screen for syphilis (such as the VDRL or RPR) and another group of more specific tests (such as FTA-ABS or MHA-TP) is used to confirm the diagnosis.
The healthcare professional can also look for the organism in a sample of genital secretions or fluid from a chancre, under a microscope.

Long Term Effects

What are the long-term effects of the infection?

If left untreated, syphilis is very serious. It can result in neurosyphilis, cardiovascular syphilis, and tumors of the skin, bones, and other organs.

Other Risks

What are the risks to others?

Syphilis is an infection that is spread from person to person sexually. It can also be passed from a pregnant woman to her baby.

Treatments

What are the treatments for the infection?

A single dose of penicillin can cure syphilis, if the individual has had it for less than a year. A person who has had syphilis for longer than a year will need additional doses of penicillin. Other antibiotics may be used for people who are allergic to penicillin.

Side Effects

What are the side effects of the treatments?

Penicillin and other antibiotics may sometimes cause rashes, allergic reactions, diarrhea, stomach upset, and nausea.

After Treatment

What happens after treatment for the infection?

If syphilis is treated effectively and on time, the person will usually have no further difficulty. One episode of syphilis, however, does not protect against another infection if the person is exposed again.

Monitor

How is the infection monitored?

Successful treatment is accompanied by a decreasing antibody level to T. pallidum. Any new or worsening symptoms should be reported to the healthcare professional.

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