Syphilis has been called “The Great Pretender”, as its symptoms can look like many other diseases. The average time between infection with syphilis and the start of the first symptom is 21 days, but can range from 10 to 90 days.However, syphilis typically follows a progression of stages that can last for weeks, months, or even years. Syphilis cases have been on the rise since 2012 with over 64,000 cases reported annually.
Symptoms of Syphilis
The appearance of a single chancre marks the primary (first) stage of syphilis symptoms, but there may be multiple sores. The chancre is usually firm, round, and painless. It appears at the location where syphilis entered the body. These painless chancres can occur in locations that make them difficult to find (e.g., the vagina or anus). The chancre lasts 3 to 6 weeks and heals regardless of whether a person is treated or not. As the disease progresses, the symptoms change.
Primary and Secondary Syphilis — Reported Cases* by Stage, Sex, and Sexual Behavior
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How is Syphilis Transmitted?
Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres occur mainly on the external genitals, vagina, anus, or in the rectum. Chancres also can occur on the lips and in the mouth. Transmission of syphilis occurs during vaginal, anal, or oral sex.
- Syphilis can be transmitted through vaginal sex
- Syphilis can be transmitted through oral sex
- Syphilis can be transmitted through anal sex
What Are the Stages and Symptoms of Syphilis?
The appearance of a single chancre marks the primary (first) stage of syphilis symptoms, but there may be multiple sores. The chancre is usually firm, round, and painless. It appears at the location where syphilis entered the body. These painless chancres can occur in locations that make them difficult to find (e.g., the vagina or anus). The chancre lasts 3 to 6 weeks and heals regardless of whether a person is treated or not.
Skin rashes and/or mucous membrane lesions (sores in the mouth, vagina, or anus) mark the second stage of symptoms. This stage typically starts with the development of a rash on one or more areas of the body. Rashes associated with secondary syphilis can appear when the primary chancre is healing or several weeks after the chancre has healed. The rash usually does not cause itching. The characteristic rash of secondary syphilis may appear as 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 resembling rashes caused by other diseases. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Large, raised, gray or white lesions, known as condyloma lata, may develop in warm, moist areas such as the mouth, underarm or groin region. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms of secondary syphilis will go away with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease.
Latent and Late Stages
The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis infection in their body even though there are no signs or symptoms. Early latent syphilis is latent syphilis where infection occurred within the past 12 months. Late latent syphilis is latent syphilis where infection occurred more than 12 months ago. Latent syphilis can last for years.
The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10–20 years after infection was first acquired. In the late stages of syphilis, the disease may damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. 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.
What is Neurosyphilis?
Syphilis can invade the nervous system at any stage of infection, and causes a wide range of symptoms varying from no symptoms at all, to headache, altered behavior, and movement problems that look like other neurologic diseases, such as Parkinson’s or Huntington’s disease. 7 This invasion of the nervous system is called “neurosyphilis.”
Ocular syphilis, a clinical manifestation of neurosyphilis, can involve almost any eye structure, but posterior uveitis and panuveitis are the most common. Ocular syphilis may lead to decreased visual acuity including permanent blindness.
How is Syphilis Treated?
Syphilis is easy to cure in its early stages. Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Proper dosing for a syphilis treatment should include three weekly injections. While undergoing treatment, you should abstain from sexual intercourse of all types.
How Does a Syphilis Test Work?
Our syphilis test requires a simple blood sample and screens for the bacterium Treponema pallidum.
What is the Link between Syphilis and HIV?
Genital sores caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. 11
Ulcerative STDs that cause sores, ulcers, or breaks in the skin or mucous membranes, such as syphilis, disrupt barriers that provide protection against infections. The genital ulcers caused by syphilis can bleed easily, and when they come into contact with oral and rectal mucosa during sex, increase the infectiousness of and susceptibility to HIV. Studies have observed that infection with syphilis was associated with subsequent HIV infection among MSM.
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