Syphilis

Overview

Syphilis is a sexually transmitted bacterial infection caused by Treponema pallidum (T.pallidum). The bacteria are transmitted through sexual intercourse, and it normally begins as a painless sore often observed on the rectum, genitals, or mouth.

Syphilis is treatable in the early stages, but it can prove to be deadly if not treated. In fact, syphilis can lead to neurological disorders, disability, and death. It is divided into primary, secondary, latent, and tertiary stages.

According to the World Health Organization, over 1 million sexually transmitted diseases are acquired every day in the entire world. Cumulatively, around 357 million people are infected with 1 of the 4 main STIs, namely gonorrhea, chlamydia, syphilis, and trichomoniasis.

A study conducted in Kenya to determine the prevalence of syphilis in the country indicated that 1.8% of adults test positive for syphilis.

Symptoms

Syphilis develops in various stages, and the symptoms vary from one stage to another. However, the stage may overlap, and the symptoms do not often occur in the same order. A person may have syphilis and stay for years without noticing any symptoms.

Primary Syphilis

  • A small sore known as a chancre (SHANG-kur) appears
  • It appears at the spot where the bacteria enter your body
  • Most individuals infected develop a single, but few develop several of them
  • It develops three weeks after exposure
  • The chancre is normally painless, and many people do not notice it at first
  • Chancre heals on its own within 3 to 6 weeks

Secondary Syphilis

  • After chancre heals, you may experience a rash on the trunk but eventually covers the entire body
  • The rashes cover everywhere including your lips, soles of the feet, and palms of your hand
  • The rash is not painful or irritating and may be accompanied by wart-like sores in the genitals or mouth
  • Few people experience hair loss, fever, muscle aches, swollen lymph nodes, and sore throat

Latent Syphilis: If not treated at the secondary stage, the symptoms disappear, and this stage may last for several years.

Tertiary (Late) Syphilis: Affects 15 to 30% of infected and untreated people. At this stage, the condition may damage your nerves, brain, heart, eyes, liver, blood vessels, bones, and joints.

Congenital Syphilis: Babies born to infected women may become infected during birth or through the placenta. Most of the newborns with congenital syphilis do not show signs even though some may experience a rash on the soles of their feet and palms of their hands.

Causes

Syphilis is caused by Treponema pallidumbacterium, which is transmitted from person to person during sexual intercourse.

It can equally be passed from mother to a fetus through the placenta during pregnancy or to an infant during delivery.

Risk Factors

Any sexually active person is at risk of contracting syphilis.

Those at highest risk include:

Diagnosis

A doctor will conduct a physical examination on you and ask a few questions concerning your sexual history before proceeding with clinical tests to confirm syphilis.

The tests include:

  • Blood tests: It helps to detect present or past infection
  • Bodily fluid: Fluid from a chancre during primary or secondary stages is assessed for the disease
  • Cerebrospinal fluid: Collected through a spinal tap and evaluated to test for any effect on the nervous system.

If the doctor diagnoses syphilis, he or she will recommend for your partner to be notified of and tested for the disease.

Treatment

If detected in the early stages, syphilis can be treated successfully. Early treatment with penicillin is very critical to prevent life-threatening consequences in the later stages.

During the primary, secondary, or late stages, those diagnosed with the infection will normally receive an intramuscular injection of Benzathine penicillin G.

The strategy to be used for treatment will largely depend on the symptoms, and the period one was exposed.

Tertiary syphilis requires that the patient is injected multiple times at weekly intervals

Neurosyphilis is extreme because it requires intravenous penicillin every 4 hours for 2 consecutive weeks to get rid of bacteria from the central nervous system.

Treatment helps cure the infection and prevent further damage to the body. However, the damage already caused cannot be undone, and that is the reason you are advised to seek early treatment.

Safe sex can resume after curing the infection.

Patients with penicillin allergy may be treated using the alternative medication in the early stages. Those in the tertiary stages and are pregnant with an allergy for penicillin may require desensitization to penicillin to allow treatment.

During the first day of treatment, the patient is likely to experience a Jarisch-Herxheimer reaction where he or she experiences side effects such as nausea, fever, achy pain, chills, and a headache. Either way, progress with the treatment to the end.

Prevention

  • Always practice safe sex/use a condom
  • Abstain or be monogamous: Without sex, you cannot get infected but if you must, then have a single uninfected partner. 
  • Avoid recreational drugs: Substance abuse or excessive use of alcohol can easily lead to unsafe sexual practices.
  • Test for syphilis during pregnancy

For more information on treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.

Sources

https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

https://www.researchgate.net/publication/51643257_Epidemiology_of_syphilis_in_Kenya_Results_from_a_nationally_representative_serological_survey

https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756

https://www.avert.org/sex-stis/sexually-transmitted-infections/syphilis

https://www.medicalnewstoday.com/articles/186656.php