Syphilis: The Great Imitator

Syphilis: The Great Imitator

Caused by a sub-species of the bacteria Treponema pallidum, syphilis afflicts more than 45 million people globally. Although this infection is rare, relative to other STIs, the prevalence of this disease is increasing. Further, while it can be easy to treat if diagnosed in time, syphilis can take a drastic toll on your well-being, adversely affect the health of others and even result in death.

How Is Syphilis Spread?

The most common method of syphilis transmission is through unprotected vaginal, oral or anal sex. It can also be passed from mother to infant or by coming into contact with a syphilis sore. Another less common method of transmission is by kissing someone on an area near the syphilis sore or through blood products such as donated blood or plasma.

About one to two-thirds of those who are exposed to the infection during its first two stages will contract the disease.

Symptoms of Syphilis

Syphilis has been nicknamed the ‘Great Imitator’, owing to the fact that it has a number of the same symptoms which are often found in other diseases. Unlike other STIs though, these symptoms manifest in four different stages in adults and older children.

Primary Stage

Within 3-90 days after exposure, an individual will develop one or more small, usually painless, sores. In most instances, they appear somewhere on the genitals or if transmitted through anal sex, on the anus or in the rectum. However, in rare cases, they may appear somewhere else on the body. These sores will last for three weeks to a month and a half and disappear without scarring.

Secondary Stage

After the first round of sores disappear, a rash breaks out all over the body, often within a month and a half to half a year after exposure. The skin discoloration resembles tiny, rose-colored circles, often called a copper penny rash, and appears on the insides of the hand and soles of the feet.

Syphilis: The Great Imitator

Besides the rash, red nodules can sometimes appear all over the body as well.

In addition to these symptoms, a stage two infected individual may have swollen glands, see white patches inside of their mouth, develop a fever, sore throat and lose weight. Rarely, inflammation of the joints, liver and optic nerve, interstitial keratitis and kidney disease may develop.

Usually, this stage lasts between one to three months and will disappear on its own without treatment.

Latent Stage

Usually, the latent stage is where the disease lies dormant, no symptoms are present and can last for several years. Early in this stage, an infected person may experience a relapse in symptoms, though this becomes less likely as the latent stage persists. Late in the stage, no symptoms are present, though it is still possible to spread the disease.

Tertiary Stage

The final stage of syphilis infection is also the most dramatic and painful. It takes three different forms and can take years or even decades to manifest.

First, gummatous syphilis manifests as large balls of inflammation called gummas which appear all over the body, usually affecting the liver, skeletal system, and skin. These gummas are considerably large than the nodules seen in stage two and can severely deform the head and body.

Cardiovascular syphilis commonly enlarges the aorta, which, when ruptured, can lead to massive internal bleeding, which could lead to death.

The third form, neurosyphilis, infects the central nervous system and may initially be asymptomatic or cause meningitis. Later, symptoms can include the onset of seizures, eye damage and dementia caused by cerebral atrophy.

Congenital Syphilis

When receiving antenatal care, women are usually screened for syphilis so, if they have it, they can be treated as not to pass it on to their child. In cases where this doesn’t happen, the infant is born with congenital syphilis, which is a persistent condition which can be life-threatening.

Unlike other STIs like chlamydia or HPV, where the infection is passed through vaginal birth, syphilis can be transmitted through the placenta, so, getting screened for this infection and receiving treatment for it immediately is critical.

While the infected child will appear to be healthy immediately after birth, the child may be underweight and will have difficulty putting on weight as he or she matures. Other symptoms which develop later, include enlargement of liver or spleen, skeletal abnormalities and the production of irritable, cracking skin around the mouth, genitals and anus.

In older children, a telltale sign of congenital syphilis includes the growth of peg-shaped, notched teeth (commonly called Hutchinson teeth), joint swelling and other skeletal problems, nose deformation and facial deformities, reduced hearing and even deafness and blindness.

If a pregnant woman does test positive for syphilis, soon after birth, her child will as well. Tests performed on the newborn can include an eye examination, several blood tests, bone x-rays and even a spinal tap.

In the case of infection early during pregnancy, many children are stillborn.

Syphilis Treatment

Syphilis can be detected with a simple blood test after one week of the infection, although the best results occur within a three-month time frame after exposure. If you do test positive for syphilis, your physician will prescribe an antibiotic like tetracycline or doxycycline to be taken as long as needed until the infection goes away.

During this time period, do not have sex and ask your sexual partner(s) to get tested as well.

The most common drug used to treat syphilis in pregnant women is a penicillin injection, though, in the case of women with penicillin allergies, alternative antibiotics are available.

Remember, just like other bacterial infections, just because you have been infected and cured of the disease once does not mean you cannot catch it again. To protect yourself from another infection, regularly get tested for sexual infections, make sure your sexual partners are as well and always practice safe sex.