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. However, without treatment, the infection will progress to the latent and possibly tertiary stage of disease.
The latent hidden stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. Without treatment, the infected person will continue to have syphilis 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.
Tertiary syphilis is rare and develops in a subset of untreated syphilis infections;, it can appear 10—30 years after infection was first acquired, and it can be fatal.
Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms of tertiary syphilis vary depending on the organ system affected. Syphilis can invade the nervous system neurosyphilis , visual system ocular syphilis , or auditory system otosyphilis at any stage of infection. These infections can cause a wide range of symptoms.
When a pregnant woman has syphilis, the infection can be transmitted to her unborn baby. All pregnant women should be tested for syphilis at the first prenatal visit. Some women need to be tested again during the third trimester 28 weeks gestation and at delivery. This includes women who live in areas of high syphilis morbidity, are previously untested, had a positive screening test in the first trimester, or are at higher risk for syphilis i.
Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases. An infected baby born alive may not have any signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks.
Untreated babies may become developmentally delayed, have seizures, or die. All babies born to mothers who test positive for syphilis during pregnancy should be screened for syphilis and examined thoroughly for evidence of congenital syphilis. Treponemal tests e. Treponemal antibodies appear earlier than nontreponemal antibodies and usually remain detectable for life, even after successful treatment. If a treponemal test is used for screening and the results are positive, a nontreponemal test with titer should be performed to confirm diagnosis and guide patient management decisions.
Based on the results, further treponemal testing may be indicated. Reverse sequence testing can identify persons previously treated for syphilis and those with untreated syphilis. False-positive results can occur in those with low likelihood of infection with reverse sequence testing as well.
Special note: Because untreated syphilis in a pregnant woman can infect her developing baby, every pregnant woman should have a blood test for syphilis. All women should be screened at their first prenatal visit. Some patients should receive a second test during the third trimester at 28 weeks and again at delivery.
All infants born to mothers who have reactive nontreponemal and treponemal test results should be evaluated for congenital syphilis. A quantitative nontreponemal test should be performed on infant serum and, if reactive, the infant should be examined thoroughly for evidence of congenital syphilis. Suspicious lesions, body fluids, or tissues e. Other recommended evaluations may include analysis of cerebrospinal fluid by VDRL, cell count and protein, CBC with differential and platelet count, and long-bone radiographs.
For further guidance on evaluation of infants for congenital syphilis, please refer to the STI Treatment Guidelines. If syphilis goes untreated, it moves from the secondary stage to the latent or hidden phase, where there are no symptoms. This stage can last for years, and the signs and symptoms may never come back or the disease can progress to the third, or tertiary stage, according to the Mayo Clinic.
The symptoms can depend on the complications that occur, but can include the following:. Syphilis is caused by a type of bacteria called Treponema pallidum, which enters the body through minor cuts or abrasions in the skin or mucous membranes, usually during sexual activity. The infection is contagious both during its primary stage — when the sore first appears — and in its secondary stage, when a rash may develop on the torso, palms of the hands, soles of the feet, and elsewhere on the body.
This is likely due to the fact that a syphilis sore can bleed, providing an easy way for HIV to enter the bloodstream. You cannot get syphilis from using the same clothing, toilet, toilet seat, or utensils as an infected person. You also can't get it from doorknobs, bathtubs, swimming pools, or other similar facilities. In rare instances, it can spread through direct, close contact with an active lesion — for example, during kissing.
Although there are signs and symptoms that often come with syphilis, it is possible to have the disease and not know it. Testing is recommended that people who are have had unprotected sex or sex with someone who has syphilis. Syphilis testing is usually done by a simple blood draw. If there are open sores, a sample of fluid from the sore may be swabbed and tested. If syphilis is treated properly with antibiotics, early syphilis can be cured without causing any permanent damage.
Without treatment, if a person develops tertiary syphilis there is a risk for severe organ damage or even death, says the CDC. Syphilis can be cured with treatment and go away. If it goes untreated, syphilis is a lifelong disease. The drug of choice is the type of penicillin known as penicillin G benzathine , sold as Bicillin L-A in the United States.
For people who are allergic to penicillin, some other antibiotics, such as doxycycline or ceftriaxone , can be used. But penicillin is the only recommended treatment for pregnant women with syphilis. Once it's cured, syphilis doesn't come back on its own, but you can still get it again if you have contact with someone who has an active syphilis infection. There are no home remedies or alternative therapies to cure syphilis. The only way to completely avoid getting syphilis is to not have sex or engage in intimate physical contact.
In addition, it's recommended that all pregnant women be screened for syphilis and, if they have it, be treated with penicillin to prevent congenital syphilis in their offspring. If syphilis is not treated it can affect your heart, brain, and eyes and may be life-threatening. Research has linked the infection to aneurysms and inflammation of the aorta, the major artery in your body.
Complications of syphilis may also include such cardiovascular and neurological problems as:. Ocular syphilis is when the infection spreads to the eye. This can cause vision changes or even blindness.
Nearly one-half of all children infected with syphilis while in the uterus die shortly before or after birth. The disease is also associated with blindness, deafness, physical deformities, and damage to the baby's nervous system. In an infant born with congenital syphilis, the risk of complications can be reduced by early detection and treatment with penicillin. Congenital syphilis can be prevented by treating the mother for syphilis during pregnancy.
Currently, the CDC recommends testing all pregnant women for syphilis at their first prenatal visit, and retesting women early in their third trimester and at delivery if they are at high risk of having acquired syphilis during their pregnancy.
According to the CDC, there were more than , reported new diagnoses of syphilis all stages in the United States in , the latest year for which national statistics are available. The number of reported primary and secondary syphilis cases — indicating relatively new infections — was just over 35,, representing a 71 percent increase since The majority of syphilis cases occurred among gay, bisexual, and other men who have sex with men MSM.
But rates of primary and secondary syphilis have also been increasing in heterosexual men and women and in all age groups. While people ages 15 to 44 accounted for nearly 81 percent of primary and secondary syphilis cases in , rates increased by 21 percent among people ages 55 to 64 and nearly 29 percent among those age 65 and older, per the CDC. These numbers serve as a reminder that older Americans, baby boomers included, still need to protect themselves during sex, particularly when initiating a new sexual relationship.
Black Americans have 4. Congenital syphilis rates in were 6. Black men have the highest rate of syphilis — That statistic is especially concerning in light of the "Tuskegee Study of Untreated Syphilis in the Negro Male," one of the most infamous studies in American health research and low point in clinical studies.
Initiated in , the year study was conducted by Public Health Service officials and followed rural Black men in Alabama, about two-thirds of whom had syphilis. The men were never told their diagnosis and were denied treatment for the disease penicillin became available as a treatment for syphilis in The unethical study was ended when whistleblowers revealed what the researchers were doing.
Many men in the study died from complications due to syphilis, and many of the wives and children of the men contracted the disease, noted a June article in The Atlantic.
Tertiary syphilis can occur years or decades after the initial infection. Tertiary syphilis can be life-threatening. Some other potential outcomes of tertiary syphilis include:.
If you think you might have syphilis, go to your doctor as soon as possible. If a sore is present, your doctor may take a sample from the sore to determine if the syphilis bacteria are present.
During this procedure, spinal fluid is collected so that your doctor can test for syphilis bacteria. This is to prevent the fetus from being infected with congenital syphilis.
Congenital syphilis can cause severe damage in a newborn and can even be fatal. You can also consider ordering an at-home syphilis testing kit. Primary and secondary syphilis are easy to treat with a penicillin injection. Penicillin is one of the most widely used antibiotics and is usually effective in treating syphilis. People who are allergic to penicillin will likely be treated with a different antibiotic, such as:.
This will often require a brief hospital stay. The bacteria can be killed, but treatment will most likely focus on easing pain and discomfort.
The best way to prevent syphilis is to practice safe sex. Use condoms during any type of sexual contact. In addition, it may be helpful to:. Syphilis can also be transmitted through shared needles. Avoid sharing needles if using injected drugs. Mothers infected with syphilis are at risk for miscarriages, still births, or premature births. This is known as congenital syphilis. Congenital syphilis can be life-threatening. Babies born with congenital syphilis can also have the following:.
This can cause damage to their:. People with syphilis have a significantly increased chance of contracting HIV. The sores the disease cause make it easier for HIV to enter the body. If you have HIV, talk to your doctor about how to recognize syphilis symptoms. The first stage of syphilis can easily go undetected. The symptoms in the second stage are also common symptoms of other illnesses.
This means that if any of the following applies to you, consider getting tested for syphilis. Get tested if you:. Make sure to finish the full course of antibiotics, even if symptoms disappear. Consider getting tested for HIV as well.
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