Syphilis
Syphilis is one of
the most common sexually transmitted infections. The majority of cases in 2015
were among gay, bisexual and other men who have male sexual partners.
The bacterium
Treponema pallidum is the causative agent of infection and is transmitted from
person to person sexually: oral, vaginal or anal sex.
There is a cure, but
if the disease progresses far enough, the treatment cannot reverse or cure the
tissue or organ damage already caused by the infection.
How is syphilis transmitted?
Syphilis is
transmitted through skin contact during intercourse, whether oral, vaginal, or
anal.
Since it can be
transmitted to a sexual partner through bacteria on the skin, a condom cannot
completely protect against transmission.
What are the symptoms?
Syphilis infection
has four different stages, each with different symptoms. The first symptoms
will appear between 10 and 90 days after the initial infection (average 21
days).
The stages and their
possible symptoms include:
- Primary syphilis: development of one or more papules that progress to a
clear, painless sore (similar to a painful chancre) usually located on the
genitals. An ulcer often heals four to six weeks after it appears.
- Secondary syphilis: two to ten weeks after the wound has healed (or sometimes
during the healing process), a rash may appear that can cover the entire body
(red or brownish rough patches); sores in the mouth, vagina, or anus; grayish
or white warty growths; heat; swollen lymph nodes; Headache; weight loss;
and/or sore throat and other flu-like symptoms such as fatigue.
- Latent syphilis: 1-2 months after the onset of secondary syphilis,
symptoms may disappear for several years.
- Advanced or tertiary syphilis: You may have neurological and
cardiovascular problems, as well as problems with other organs. The symptoms
depend on the affected organ.
- Neurosyphilis and ocular syphilis: These can become a problem at any stage of
a syphilis infection if the bacteria enters the nervous system or the eyes,
respectively. Possible symptoms of neurosyphilis include headaches, movement or
coordination problems, behavioral changes, paralysis, dementia, and/or sensory
disturbances. Possible symptoms of eye syphilis include changes in vision,
visual field loss and/or blindness.
How can I get tested?
If you suspect that
you may have syphilis, it is important to get tested. A commonly used test is a
serological test, which checks for antibodies in your blood. Initially, one of
two tests, called the non-treponemal test, is used to check for antibodies to
syphilis-like infections:
- Rapid Plasma Reagen. It is a good screening test that can also be
used to monitor infection levels after starting treatment.
- Venereal Disease Research Laboratory. Uses a blood sample or a CSF sample and is
mainly used to diagnose neurosyphilis.
To confirm initial screening tests, such as a rapid
plasma reagent test, treponemal tests may only be performed to specifically
target syphilis antibodies:
- Fluorescent treponemal antibody absorption. Usually used during the first 3-4 weeks
after exposure. Uses a sample of blood or cerebrospinal fluid to detect
antibodies specific to syphilis bacteria and diagnose syphilis (or
neurosyphilis).
- T. pallidum particle agglutination
assay. It
is more specific and produces fewer false positives than fluorescent treponemal
antibody absorption.
- Microhemagglutination assay. It is another test to confirm the diagnosis of
syphilis, but is now less commonly used.
- Immunoassays. Automated tests
that facilitate the specific detection of syphilis.
Although much less
commonly used, there are two tests available that can detect the presence of
syphilis bacteria (not just antibodies):
- Microscopy in the dark
field. At the first
suspicion of syphilis, a scraping from the chancre can be placed on a glass
slide and examined using a certain type of microscope.
- Polymerase chain reaction. Using a sample of blood, cerebrospinal
fluid, or the wound itself, polymerase chain reaction can specifically detect
the genetic material (DNA) of bacteria.
Based on the results,
you and your doctor can take the necessary steps to clear the infection from
your body.
What treatment options are available?
Antibiotics are used
to treat syphilis during pregnancy.
The good news is that
it is easily treated with antibiotics. Penicillin G is the only effective
treatment, meaning that people who are allergic to penicillin may not have a
suitable alternative treatment. Talk to your doctor if this applies to you.
Treatment with
penicillin G will rid your body of infection, but cannot repair organ/tissue
damage that has already occurred. Most often, the diagnosis of syphilis is made
in the primary or secondary stages before most tissues or organs are affected,
unless the disease has already progressed to ocular or neurosyphilis.
Can this be avoided?
As with most sexually
transmitted infections, there are only two ways to 100% avoid infection:
abstaining from all sexual activity and being in a monogamous relationship in
which each partner has sex only with the other, and neither of them currently
time is not infected with any sexually transmitted disease. infection.
Consistent and correct use of condoms during oral, vaginal and anal sex is always recommended. However, because the bacteria that causes syphilis can be found on skin that is not protected by a condom, using a condom does not significantly reduce your chances of transmitting or contracting the disease.