Syphilis is a sexually transmitted disease (STD). It has been dubbed The Great Imitator because so many of the symptoms look like something else and misdiagnosis is common. Prior to the rise of HIV, syphilis was typically considered the worst STD one was likely to encounter.
Caused by the Treponema pallidum bacterium, the disease is almost always contracted through sexual contact with an existing syphilis sore, although a congenital infection where a pregnant mother passes the disease to her unborn child is possible. Syphilis sores typically occur on the genitals, anus, or inside the rectum, but they may also occur on the mouth.
In recent years the incidence rate (new cases) of syphilis has increased in both Canada and the US. Most new cases (up to 66%) are being diagnosed in individuals within the male homosexual community.
Symptoms and Complications
One of the classic problems with syphilis is that an infected person may display no symptoms for many years, yet remain at risk for harm from the disease anyway. Syphilis is a long term illness that progress through stages. The symptoms of syphilis vary depending on the stage in the life cycle of the bacterium
Stages of Syphilis
Primary stage syphilis symptoms are usually marked by the development of one or more sores. These can appear as early as 10 days following infection, or as late as 90 days, but the appearance of sores at around 3 weeks from infection is typical. These sores are small, round, solid, and painless, and appear at the point of infection. They last for 3 to 6 weeks, and then heal on their own. However, healed sores do not mean elimination of the syphilis bacterium.
The secondary stage of syphilis symptoms is noted for its skin rashes and mucous membrane lesions. The rash will appear as rough, red, or reddish brown spots that are not especially itchy. These rashes may appear differently, however, and this leads to misdiagnosis. Other symptoms include fatigue, fever, hair loss, headaches, muscle ache, swollen lymph nodes, sore throat, and weight loss. As with primary stage symptoms, these symptoms will clear up on their own, but this does not mean the syphilis has gone away.
Without treatment, a person with syphilis will continue to have the disease, even though there are no further symptoms. This can go on for many years before late stage syphilis appears. The disease may then go on to cause damage the bones, brain, eyes, heart, nervous system, blood vessels, and liver. Symptoms of this degeneration include loss of muscle coordination, numbness, gradual blindness, dementia, and paralysis. Late syphilis can be fatal.
Babies infected with syphilis by their mothers may develop seizures or developmental problems within weeks of birth.
Treatment
Syphilis is a simple matter to cure, if caught in the early stages only one intramuscular shot of the antibiotic penicillin G or azithromycin is required. However, this is only the case for infections of one year or less. Additional shots will be needed for longer infections. Other antibiotics can be substituted for those who are allergic to penicillin. Treatment for syphilis will cure a person of the disease, but it will not remedy whatever damage has already been done.
In recent years, drug resistant syphilis has been spreading. The most recent information shows that 10% of new cases are immune to azithromycin.
Prevention
The most direct means of preventing a syphilis infection is to abstain from sexual intercourse. This is followed by being in a sexually monogamous relationship with a previously tested partner, and then by requiring all sexual partners to be tested for syphilis. Condoms, when used properly, greatly reduce the chance of infection, but do not eliminate it. Washing the genitals with an antiseptic, either before or after sex, has no demonstrable effect on reducing the risk of transmission.
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