Syphilis is a bacterial infection that is usually transmitted through sexual contact. The infection is spread by close contact with an infected sore. These sores can occur in places that are difficult to see which makes it difficult to know when someone has been infected and makes transmission much easier. The only guaranteed way to know if someone has syphilis is to get tested. The symptoms of syphilis aren’t always obvious and they may eventually disappear, but the infection is still present and must be treated as soon as possible. Syphilis can usually be treated and cured with antibiotics, but if left untreated, it can spread to the brain and other parts of the body and cause serious complications. Symptoms of syphilis usually present in three stages (primary, secondary and tertiary).

Early (primary) symptoms of syphilis can include:

  • Small painless sore or ulcer (called a chancre)
    • May appear on the vagina, penis or anus, although sometimes they appear on the mouth, lips, fingers or buttocks
  • Most people only have one sore, but some people have several

How can I get it?

Syphilis is a bacterial infection that is primarily transmitted through sexual contact between partners. Women with syphilis can also transmit the infection to their baby through childbirth. It is important to remember that even if someone does not present any symptoms, they are still contagious. Many people don’t notice the symptoms, so it is easy for syphilis to be transmitted from partner to partner without them being aware of the risk.  This is why it is important to get tested if you suspect that you or your partner may be at risk for syphilis infection.

What are the risk factors?

Risk factors for syphilis include:

  • Multiple sexual partners or frequent changing of sexual partners in the past year
  • Inconsistent or incorrect condom use
  • HIV infection
  • Having other sexually transmitted infections

What are the symptoms?

The symptoms of syphilis are similar for both men and women. Symptoms are often mild and therefore easy to miss.
Early symptoms (primary stage syphilis)
Early symptoms usually develop around 2-3 weeks after exposure, although they can start later than this.

  • Small painless sore or ulcer (called a chancre)
    • May appear on the vagina, penis or anus, although sometimes they appear on the mouth, lips, fingers or buttocks
  • Most people only have one sore, but some people have several

Later symptoms (secondary stage syphilis)
Secondary symptoms usually develop a few weeks after the initial symptoms.

They include:

  • Blotchy, red rash that often appears on the palms of the hands and soles of the feet, but can appear anywhere on the body
  • Small skin growths (like genital warts) that can appear on the vulva for women and on the anus for both men and women
  • White patches in the mouth
  • Flu-like symptoms such as tiredness, headaches, joint-pain and fever
  • Swollen glands
  • Occasionally, patchy hair loss

After the secondary symptoms, there is usually a gap between symptoms. This stage is called the latent stage and can last for decades. It is still possible to pass on the infection, although this usually happens within two years of being infected.

Serious symptoms (tertiary syphilis)

A person can have a syphilis infection for year without any symptoms. Eventually, though, the infection will pass to other parts of the body, like the brain and heart and cause serious, potentially life-threatening damage. Syphilis is still treatable at this stage, but the damage may be irreversible.

  • Meningitis
  • Stroke
  • Dementia
  • Loss of co-ordination
  • Numbness
  • Vison problems or blindness
  • Heart problems

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Diagnosis

The only way to know if you have syphilis is to get tested. Testing for syphilis involves a blood test, physical exam and a swab of any sores. Some clinics may be able to test the sample right away, and give you immediate results, but other labs will take up to two weeks.

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Treatment

Syphilis is treatable with antibiotics, usually penicillin. If the patient has had syphilis for less than two years, this usually consists of an injection to the bum or a 10-14 day course of antibiotic pills if they are unable to take penicillin. If the patient has had syphilis for more than two years, then three injections of penicillin, spaced one week apart, are administered or a 28 day course of antibiotic pills. More serious cases that affect the brain are usually given daily penicillin injections for two weeks or a 28 day course of antibiotic pills.

Some people experience side effects shortly after treatment, including:

  • Fever
  • Headaches
  • Muscle and joint pain

These symptoms are usually short-lived.

Patients should avoid sexual contact with anyone until two weeks after their treatment is complete and follow-up testing has confirmed they are free of infection. This is to make sure that the antibiotics have a chance to work and to avoid transmitting the infection to anyone else.

If tested positive for syphilis, it is important that current and past partners (during the last six months) of the patient get tested (and treated) as well.

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