Syphillis

What is Syphillis?

Syphilis is caused by the bacteria T. pallidum, a spiral shaped organism that moves throughout the body by splitting in two about once every day. The disease begins with a chancre which normally forms on the genital area. If untreated, this chancre will heal but the disease will progress possibly causing many complications- and in some instances death. Syphilis can now be effectively treated with penicillin or other antibiotics (for those allergic to penicillin). The widespread use of antibiotics has reduced the prevalence of syphilis significantly.

What are the symptoms of Syphillis?

Symptoms of syphilis undergo several stages of development. Throughout these stages, the symptoms felt by the patient vary.

The Primary Stage

This first stage of syphilis is characterized by a lesion (or chancre) which normally forms around the genital region. In about half of the cases reported the lesion has a raised, firm red border. The chancre is generally a dark pink color and does not bleed easily. It must be stressed that the appearance of this chancre can vary greatly. Furthermore, it is not necessarily a single lesion; multiple lesions may exist but are less common. If the lesion is untreated, it may heal on its own. However, without the attention of a physician the disease will progress.

The Secondary Stage

Once the primary lesion has healed, new symptoms will affect the patient. Secondary lesions are likely to form. These lesions are normally on the palms of the hands and the soles of the feet but it is possible for them to form in other areas as well. Other symptoms include a sore throat, low-grade fever, headache and a rash. The appearance and location of the rash is highly variable; it does not itch and is not uncomfortable. If left untreated, the secondary lesions will heal and all other symptoms will disappear; this indicates that the disease has evolved into latent syphilis.

Latent Syphillis

This third stage of syphilis usually begins from 6 months to 2 years after the initial infection. About 25% of patients may experience a return of some the secondary symptoms. Yet in most cases, the latent stage is asymptomatic. Many may assume that the disease has cured itself and it is therefore sometimes left untreated. Latent syphilis may stay with the patient for life or late syphilis may appear within 2 years of the initial infection.

Late Syphillis (also referred to as Tertiary Syphillis

Late syphilis may emerge in any area of the body as late as 30 to 50 years following the initial infection. Around 35% of those who are left untreated will contract late syphilis. Late syphilis may take the forms of late benign syphilis, cardiovascular syphilis and neurosyphilitic disease. A patient may have one or a combination of these forms. The mortality rate for all patients with untreated syphilis is approximately 25%. Although the majority of patients who are left untreated will not develop late syphilis, there is no way to diagnose which patients are at risk.

Tertiary Benign or Late Benign Syphilis

Late syphilis is an extremely rare disease in Canada and the United States. Late benign syphilis is the most common form of late syphilis which normally appears 3 to 7 years after initial exposure. Harmful ulcers (called gummas) typically form on or in the affected organs. It may affect the skin, liver, digestive tract, muscles, eyes and endocrine organs. The term "benign" indicates that the ulcers rarely cause physical impairment or death. If a proper treatment by a physician is followed, the gummas will heal and the patient will recover in most cases.

Cardiovascular Syphilis

Cardiovascular syphilis is a relatively rare form of syphilis which affects about 10% of all treated patients after 10 to 40 years of untreated syphilis. This form of syphilis results in damage to the heart and major blood vessels, and is therefore often fatal.

Neurosyphilitic Disease

Under 10% of all untreated patients will be affected by neurosyphilitc disease. The central nervous system is adversely affected which generally results in paralysis and/or paresis (insanity).

How is it contracted?

Syphilis can be transmitted to another person during kissing, anal and vaginal intercourse and oral-genital contact. It can enter the body by penetrating the mucous membranes or any small cracks in the skin. Another mode of transmission is to the fetus when the mother is infected with the disease. Syphilis does not survive well outside the body so that non-sexual contractions of the disease are uncommon. Use of a latex condom and dental dam will significantly reduce the risk of contracting syphilis.

How is it treated?

Syphilis is effectively treated with antibiotics, penicillin the most common. Those who cannot take penicillin will most likely be administered safer variants of penicillin. See your physician for details about which treatment is right for you.