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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Syphilis

What is it?

Syphilis, a bacterial infection, is a highly contagious sexually transmitted disease.Once infection occurs, the bacteria travel quickly through the bloodstream and lymphatic system of the infected person and produce a wide variety of symptoms. If not treated, syphilis progresses through three main stages: primary (three to four weeks after infection), secondary (four to eight weeks later), and tertiary (one to 30 years after infection). Incidence of primary syphilis in the United States has declined steadily. The skin lesions of both primary and secondary syphilis heal spontaneously over a period of several weeks to months. The secondary and tertiary stages are separated by a latent period during which the patient displays no symptoms and appears healthy. Latency usually lasts for years—often for a lifetime. A person infected with syphilis is extremely contagious during the primary and secondary stages, but not during the latent and tertiary phases. Adequate treatment with antibiotics during the primary or secondary stages cures the infection. Untreated syphilis that progresses to the tertiary stage may damage tissue in the heart, brain, spinal cord, eyes, and other organs, and can be fatal. Although tertiary symptoms appear in only about 30 percent of untreated patients, by the time these symptoms develop, tissue destruction is widespread, and antibiotic treatment is no longer effective. Therefore, early detection and treatment of syphilis are crucial.

What Causes It?

  • Infection by the Treponema pallidum bacterium causes syphilis.
  • Syphilis is spread by sexual contact, including vaginal, oral, and anal intercourse. Those with multiple sexual partners are at higher risk.
  • Syphilis has been strongly associated with drug use, especially crack cocaine.
  • Infected pregnant women may transfer syphilis to the fetus.
  • Persons with syphilis are at substantially increased risk for HIV infection.

Prevention

  • Use latex condoms during sexual intercourse to reduce the risk of transmission. A mutually monogamous relationship is safest.

Diagnosis

  • Patient history and physical examination.
  • Blood tests for antibodies against the bacteria.
  • Microscopic examination of fluid from lesions.
  • Lumbar puncture (spinal tap) can diagnose late central nervous system involvement (neurosyphilis).

How to Treat It

  • Intramuscular injections of penicillin can cure primary or secondary syphilis.Other antibiotics are used in people allergic to penicillin. Sexual partners should be treated as well.
  • To prevent the spread of the syphilis, avoid sexual intercourse during treatment and until at least two follow- up examinations show no evidence of infection.

When to Call a Doctor

  • Call a doctor if you or your sexual partner develops a painless sore on the mouth or genital area.
  • Call a doctor if you have had sexual contact with someone you suspect may have syphilis.