What is syphilis?

Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum, a spirochaete bacterium. Other subspecies of the same bacterium cause bejel and yaws. It might be hard to notice syphilis symptoms at its early stages. The most accurate method to diagnose the disease is to get tested. STD rapid kit tests are ideal for diagnosing early syphilis in any of its four stages. It takes less than twenty minutes to diagnose syphilis alone at home and start treatment immediately. Treating syphilis requires antibiotics, and untreated syphilis might lead to life-threatening and irreversible complications. Syphilis might also affect your unborn child.  

How common is syphilis?

An estimated 115,045 adults received a definite diagnosis of syphilis in 2018 in the US. These were only the reported cases. Experts suggest that there are so many more unreported cases of syphilis. Interestingly, about 35,063 cases were primary and secondary syphilis, the two earliest stages of the disease. Most primary and secondary cases were among bisexual and gay men or generally men who have sex with men (MSM).

How can you get syphilis?

Syphilis is transmissible through person-to-person contact with syphilis' primary lesion, the syphilitic sore. You can get in contact with it without knowing it. It could present in areas that are impossible to detect, such as in the vagina or rectum. Also, it might form at places hard to notice, such as the scrotum or the foreskin of the penis. Therefore, you can get syphilis by vaginal, anal, or oral sex, but also through non-penetrative sex, such as frottage. Another way of syphilis transmission is through a pregnant woman to her unborn baby, leading to congenital syphilis. 

Congenital syphilis

Congenital syphilis is the result of maternal syphilis transmission to her baby. It can lead to miscarriage, stillbirth, premature baby, or preterm baby. Babies born with congenital syphilis might present with bone deformities, severe anemia, hepatomegaly, splenomegaly, and jaundice. Other more severe complications might include central nervous system disturbances and meningitis. However, early diagnosis can provide both the mother and the baby with treatment. 

What are the symptoms of syphilis?

Syphilis symptoms might look like signs of other diseases due to their high heterogeneity. Through the years, the condition took the nickname The Great Pretender because it looked like it could mimic so many other diseases, making it a quite challenging diagnosis. Therefore, it is almost impossible to diagnose syphilis without getting tested and only by relying on its symptomatology. The following are the four stages of syphilis, primary and secondary ones being the most contagious.  

Primary stage

The hallmark of this stage is the appearance of a single chancre. It is a firm, round, painless sore that signifies the entry point of the infection. In other words, it is where the bacterium Treponema pallidum entered your body. The entry point might be anywhere. It could appear in or around the genitals, anal area, or mouth. Regardless of being treated or not, the chancre lasts for 3 to 6 weeks and then heals by itself. If the infected individual does not get tested and receive treatment, he or she will pass on the secondary stage of syphilis. 

Secondary stage

The hallmark of this stage is skin rash and sores. The rash is typical and starts from the sternum towards the limbs, to finally involve the palms and soles. It appears as red, or reddish-brown spots and may mimic other dermatological conditions. Other times, you can barely notice it. It generally doesn't produce itchiness. Individuals at this stage may also develop condyloma lata in moist areas of the body, such as the mouth, armpits, or genitals. Other somatic symptoms may be:

  • Fever and muscle aches
  • Lymphadenopathy 
  • Sore throat 
  • Hair loss
  • Headache
  • Unexplained weight loss
  • Tiredness

Regardless of being treated or not, the rash heals by itself. If the infected individual does not get tested and receive treatment, he or she will pass on the latent stage of syphilis. 

Latent stage

Latent means that something is hidden or concealed. This stage of syphilis is dormant and gives the impression that nothing is wrong. It is an entirely asymptomatic period that may last for years. If the infected individual does not get tested and receive treatment, he or she will pass on the final and deadly stage of syphilis, known as tertiary syphilis. 

Tertiary syphilis

Tertiary syphilis is not prevalent. It may manifest itself years after the primary infection. If it does, it is usually deadly. It leads to multiple organ failure, such as the nervous system, heart, liver, lungs, etc. The symptoms are not specific but depend on the organ or system of organs insulted. 

What is neurosyphilis?

Neurosyphilis is when the infection invades the nervous system. It can take place at any stage of syphilis and may lead to many neurological disturbances. The most prevalent ones are headache, coordination disturbances, altered behavior, dementia, paralysis, or sensory disturbances. Similarly, you can get ocular syphilis anytime, as soon as the infection invades your eyes. It most commonly causes posterior uveitis and panuveitis. Visual symptoms and complaints include some of the following:

  • Altered vision
  • Decreased visual acuity
  • Irreversible blindness

Who should get tested?

Doctors suggest immediate testing in those with symptoms and signs of syphilis, or those who recently practiced protected or unprotected sex with a partner who has syphilis. However, some high-risk categories should get regular screening tests, regardless of having symptoms or not. These are pregnant women, MSM, HIV-positive, or exposed to HIV and receiving PrEP.

How to test for syphilis alone?

If you don't want to waste valuable time and start treatment right away, you can get tested for syphilis alone at home with an STD kit. All you have to do is buy it and follow the simple-written instructions. To perform the test, you have to follow some steps which include pinching your finger, and drawing some blood for testing. Make sure you read the instructions twice and follow them to the letter. You will have your results in less than twenty minutes. Keep in mind that kits arrive sealed to your place for your personal use. 

Can you get syphilis again?

You can get syphilis again, even if you received treatment for a previous infection. In contrast to viral diseases, such as the ones caused by HIV or HBV, that you can get only once in your life, you might get syphilis as many times as you come in contact with an infected chancre. Regardless of how many times you get syphilis and treat it, you can get it again all over the beginning. However, with appropriate treatment, syphilis does not recur. 

How to identify syphilis blisters