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Syphilis

What is syphilis?
Syphilis is a sexually transmitted infection (STI) caused by bacteria; untreated, the infection goes through four stages – the primary, secondary, latent and tertiary.

Transmission happens most readily when syphilis bacteria come in contact with a mucous membrane but it may also be transmitted through small breaks in the skin. Oral, anal or vaginal intercourse may spread the infection. Mothers infected with syphilis may pass the disease on to the fetus during pregnancy. Syphilis may be transmitted in the blood exchange that can happen during needle and syringe sharing; contact with the blood of an infected person may also transmit the infection.

How do I know if I have syphilis?
Symptoms usually appear from one to 12 weeks after exposure and vary by phase. The four stages of untreated syphilis are:

Primary: A small painless sore, called a chancre, appears. It’s usually found on or inside the genitals, anus or mouth but can appear elsewhere. It can look like a pimple, a blister or a wet ulcer. Because the sore is often hidden in folds of the labia or in the foreskin of the penis, many people don’t know they’re infected. Some people also have swollen lymph nodes in the groin; this is far more common in men than women. The primary stage of syphilis is the most infectious. The sore will heal without treatment in four to six weeks, but the bacteria remain and will continue to spread if untreated.

Secondary: This stage generally begins one week to six months after the primary stage ends, and may last from several weeks up to a year. After the chancre heals, the infection can spread throughout the entire body. Symptoms include lesions; a non-itchy body rash which may appear only on the palms of hands or soles of feet; mild fever; flu-like symptoms; headaches; and swollen glands. These may reoccur for several years.

Latent: There are no symptoms during this stage, which occurs two to more than 30 years after infection. Blood tests are needed to detect infection. One-third of cases will evolve to the final, or tertiary, stage.

Tertiary: This stage develops many months to years after the initial infection and takes on many forms. The infection attacks major organs such as the brain, heart, or nervous system, and can cause severe complications, such as blindness, heart disease, mental incapacity and death.

How is syphilis diagnosed?
Diagnosis includes a medical history, physical exam, microscopic exams and blood tests.

How is syphilis treated?
The recommended treatment is oral or injectable antibiotics; more than one course may be needed. It’s important to complete the full course of antibiotics, even after symptoms disappear, and to return to your health care provider for follow-up exam. To prevent reinfection, your sexual partners should be seen by a clinician, even if they have no symptoms.