Syphilis Causes, Symptoms and Treatment

The syphilis is a sexually transmitted infection (STI) caused by a bacterium called Treponema pallidum . It is initially manifested by the appearance of a painless ulceration in the penis, vagina or anus . If left untreated, syphilis can cause serious health problems , affecting the heart and brain.

Syphilis was a major cause of disability and mortality but has been much less common since the discovery of antibiotics in 1945. The disease is uncommon in Canada, but the number of people infected has increased significantly since 1997, suggesting that people do not protect themselves properly during sex . In 2006, close to 1,500 cases were reported in Canada. The most affected people are men aged 25 to 39 years .


Causes of Syphilis

Syphilis can be transmitted during oral, genital or anal sex with an infected partner . More rarely, it can be transmitted by the exchange of syringes or by a skin lesion. Finally, it can be transmitted from mother to child during pregnancy.

Possible complications

syphilis untreated can be very destructive and cause many complications such as internal or external lesions, cardiovascular disorders and mental health serious. It can, in some cases, lead to death .

Having syphilis also increases your chances of contracting HIV.

When to consult?

If you have had unprotected sex , or if you have ulcers, redness or pimples on your genitals, see your doctor for the appropriate screening tests.

Symptoms of syphilis

The syphilis has three stages and a latency period. The primary, secondary and early latent stages of syphilis are considered infectious. Each stage has different symptoms .

Primary stage

The first symptoms occur 3 to 90 days after infection, but usually 3 weeks.

  • At first, the infection takes on the appearance of a red button ;
  • Then the bacteria multiply and eventually create one or more painless ulcers at the site of infection, usually in the genital, anal or throat area. This ulcer is called syphilitic chancre. It may be visible on the penis, but easily hidden in the vagina or anus, especially since it is painless. Most infected persons develop only one chancre, but some develop more than one;
  • The wound eventually resolves itself in 1 or 2 months. If it has not been treated, it does not mean that the infection is cured.


Secondary stage

When left untreated, syphilis evolves. From 2 to 10 weeks after the onset of ulcers, the following symptoms occur:

  • Fever, fatigue, headache and muscle aches;
  • Hair loss (alopecia);
  • Redness and rash on the mucous membranes and skin, including on the palms and soles of the feet;
  • Inflammation of the ganglia ;
  • Inflammation of the uvea (uveitis), the vascularized portion of the eye, or retina (retinitis).

These symptoms may go away on their own but that does not mean that the infection is cured. They can also manifest themselves and reappear intermittently, for months or even years.

Latency period

After about 2 years, syphilis enters a state of latency, period when no symptoms appear. However, the infection can still develop. This period can last from 1 year to 30 years.

Tertiary stadium

If left untreated, 15-30% of those infected with syphilis will have very severe symptoms that may even in some cases lead to death :

  • Cardiovascular syphilis (inflammation of the aorta, aneurysm or aortic stenosis, etc.);
  • Neurological syphilis ( cerebrovascular accident , meningitis, deafness, visual disturbances, headache, vertigo, personality changes, dementia, etc.);
  • Congenital syphilis. The treponema is transmitted by the infected mother through the placenta and will lead to spontaneous abortions, neonatal deaths. Most affected newborns will have no symptoms at birth, but these will appear in the next 3-4 months;
  • Gum  : destruction of the tissues of any organ.

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People at risk for Syphilis

  • The men who have sex with men;
  • People who have unprotected sex ;
  • People who have multiple sexual partners
  • People with HIV or other STIs
  • The drug users who inject and their partners.


Why prevent?
Prevention aims to reduce the incidence of syphilis by preventing transmission of the bacteria.
Basic preventive measures
The proper use of condoms helps prevent the transmission of syphilis during anal or vaginal intercourse. The  condoms  or  dental dams  can also serve as means of protection during oral sex.


Screening measures
Routine screening for syphilis to the 1 st  pregnancy visit:

With the upsurge of syphilis in Canada, but also in the United States and Europe, routine screening is essential for all pregnant women.

Screening for unprotected sex

A screening test helps to prevent transmission of the infection to new partners. In the case of a positive result, you should notify anyone with whom you have had sex and who may have been exposed. This person will have to be screened and treated, if necessary.

Syphilis can be detected with a blood test.


Medical treatments of Syphilis

The syphilis is treated with antibiotics, usually penicillin , by intramuscular injection. In case of allergy to penicillin, other antibiotics are available.

If the infection has been less than 1 year old, it is possible that a single dose treatment is sufficient. New blood tests will be done following the treatment to check if the antibiotics have been effective. Immunosuppressed persons, especially those with HIV, may require longer-term treatment.

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