What is syphilis?
Syphilis is an infection caused by the bacterium Treponema pallidum, which is spiral-shaped and has a flagellum that allows it to move by rotation, infecting tissues.
These characteristics allow it to easily enter the body through areas of broken skin or mucous membranes, which are naturally porous. The bacteria can then migrate to the bloodstream and other organs.
Syphilis infection can manifest itself through various symptoms and present in different stages (primary, secondary, latent, or tertiary syphilis).
As with many sexually transmitted infections (STIs), it is possible to be infected without realizing it.
Often, the initial sign of infection goes unnoticed and there may be periods without symptoms.
Often, the initial signs of infection go unnoticed and there may be periods without symptoms.
For this reason, testing and early diagnosis are important, not only to prevent transmission to others, but also to avoid the need for more aggressive treatments (which become essential in more advanced stages of the disease).
If you have sex with multiple partners and/or unprotected sex, it is advisable to get tested for STIs, including syphilis.
What are the symptoms of syphilis?
To know if you are infected with syphilis, you need to get tested.
Syphilis is a disease that leaves an immunological mark, meaning that once you are infected, even if you have been treated, rapid tests will always come back positive. Therefore, it is not an infection with an immediate diagnosis, and it must be correctly interpreted by an infectious disease specialist.
Ideally, a positive rapid test should be confirmed by laboratory tests to determine whether you are currently infected or whether it corresponds to a past infection.
The symptoms of syphilis are diverse and depend on the stage of the disease, ranging from the mildest – such as itching – to more serious diseases such as meningitis.
The severity of the infection means that it can attack one or more organs, and in people with HIV or other similar infections, the disease progresses more rapidly than in people with a healthy immune system.
Syphilis can occur in three stages with characteristic symptoms and varying degrees of severity. These stages are often interspersed with asymptomatic periods of apparent health.
Primary syphilis
When Treponema pallidum enters the body through sexual contact, they create a primary lesion at the site of inoculation. This wound appears as a painless ulcer and may therefore go unnoticed.
After an incubation period of about 3 to 4 weeks (which can, however, range from 1 to 12 weeks), primary syphilis appears.
The original site of infection, i.e., the place where the bacteria enter and multiply, then develops into a firm, round, painless lump. There may be a painless enlargement of the lymph nodes near the sore, but this stage usually goes unnoticed in most cases.
This painless sore can appear anywhere, but is most common in the following areas:
- In men: penis, anus, and rectum;
- In women: vulva, cervix, rectum, and perineum;
- Lips or oropharynx, in both sexes.
Usually, this lump heals and disappears spontaneously within 3 to 12 weeks, and the person then becomes asymptomatic. However, the disease can be passed on to others if the person has unprotected sex.
At this stage, the infected person should be tested, diagnosed, and treated to prevent the disease from progressing.
Without treatment, and despite the disappearance of the lump, the disease progresses because the bacteria that develop at the site of inoculation migrate into the bloodstream.
Secondary syphilis
Secondary syphilis appears a few weeks or months after infection.
At this stage, symptoms include skin irritations, which can cause itching, especially on the palms of the hands and soles of the feet, manifesting physically as rough, reddish-brown spots. In addition to these, lesions appear on the mucous membranes such as the mouth, vagina, and anus.
The lymph nodes become swollen and fever and general malaise may occur.
However, these symptoms may be mild and go unnoticed.
Tertiary syphilis
Tertiary or latent syphilis appears 10 to 30 years after infection.
If left untreated, the syphilis bacteria remain in the body, but without apparent signs or symptoms.
Not everyone develops tertiary syphilis, but when it does appear, this stage is associated with severe and potentially fatal symptoms, affecting vital organs such as the heart, brain, or liver.
The most common symptoms include severe headache, motor problems, dementia, and paralysis.
How can you become infected?
Syphilis is transmitted and enters the body when there is:
- Direct contact with a syphilitic sore;
- Unprotected sex (vaginal, oral, or anal);
- During pregnancy or childbirth (from mother to child).
How can you avoid it?
Like most infections, you can prevent syphilis infection by consistently using condoms in all sexual practices. Remember that, unlike HIV, syphilis is highly infectious, even during oral sex.
How to treat syphilis?
Syphilis should be treated with antibiotics.
However, even with treatment, when the damage is extensive, it is not possible to reverse the effects—for this reason, early diagnosis and immediate treatment are essential.
