RESOURCES:STI's - Syphilis

Sexual Health Information

Click the following link for a brief video intro to Syphilis on video, suitable for showing to teenage students.

Follow this link for detailed medical guidlelinesGuidelines for the management of Syphilis from BASHH

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum. Primary syphilis presents as a small painless open sore after exposure to the bacteria. Although the lesion heals within 6 to 8 weeks, the untreated organism will continue to multiply unchecked, causing many complications. Infection may last for 30 years or more and result in severe neurological complications

Syphilis can be divided into stages - primary, secondary, latent and tertiary.

Primary stage

Between nine and 90 days after sexual contact, the person develops a small, reddish or brownish, button-like lump at the point of infection, the size of a pea. The lesion is commonly located on the penis, the anus or the vulva, or in the mouth. It is painless – so many people believe it's nothing serious. A few days later, the lump breaks down into a ‘chancre' – a painless ulcer. The chancre heals in 3 to 10 weeks, sometimes leaving a slight scar. But the bacteria stay in the body leading on to the ...

Secondary stage

Roughly two months after the original infection comes ‘secondary syphilis'.
The features of this can include: rashes, feeling generally unwell, fever, headache, greyish-white patches inside the mouth and sometimes in the genital area, swollen glands.

However, secondary syphilis can produce such a variety of symptoms that few doctors could diagnose it without blood tests. The secondary stage settles, and enters a latent phase of up to 10 years. Syphilis proceeds to the tertiary (third) stage.

Tertiary stage

Years after the original infection (between three years and 20 years, most commonly after 10 years), the syphilis attacks the brain, the heart, the blood vessels, the spinal cord, the skin, the liver and the bones. The characteristic in tertiary syphilis is the presence of "Gumma"

Syphilis used to be a common cause of mental illness, paralysis and death. Fortunately, most cases of syphilis are diagnosed and treated in the early stages.

Click on this link to see a video ofGumma - in brain tissue in tertiary syphilis under a microscope Diagnosis

Some health care providers can diagnose syphilis by examining material from a chancre using a dark-field microscope. If syphilis bacteria are present in the sore, they will show through the microscope.

A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe, and inexpensive blood test. A low level of antibodies will likely stay in the blood for months or years even after the disease has been successfully treated.

Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.

Treatment

Treatment with penicillin will always eradicate the bacteria, but cannot halt the damage caused in the latent phase. There are alternative anti-biotic treatments for people who can't tolerate penicillin.

Diagnosis and Treatment is most commonly carried out in a specially equipped clinic, where a full sexual history is taken in complete confidence, contacts are identified and safe sex advice is given for the future.

Syphilis and HIV

Genital sores (chancres) caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. Ulcerative STDs that cause sores, ulcers, or breaks in the skin or mucous membranes, such as syphilis, disrupt barriers that provide protection against infections. The genital ulcers caused by syphilis can bleed easily, and when they come into contact with oral and rectal mucosa during sex, increase the infectiousness of and susceptibility to HIV. Having other STDs is also an important predictor for becoming HIV infected because STDs are a marker for behaviors associated with HIV transmission.

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