Syphilis is a sexually transmitted disease caused by a bacterial infection , or in some cases, it can be transmitted from mother to child during pregnancy or during childbirth. Most of the symptoms are related to the skin, such as sores or rashes, and often result in sores around the genitals.
Syphilis is a disease that can occur in both males and females. If the infected person, whether in infants or adults, does not receive proper treatment from a doctor, the bacteria can spread to other organs of the body, resulting in serious complications or even death.
Symptoms of syphilis
Syphilis can be divided into three stages, each with different symptoms as follows:
Stage 1 (Early/Primary Syphilis)
In the first stage, patients will start to develop small sores in the infected area for about 3 weeks or no more than 10–90 days, especially on the genitals and lips, without any associated pain or soreness.
The edges of the wound are smooth and hard, or called a chancre . The symptoms usually go away on their own within about 6 weeks even without treatment.
Stage 2 (Secondary Stage)
During this stage, patients will start to develop a rash that looks like a wart on the palms and soles of the feet, genitals, or other parts of the body such as the groin, anus, inside the mouth, but there is no itching of the skin. Some people may have a sore throat, white patches in the mouth, fever, swollen lymph nodes, fatigue, weight loss, hair loss. But these symptoms usually go away even without treatment.
Latent Syphilis
This is a period when there are few symptoms of the disease, but the patient still has the virus in their body and can be detected in blood tests. This period can last for years before progressing to the final stage.
Stage 3 (Tertiary Syphilis)
At this stage, the infection will start to cause abnormalities and complications in the heart, brain, nerves, or various organs of the body, depending on where the infection has spread. This will lead to various diseases such as paralysis, blindness, dementia , deafness, impotence, heart disease, insanity, and risk of death.
Although early symptoms of the disease often appear and disappear, and late symptoms are rarely asymptomatic, the virus is still present in the body. People who have signs of the disease need to receive proper treatment before the disease develops and becomes severe and affects other systems in the body.
Causes of syphilis
Syphilis is caused by infection with the bacteria Treponema Pallidum. It occurs through direct contact with the sores of an infected person, especially during sexual intercourse. In some cases, it can occur when an infected pregnant woman passes the infection to her fetus or during birth, through sharing needles with others, or through receiving blood from others.
During stages 1-2 of infection, it is most easily spread to others. However, sharing contaminated items does not always result in the spread of infection, such as using the bathroom, wearing clothes, or sharing utensils. However, if the skin that has come into contact with the infection has a wound, infection may occur.
Diagnosis of syphilis
To diagnose syphilis, the doctor will ask general questions such as symptoms, medical history, sexual behavior, and perform a preliminary physical examination. The doctor or nurse will examine the genitals or other parts of the body for any sores or abnormalities that may be caused by syphilis.
Then, if the doctor thinks that the person being tested has a possibility of having syphilis, the doctor will order additional laboratory tests. The laboratory tests that are often used for diagnosis include:
- Blood tests, which may be a VDRL test to measure antibody levels or a test to look for syphilis directly . In some cases where the test results show infection, a repeat test may be needed to help confirm the infection.
- Swab Test: In cases where the patient has a wound or rash on the body, the doctor may collect a sample of the skin or lymph from the wound for laboratory testing to find the bacteria that cause syphilis.
This is because in some stages, there may be no symptoms until the disease reaches its final stage. Therefore, diagnosis must also take into account the stage of the disease. The doctor may order laboratory tests according to the stage of the disease that the patient has. For example, the doctor may perform a spinal tap/lumbar puncture in cases where the patient has neurological symptoms but no other symptoms of the disease are found.
Treatment of syphilis
Syphilis can be treated with antibiotics in the Penicillin group . During treatment, patients should abstain from sexual intercourse to help prevent the spread of the disease or prevent the disease from recurring if infected by another person. They should also recommend that their sexual partners come for examination as well.
In Thailand, most of the treatments are penicillin G, which can be further divided into several types, such as Benzathine Penicillin G and Aqueous Penicillin G, which the doctor will inject into the patient based on how long the illness has been.
- For patients in stages 1–2, 2.4 million units of benzathine penicillin G will be injected intramuscularly once.
- In patients with latent or stage 3 infection, 2.4 million units of benzathine penicillin G are injected intramuscularly once a week for 3 weeks.
- If syphilis has spread to the brain (neurosyphilis), the doctor will inject benzathine penicillin G intramuscularly 18–24 million units per day, divided into 3–4 million units every 4 hours for 10–14 days, or inject procaine penicillin 2.4 million units intramuscularly once a day, along with taking probenecid 500 mgfour times a day for 10–14 days.
- For patients allergic to penicillin, there is no definite replacement drug. Doxycycline 100 mg twice daily may be taken together with tetracycline500 mg four times daily for 14 days or ceftriaxone 1–2 g intramuscularly for 10–14 days.
Patients with a history of drug allergies should inform their doctor so that the medication can be evaluated and adjusted by an infectious disease specialist.
However , drug treatment may cause side effects in some patients, such as fever, dizziness, muscle or joint pain. However, these symptoms will gradually ease over a short period of time. Sometimes, the doctor may prescribe Paracetamol to help relieve symptoms.
Complications of syphilis
If patients do not receive continuous treatment to be cured, the symptoms of the disease that have entered the final stage may become more severe when the infection spreads to various systems of the body, such as paralysis, heart disease, blindness , dementia, impotence, insanity, deafness, and there is a risk of death.
In pregnant women, there is a risk of miscarriage or death of the baby during birth, including the baby may have congenital syphilis if the infection is passed from mother to baby, resulting in abnormalities in many organs within a few weeks after birth, such as bones, eyes, teeth, brain, hearing.
In addition, people with syphilis may be more at risk of contracting HIV through sores on their bodies than people without syphilis.
Syphilis prevention
The best way to prevent syphilis is to reduce your risk of contracting the infection, especially through sexual contact, by avoiding sex with people who have the disease and not having multiple sexual partners.
In addition, condoms should be used for protection during every sexual encounter , including oral sex. In some cases, the virus can be transmitted through the use of needles for injection, so sharing these items with others should be avoided.
Pregnant women should have a blood test to screen for the disease between the 8th and 12th weeks of pregnancy to prevent transmission to the baby and to better plan treatment if infection is detected.
