What Is Syphilis?

What Is Syphilis?

Syphilis, as it is commonly known, is a sexually transmitted infection caused by a bacterium called Treponema pallidum. It can be easily transmitted by contact with the sores caused by the disease. When not treated correctly, it leads to serious health problems.

Routes of Transmission

Syphilis is transmitted by direct contact with the sores (chancres) of a person who has the disease. These sores may appear on the external genital organs, vagina, anus, rectum, mouth and lips. Like other sexually transmitted infections, it is transmitted through vaginal, oral and anal contact. It can also be passed from mother to baby during pregnancy and birth.

Ways of Prevention

If you are going to have sexual intercourse, you must use protective methods.

1. Use a condom before every type of sexual intercourse (vaginal, oral and anal). Take care that the condom does not tear and that it is used correctly.
2. Talk to your partner about sexually transmitted infections.
3. Mutual monogamy reduces the risk.
4. If your partner has symptoms of a sexually transmitted infection (sores that indicate syphilis, pain during urination, redness or warts in the genital area), avoid sexual intercourse until they have been treated.

Symptoms of Syphilis

The symptoms of syphilis appear in three stages, and the symptoms are mild at first. The signs may disappear in between, and the patient may think they have recovered.

Because the symptoms of the disease mimic other diseases, syphilis is called "the great imitator" in some cultures.

In the 1st stage of syphilis , that is, about 3 weeks after contact, a smooth-edged, painless, red lesion (chancre) typically forms around the genital organ where the bacterium was first transmitted. These lesions are often accompanied by a palpable lymph node in the area. In about 30% of patients, unusually, the lesions can be painful. If left untreated, the lesions disappear after about 3-6 weeks. The patient thinks they have recovered, but the bacteria multiply and spread throughout the body.

The 2nd stage of syphilis  classically appears 6-10 weeks after the first stage, though it may not occur in some patients. Flu-like symptoms are seen in this stage:

1. Fever
2. Fatigue
3. Muscle aches
4. Sore throat

The most typical finding is a non-itchy skin rash that often involves the palms and soles; widespread swelling of the lymph nodes may be seen.

After this stage, the disease enters the latent (dormant) stage. It causes no complaints in the patient, but the presence of the disease can be detected by blood tests.

The 3rd stage of syphilis appears about 3-15 years after the first stage. The 3rd stage of syphilis can present in 3 different forms;

Gummatous Syphilis 

In this form, soft, large, tumor-like lesions called gummas can appear on the skin, in the bones and even in some internal organs.

Neurosyphilis

In this form, the disease affects the nervous system. It causes paralysis, loss of sensation, dementia, psychiatric problems and eye problems.

Cardiovascular Syphilis

This form involves the aorta, the main vessel that carries blood from the heart to the body, and leads to aortic aneurysms. The 3rd stage of syphilis can be fatal. If a pregnant woman has syphilis, the risk of premature birth, and of deformity and death in the baby, is very high.

Diagnosis of Syphilis

For the diagnosis of syphilis, a blood test is performed and a fluid sample is taken from the sore called a chancre. In the very early period, blood tests may be negative; if suspicion persists, the test should be repeated after 2-3 weeks. If syphilis is very advanced, cerebrospinal fluid is collected to check whether it has spread to the central nervous system.

If syphilis is suspected, because there is also a risk of having other sexually transmitted infections, screening for chlamydia, gonorrhea and HIV is also performed with this blood test. The person is advised not to have sexual intercourse until the test results are available. Syphilis is diagnosed with blood tests (TPHA/TPPA/EIA and RPR/VDRL); when there is no sore, a negative PCR does not rule out syphilis.

Treatment of Syphilis

Syphilis treatment is carried out with antibiotics after diagnosis by blood tests. The correct use of antibiotics is important in treatment, but treatment does not undo the damage caused by the infection. That is, other treatments may be needed for the complications of syphilis.

To get rid of the infection, make sure you take all your antibiotics as your doctor advises; otherwise, the bacterium may become resistant to antibiotic treatment. Penicillin is the preferred antibiotic for syphilis, so if you know you are allergic to penicillin, be sure to tell your doctor.

If you have syphilis, your partners also need to be treated. Having had syphilis does not provide protection against the disease. Even if a successful and correct treatment is given, a person can get syphilis again in the future.