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What is Syphilis? | What are the Symptoms of Syphilis?

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This week with Dr. Dominic Rowley, we are discussing syphilis and the resurgence of the infection in recent years. See below for an overview of points covered in this video. For more information please navigate to: https://www.letsgetchecked.com/gb/en/sexual-health/sti-testing?utm_source=youtube&utm_medium=video&utm_campaign=Rowley_Videos_YT&utm_term=Syphilis%20YT%20video%201&utm_content=video%20description 0:19 - What is syphilis? 0:32 - How is syphilis transmitted?

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AFP Journal

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 2003 Jul 15;68(2):297.

What is syphilis?

Syphilis (say: sif-ih-liss) is a sexually transmitted disease (STD) caused by a bacterium named Treponema pallidum. (say: Trep-oh-nee-mah pal-lih-dum). If syphilis is not treated, it can cause serious problems. The good news is that syphilis usually can be cured with penicillin or another antibiotic.

What are the stages and signs of syphilis?

Syphilis has four stages, depending on how long a person has had the disease. Each stage can have different signs.

Primary syphilis is the first stage. If you were infected recently, you may have a painless sore at the opening to your vagina or on your penis. This sore is called a chancre (say: shan-ker). Usually there is only one chancre, but there can be more.

If primary syphilis is not treated, it turns into secondary syphilis. You may have flu-like symptoms and a rash on your entire body. You may have skin sores called condyloma latum (say: kon-dih-low-mah lah-tum). These warty sores usually develop near your vagina or penis, or near your rectum. You also may have problems with your liver, kidneys, and other organs.

The next stage is latent syphilis. In this stage, you have no signs of syphilis, but blood tests show that you are still infected.

Late syphilis is untreated syphilis that has been present for many years. If you have late syphilis, you may develop gummas (say: gum-mahs). These are rubbery sores on your skin or on organs inside your body. You also can have problems with your heart and blood vessels. One of the most serious problems that can happen is a brain infection called neurosyphilis. This infection can cause abnormal hearing, vision, or thinking, and death.

How is syphilis diagnosed?

If you have a skin sore, scrapings from the sore may be looked at under a microscope.

More often, doctors rely on blood tests. Several blood tests are needed to be sure that syphilis is present.

A spinal tap is done if there is concern that syphilis has spread to your brain. For this test, fluid is taken from around your spinal cord and tested for signs of neurosyphilis.

How is syphilis treated?

Syphilis usually can be cured with penicillin. If you are allergic to penicillin, you might be treated with another type of antibiotic.

What else should I think about if I have syphilis?

Because syphilis is an STD, it is important for all your sexual partners to be tested and treated. It is also important to talk to your doctor about being tested for other STDs. Talk to your doctor about how-and when-to safely resume sexual activity.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

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AFP Journal Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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What is syphilis?

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms.

How is syphilis spread?

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.

Syphilis can spread from a mother with syphilis to her unborn baby.

You cannot get syphilis through casual contact with objects, such as:

toilet seats

doorknobs

swimming pools

hot tubs

bathtubs

sharing clothing, or eating utensils

How can I reduce my risk of getting syphilis?

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have syphilis.

Using condoms the right way every time you have sex.

Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Am I at risk for syphilis?

Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with a partner who has syphilis. If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for syphilis or other STDs.

You should get tested regularly for syphilis if you are sexually active and

are a gay or bisexual man;

have HIV;

are taking pre-exposure prophylaxis (PrEP) for HIV prevention; or

have partner(s) who have tested positive for syphilis.

All pregnant people should receive syphilis testing at their first prenatal visit. Some pregnant people need to receive syphilis testing again during the third trimester at 28 weeks and at delivery.

I'm pregnant. How does syphilis affect my baby?

If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should receive syphilis testing at least once during your pregnancy. Receive treatment right away if you test positive.

At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems within a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and can die.

What are the signs and symptoms of syphilis?

There are four stages of syphilis (primary, secondary, latent, and tertiary). Each stage has different signs and symptoms.

Primary Stage

During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the

Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

Secondary Stage

During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look

The rash usually won't itch, and it is sometimes so faint that you won't notice it. Other symptoms may include:

fever;

swollen lymph glands;

sore throat;

patchy hair loss;

headaches;

weight loss;

muscle aches; and

fatigue (feeling very tired).

The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

Latent Stage

The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

Tertiary Stage

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10-30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.

Neurosyphilis, Ocular Syphilis, and Otosyphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

Signs and symptoms of neurosyphilis can include:

severe headache;

muscle weakness and/or trouble with muscle movements; and

changes to your mental state (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, and/or decision making).

Signs and symptoms of ocular syphilis can include:

eye pain and/or redness; and

changes in your vision or even blindness.

Signs and symptoms of otosyphilis may include:

hearing loss;

ringing, buzzing, roaring, or hissing in the ears ("tinnitus"); and

dizziness or vertigo (feeling like you or your surroundings are moving or spinning).

How will I or my healthcare providers know if I have syphilis?

Most of the time, healthcare providers will use a blood test to test for syphilis. Some will diagnose syphilis by testing fluid from a syphilis sore.

Is there a cure for syphilis?

Yes, syphilis is curable with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection can cause.

Can I get syphilis again, after receiving treatment?

Having syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is necessary to make sure your treatment was successful.

It may not be obvious that a sex partner has syphilis. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis, can be hard to see. You may get syphilis again, if your sex partner(s) does not receive testing and treatment.

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Syphilis Fact Sheet from CDC. What is syphilis? How common is syphilis? How do people get syphilis? And more...

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You don't hear about syphilis outbreaks anymore. It's sad to hear about cases of syphilis because they are preventable. If you are going to have sex, just practice safe sex.

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WISCONSIN (CBS 58) -- The Wisconsin Department of Health Services is urging pregnant women in Milwaukee to get screened for syphilis.

It's a shocking statistic -- the number of people diagnosed with syphilis in the city has increased nearly 300% compared to pre-pandemic levels.

Syphilis is a sexually transmitted infection that, if left untreated, can affect your heart and blood vessels.

Infected mothers can also pass the infection on to their babies, which health officials say can be fatal.

DHS says per CDC guidelines, pregnant people who live in areas where there are higher rates of syphilis should be screened at least twice during pregnancy, once in the first trimester and again during the third trimester.

DHS recommends repeat third trimester testing in Brown, Dane, Milwaukee, Racine, Waukesha, and Winnebago counties.

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racine news; kenosha news; washington news; sheboygan news; waukesha news; ozaukee news; walworth news; milwaukee news;  milwaukee weather; sports; traffic; brewers;  bucks; packers; telemundo

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Syphilis cases up 300% in city of Milwaukee

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WISCONSIN (CBS 58) -- The Wisconsin Department of Health Services is urging pregnant women in Milwaukee to get screened for syphilis. It's a shocking statistic -- the number of people diagnosed with syphilis in the city has increased nearly 300% compared to pre-pandemic levels.

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Partner notification is very important in reducing transmission of Syphilis. This study is interesting on different ways to notify those who have been exposed. When working in a clinic, there are two ways to report an STI.
1. Notify patient by phone of an abnormal lab result.
2. Report the abnormal lab result to the county health department where the patient resides.

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The number one way to prevent Syphilis is to abstain from any types of sexual activity.

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If you are going to have sex, practice safe sex!

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It is suggested that if you test positive for syphilis that you get tested for HIV also. Penicillin is the number one treatment. But if allergic to penicillin, Doxycycline can be used.

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The recommended treatment for syphilis is the antibiotic penicillin, specifically the type known as penicillin G benzathine, sold as Bicillin L-A in the United States.

Penicillin has proven to be effective at killing Treponema pallidum, the bacterium that causes syphilis.

The cost of penicillin G benzathine varies. Most health insurance will cover it, with a possible copay depending on your plan. If you don't have insurance, you may pay anywhere from $15 to $50 or more for the medication.

You should abstain from sexual contact until your treatment is completed and blood tests have confirmed that the infection is cured.

Your doctor may also recommend that you be tested for HIV, since having syphilis puts you at increased risk for this infection.

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Syphilis Treatment - Allergy, Reactions, Penicillin Antibiotics, and Alternatives | Everyday Health

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The recommended treatment for syphilis is the antibiotic penicillin, specifically the type known as penicillin G benzathine, sold as Bicillin L-A in the United States. Penicillin has proven to be effective at killing Treponema pallidum, the bacterium that causes syphilis. The cost of penicillin G benzathine varies.

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Even after treatment, you will still have antibodies in your system and still have a positive blood test. It is best to notify your doctor that you were treated, when you were treated, and how many doses were required for treatment

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A rapid plasma reagin (RPR) test is a blood test used to screen you for syphilis. It works by detecting the nonspecific antibodies that your body produces while fighting the infection.

Syphilis is a sexually transmitted infection (STI) caused by the spirochete bacterium Treponema pallidum. It can be fatal if left untreated.

Combined with specific antibody testing, the RPR test allows your doctor to confirm the diagnosis of active infection and start your treatment. This reduces the chances of complications and the spread of the disease by an infected but unaware person.

Your doctor may order an RPR test for several reasons. It's a quick way to screen those at high risk for syphilis. Your doctor may also order this test if you have syphilis-like sores or a rash. Doctors also routinely screen pregnant women for syphilis using an RPR test.

States used to require that people who are applying for a marriage certificate get a screening test for syphilis. The only state that still requires a blood test of any type is Montana, and a syphilis test is no longer included.

The RPR test measures antibodies that are present in the blood of someone who has syphilis, rather than the bacterium that causes the disease. It can also be used to check the progress of treatment for active syphilis. After a course of effective antibiotic therapy, your doctor would expect to see the number of antibodies drop, and an RPR test could confirm this.

Doctors obtain blood for the RPR test with a simple procedure called a venipuncture. This can be done in your doctor's office or a lab. You don't need to fast or take any other special measures before this test. The test involves the following steps:

1. A healthcare provider will ask you to sit in a comfortable chair or lie down on a cot or a gurney.

2. They then tie rubber tubing around your upper arm to help make your veins stand out. When they find your vein, they will swab the spot with rubbing alcohol to cleanse it and insert a needle into the vein. The needle may produce a sudden, sharp pain, but it typically doesn't last long.

3. Once they have the blood sample, they'll remove the needle from your vein, hold pressure on the puncture site for a few seconds, and offer you a bandage.

Venipuncture is minimally invasive and carries very few risks. Some people complain of soreness, bleeding, or bruising after the test. You can apply an ice pack to the puncture wound to help relieve these symptoms.

Some people may become light-headed or dizzy during the test. Tell the healthcare provider if your dizziness lasts longer than a few minutes.

A normal RPR blood sample shows no antibodies typically produced during an infection. However, your doctor cannot completely rule out syphilis if they see no antibodies.

Once you've been infected, it takes some time for your immune system to create antibodies. Shortly after infection, a test may not yet show any antibodies. This is known as a false negative.

False negatives tend to be more common in the initial and end stages of infection. Among people who are in the secondary (middle) stage of infection, the RPR test result is nearly always positive.

The RPR test also can produce false-positive results, suggesting you have syphilis when you actually don't. One reason for a false positive is the presence of another disease that produces antibodies similar to the ones produced during a syphilis infection. A few of the conditions that can cause a false positive include the following:

If your result is negative, your doctor may ask you to wait a few weeks and then return for another test if you're at a higher risk for syphilis. This is because of the RPR test's potential for a false negative.

Due to the risk of false-positive results, your doctor will confirm the presence of syphilis with a second test, one that is specific for antibodies against the bacterium that causes syphilis, before starting your treatment. One such test is called the fluorescent treponemal antibody-absorption (FTA-ABS) test.

Your doctor will start you on antibiotic treatment, usually penicillin injected into the muscle, if your RPR and FTA-ABS test both show signs of syphilis. New infection usually responds to treatment quickly.

At the end of treatment, your doctor will most likely recommend that you get another RPR test to make sure your antibody levels are dropping.

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rpr test purpose procedure and test results

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A rapid plasma reagin (RPR) test is a blood test used to screen you for syphilis. It works by detecting the nonspecific antibodies that your body produces while fighting the infection. Syphilis is a sexually transmitted infection (STI) caused by the spirochete bacterium Treponema pallidum. It can be fatal if left untreated.