Syphilis: Causes, Symptoms & Treatments

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Syphilis is a sexually transmitted infection that can cause serious health problems if it is not treated. Singapore Government reported an average of 1500 syphilis cases yearly in the last five years. The rise of dating mobile applications and social media allows people to hook up and have casual sex. In addition, advances in medicine made people less afraid of contracting the human immunodeficiency virus (HIV), leading to less protection during sex.

Syphilis: Causes, Symptoms & Treatments
Syphilis: Causes, Symptoms & Treatments

What is Syphilis?

Syphilis is a sexually transmitted infection caused by a type of bacteria known as Treponema pallidum.
It can be challenging to diagnose. Someone can have it without showing any symptoms for years. However, the earlier syphilis is discovered, the better. In addition, syphilis that remains untreated for a long time can cause major damage to important organs, like the heart and brain.
In Singapore, it is a notifiable disease under the Infectious Diseases Act. According to press Todayonline, from 2014 to 2018, MOH reported an average of about 1,500 syphilis cases yearly here.

What are the signs and symptoms?

Symptoms of syphilis in adults vary by stage. The four stages, which are:

  • Primary stage
  • Secondary
  • Latent
  • Tertiary

Primary syphilis

During the first stage, you may notice small, round sores called chancres. Sores are painless, so they easily go unnoticed. On average, the sore shows up around three weeks after infection, but it can take between 10 and 90 days to appear. The sore lasts 3 to 6 weeks and heals regardless of whether or not you receive treatment.

Syphilis is transmitted by direct contact with a sore. This usually occurs during sexual activity, including oral sex.

Secondary syphilis

During the second stage of syphilis, skin rashes and/or mucous membrane lesions may develop. Mucous membrane lesions are 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.

Other symptoms of the secondary stage may include:

  • Headaches
  • Swollen lymph glands
  • Fatigue
  • Fever
  • Weight loss
  • Hair loss
  • Aching joints

These symptoms will go away when you receive the right treatment. However, without treatment, your infection will move to the third stage, the latent.

Latent syphilis

There are no visible signs or symptoms of syphilis during the third stage of syphilis. The primary and secondary symptoms disappear, and there won’t be any noticeable symptoms at this stage. If you do not receive treatment, you can continue to have syphilis in your body for years without any signs or symptoms.

Tertiary syphilis

Most people with untreated syphilis do not develop the tertiary stage. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. When you do not receive treatment, you may enter this stage. The disease will damage your internal organs and can result in death. Other potential outcomes include:

  • Mental illness
  • Memory loss
  • Heart disease
  • Destruction of soft tissue and bone
  • Blindness
  • Deafness
  • Neurosyphilis is an infection of the brain or spinal cord

What is the treatment?

Treatment for syphilis can be successful, particularly in the early stages. Penicillin is one of the most widely used antibiotics and is usually effective in treating syphilis. People who are allergic to penicillin will likely be treated with a different antibiotic, such as:

  • Doxycycline
  • Azithromycin
  • Ceftriaxone

Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done. During treatment, you must abstain from sexual contact with new partners until the syphilis sores are completely healed. If you are sexually active, your partners need to test and receive treatment if necessary.

Having syphilis once does not protect you from getting it again. Even after you’ve been successfully treated, you can still be re-infected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your health care provider is recommended to make sure that your treatment was successful.

When should I test for syphilis?

A blood test is used to test for syphilis. Some health care providers will diagnose syphilis by testing fluid from a syphilis sore. You need to get tested if you:

  • have had condomless sex with someone who might have had syphilis
  • are pregnant
  • Be a sex worker
  • In prison
  • have had condomless sex with multiple people
  • have a partner who has had condomless sex with multiple people
  • are a man who has sex with men

You can use Telemedicine, which is known as consulting doctor online, at the MaNaDr application. Using MaNaDr, you can stay at home to consult a doctor online and receive care remotely without the need to get out of the house.

Consult a doctor online to get the best treatment


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