Syphilis: Causes, Symptoms, Diagnosis, and Treatment
Introduction
Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It remains a global public health concern due to its potential for serious complications if left untreated, including damage to the brain, heart, and other organs. The disease progresses in distinct stages, each with characteristic signs and symptoms.
Causes and Transmission
Syphilis is primarily transmitted through direct contact with syphilitic sores (chancres) during vaginal, anal, or oral sex. It can also be passed from mother to child during pregnancy or childbirth, leading to congenital syphilis, which can be life-threatening for the newborn. Less commonly, it can spread through blood transfusions if proper screening is not performed.
Stages and Symptoms
The disease progresses in four main stages:
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Primary Syphilis
The first stage begins with a painless sore at the site of infection, usually on the genitals, anus, or mouth. The sore appears about 3 weeks after exposure and heals within 3–6 weeks without treatment. -
Secondary Syphilis
Weeks to months later, symptoms may include skin rashes, mucous membrane lesions, fever, swollen lymph nodes, sore throat, and fatigue. These symptoms may resolve without treatment, but the infection remains in the body. -
Latent Syphilis
This stage has no visible symptoms. The infection can remain dormant for years, but the bacteria remain active. -
Tertiary Syphilis
If untreated, syphilis can progress to this severe stage years later, causing damage to the heart, brain, nerves, eyes, and bones. It can lead to paralysis, dementia, blindness, or death.
Complications
Untreated syphilis increases the risk of HIV infection and can cause irreversible damage to organs. Congenital syphilis in newborns may result in stillbirth, developmental delays, and severe deformities.
Diagnosis
Diagnosis is made through:
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Blood tests to detect antibodies against Treponema pallidum.
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Microscopic examination (dark-field microscopy) of fluid from sores.
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Rapid diagnostic tests for quick screening, especially in high-risk populations.
Treatment
Penicillin G, administered via intramuscular injection, remains the gold standard treatment. The dosage and duration depend on the stage of infection. For those allergic to penicillin, alternative antibiotics such as doxycycline or azithromycin may be used, although penicillin is preferred, especially for pregnant women.
Prevention
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Consistent and correct use of condoms during sexual activity.
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Regular STI screening, especially for high-risk individuals.
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Avoiding sexual contact with individuals who have visible sores or rashes.
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Prenatal screening to prevent congenital syphilis.
Conclusion
Syphilis is a preventable and curable disease, but delayed diagnosis can lead to severe, life-threatening complications. Public health efforts should focus on education, safe sex practices, early screening, and timely treatment to control its spread and protect vulnerable populations.
