1. STDs
2. Syphilis

Syphilis Singapore | Shim Clinic

What Is Syphilis

Syphilis is a systemic infection caused by Treponema pallidum. Syphilis is one of the oldest infections transmitted through sexual contact. There are some historic records of a syphilis outbreak that occurred around 3,000BC. The global prevalence of syphilis is high, making it one of the most common sexually transmitted diseases.

With the exception of mother- to-child transmission, syphilis is almost exclusively spread by direct contact with infectious lesions. The infection is caused by a bacterium that can be passed from one person to another during unprotected sexual activity. Usually, the disease starts with a painless sore that will most often appear in the genital region or close to the mouth.  After that initial infection, however, syphilis can remain dormant for a very long, long time. Eventually, it can become reactivated.

Without treatment, syphilis can lead to serious complications and miscellaneous health problems. That’s why it’s important to have awareness about prevention practices, as well as the early symptoms that could provide indications of an active infection.

Common Syphilis Symptoms

Like many other sexually transmitted diseases (STDs), syphilis will develop in stages. The symptoms that you experience will be dependent on the stage of the infection. There are multiple stages of syphilis and each one is characterised by specific symptoms:

Primary Syphilis

As already mentioned, the first symptom is a small sore. This sore appearing close to the mouth or in the genital region is indicative of primary syphilis. The sore is medically known as chancre and it usually occurs at the spot where the bacterium entered the body. Most people will get a single sore as a sign of primary syphilis but in some instances, multiple chancres could appear.

Secondary Syphilis

This next stage will occur within a couple of weeks after becoming infected. Most often, secondary syphilis will be characterised by a rash that starts in the abdominal region and spreads. The rash is different from allergic ones because it doesn’t cause an itch. It can be accompanied by the appearance of warts in the genital region and in the mouth. For some individuals, secondary syphilis also causes fatigue, muscle aches, hair loss and a fever.

Latent Syphilis

If syphilis isn’t treated during the primary or secondary stages, it will become latent. That means that it will not cause any symptoms but the infection will remain hidden in the body until it becomes reactivated.

Tertiary Syphilis

A third of all people who don’t get treatment for syphilis will develop complications known as tertiary syphilis. Because it attacks the nervous system, the syphilis bacterium can cause nerve and brain damage. It can also lead to eye, bone, liver, joint and blood vessel problems.

Other Complications of Syphilis

Apart from the symptoms common for each of the stages, syphilis can cause some additional complications. The most typical ones when the condition isn’t treated include:

• The appearance of bumps called gummas on the skin, bones or organs. These bumps can damage the healthy tissue that surrounds them.
• Nervous system problems like brain damage, meningitis, paralysis, hearing or vision loss.
• HIV – people with syphilis are at a higher risk of becoming HIV-positive through unprotected sexual activity.
• Syphilis can also target the heart, damaging its valves and leading to an inflamed aorta (a condition that is known as aortitis).

It’s also very important to understand the fact that syphilis can cause very serious complications during pregnancy. Pregnant women are advised to get a syphilis test as soon as they find out that they’re expecting. Pregnant women who have syphilis are at a significantly higher risk of stillbirth or giving birth to a baby who is sick to the degree of passing away shortly after being born.

Learn more about the symptoms of syphilis here.

Testing for Syphilis

Various types of tests are reliable enough to identify the presence of the syphilis bacterium in the body. You may want to get tested in one of the following ways:

• Microscopy: fluid can be drained out of the chancre and examined under a microscope to determine if there are bacteria in it. Such a test can be performed during the primary stage of syphilis, allowing for the quick identification of the condition and the selection of the right treatment.
• Blood tests: a quick blood test can help detect bacteria, especially if the infection has been ongoing for a while. Depending on the laboratory and the type of being used, results can be provided as fast as a single day.
• Cerebrospinal fluid tests: when syphilis reaches a stage to start affecting the nervous system, fluid could be taken from the spine to check for the presence of bacteria. This kind of testing is required whenever someone shows up with symptoms like brain damage, nerve damage or the loss of eyesight.

Syphilis testing is often included in larger venereal disease testing panels that check for multiple conditions. You may want to get a consultation first to determine what kind of testing makes the most sense (your lifestyle and risk factors will have to be taken in consideration).

Learn more about Shim Clinic’s syphilis testing service as well as other STD testing services.

Treatment of Syphilis

Like other bacterial infections syphilis can be treated with antibiotics.

Antibiotics like penicillin are very effective for the treatment of primary and secondary syphilis. This is why identifying the infection early enough is crucial. Very often, a single shot of penicillin will be enough to make the treatment successful.

People who are allergic to penicillin shouldn’t worry. The syphilis bacterium is susceptible to several other kinds of antibiotic treatments.

If treatment is administered late, however, syphilis could cause permanent heart and nervous system damage. This kind of damage is irreversible and there will be no treatment for it. Treatment in such instances will focus on getting rid of the bacterium while also reducing pain and discomfort.

People who are undergoing treatment for syphilis should refrain from sexual contact until sores disappear completely or the course of antibiotics is finished. To be on the safe side, ask your doctor when it would be ok to have sex again.

Learn more about how Shim Clinic treats syphilis.

Syphilis Prevention Practices

To reduce the risk of contracting syphilis or eliminate it altogether, you can do a couple of very simple, yet important things:

• Abstain from unsafe sex: if you want to get intimate with someone new in your life, do get tested and use barrier contraception.
• Always use protection during sex: barrier contraception like condoms will give you the most reliable protection against sexually transmitted infections. It’s important to use contraception correctly and every single time you decide to have sex. A dental dam used during oral sex is also very effective.
• Get tested regularly: even if you are in a committed monogamous relationship, you should get tested for sexually transmitted infections every once in a while. People who engage in casual sex and at-risk groups need to get tested more often – every few months. Because of the risk for pregnant women, do get tested for syphilis as soon as you find out that you’re expecting.
• Inform your partners about an infection: if you find out that you have syphilis, do inform current and past sexual partners about it. That’s the responsible thing to do and it will allow others to get treatment quickly in the event of being infected.

References:

1. (2008). UK National Guidelines on Management of Syphilis. Retrieved from, http://www.bashh.org/documents/1771.
2. Libois, A., De, W.S., Poll, B., Garcia, F., Florance, F., Del Rio, A., et al. (2007). HIV and Syphilis: When to Perform a Lumbar Puncture. Sex Transm Dis, 34:141–4. Retrieved from PubMed.
3. Rolfs, R.T., Joesoef, M.R., Hendershotm, E.F., Rompalo, A.M., Chiu, M., Bolan, G., et. al. (1997). A Randomised Trial of Eenhanced Therapy for Early Syphilis in Patients With and Without Human Immunodeficiency Virus Infection. N Engl J Med, 337: 307-14. Retrieved from PubMed.
4. Workowski, K. & Berman, S. (2010). CDC Sexually Transmitted Disease Treatment Guidelines (2010). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm
5. Yang, C.J., Chang, S.Y., & Hung, C.C.(2009). Sensitivity and Specificity of Lumbar Puncture in HIV-infected Patients with Syphilis and No Neurologic Symptoms Reply. Clin Infect Dis, 49:162–3. Retrieved from, PubMed.

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References

• Syphilis @ Wikipedia