Treatment and Recovery From Syphilis

Syphilis plagued humans for more than 400 years before effective and easily available treatment methods were discovered, placing an immense burden on doctors and healthcare systems. For centuries, contracting the disease was sometimes a death sentence.

With multiple stages and a range of associated symptoms (including an asymptomatic stage), syphilis can be difficult to observe and is easily mistaken for other illnesses. While it is relatively easy to treat syphilis today, if it is caught early in its progression, there are nuances to each stage of treatment.

Overview and symptoms

Syphilis advances in various stages and may target specific or multiple organ functions or parts of the body. Primary- and secondary-stage syphilis are the most common cases, and patients sometimes see the development of mostly painless sores called chancres at the physical point of infection on the body. Swollen lymph nodes are also often reported during the primary stage of syphilis.

Sometimes, however, chancres form on unnoticed parts of the body like the mouth, genitals (including under the testicles) or anus. Wherever they form, chancres usually appear and heal on their own during the primary stage, and are often followed by red or reddish-brown spotty rashes on the palms, soles of the feet or elsewhere on the body as part of a secondary stage. The secondary stage also includes fatigue, fever, hair and weight loss, headaches and sore throat, as well as the development of sores on moist parts of the body like the genitals, mouth cavity or anus.

Latent-stage syphilis follows the secondary stage and is asymptomatic. Considered the "hidden stage" of syphilis, it can occur more than one year after infection, when patients often mistakenly think they are healed or no longer contagious. Even without symptoms, syphilis is still active in the body, and sexual contact can lead to the transmission of the disease to others.

The latent stage is followed by the destructive tertiary stage of syphilis, which can develop as quickly as one year after infection. In addition to potentially causing organ damage, this stage of syphilis is distinguished by the development of gummas, or deep-growing sores, which eat away at surrounding tissue.

If the infection reaches the tertiary stage, it means a patient enters into a higher likelihood of developing specific forms of syphilis that target parts of the body like the lungs, heart, eyes and brain.

Diagnosis

Testing protocols depend on various factors, including the stage of syphilis and the patient's health and treatment history. In order to identify a case of syphilis, some laboratories use dark-field microscopy to identify and confirm the presence of Treponema pallidum, the bacteria responsible for venereal syphilis, and blood tests are the standard practice for screening patients for sexually transmitted syphilis.

Two types of tests are needed to validate a presumptive diagnosis of syphilis. A blood screen is conducted using either a treponemal or nontreponemal test. Nontreponemal tests are inexpensive and not exclusive to syphilis because they do not screen for the T. pallidum bacteria specifically, while treponemal tests scan for the presence of the syphilis-causing bacteria. Both tests have potential flaws that can be negated by securing results from either test's counterpart.

Once the presence and stage of syphilis have both been identified, treatment can begin.

Treatment

Syphilis is treated by using antibiotics, most commonly penicillin. The distribution of antibiotics to a given patient is largely dictated by the stage and severity of a syphilis diagnosis, as well as the person's history with syphilis or other sexually transmitted diseases.

When used, penicillin or other antibiotics are typically administered via injection. The age of a patient and the advancement of syphilis in the body may determine the need for repeated doses, which can cure the disease but not reverse any syphilitic damage done prior to treatment. This type of damage may include permanent brain damage, blindness or lifelong breathing difficulty.

After diagnosis, it's crucial that the patient abstain from sexual contact during and sometimes temporarily after treatment, especially if multiple treatments are required. Until a doctor or medical center has cleared you, a syphilis diagnosis should be regarded as likely contagious.

It is important to remember that latent syphilis is inevitable in the absence of treatment and that symptoms vary across all stages. Symptoms should not be used as milestones for potential exposure and contact points. If you've been diagnosed with syphilis, notifying anyone who you may have exposed is important because doing so gives them the opportunity to seek treatment in a timely manner.

Your medical center can help you access resources for tracking and making communicative contact with anyone you may have exposed to syphilis. These conversations can be uncomfortable, awkward and embarrassing, but everyone has a right to information that may have an impact on their health.

Prevention

Abstaining from sexual contact is the only guaranteed way of avoiding syphilis and other sexually transmitted conditions. Sexual partners should be able to give you some idea of their most recent testing history and sexual habits, and a general sense of the timeliness and comprehensiveness of their most recent STD/STI screening is a good indicator that they stay informed of their status.

But every point of sexual contact with another person carries certain risks, and a sexually active lifestyle is safest when you are in regular contact with a doctor and have access to screening results via an online health portal or your medical chart.

Syphilis can also be transferred congenitally, so it's important for pregnant women to be tested for syphilis at least once. Congenital syphilis can be deadly to an unborn or newborn child, and numerous birth complications and birth defects are associated with untreated or late-treated syphilis in pregnant mothers.

Open sores can make it easier to transmit other infectious conditions, such as the human immunodeficiency virus (HIV). A positive syphilis diagnosis is sometimes associated with a high likelihood of HIV diagnosis, and vice versa, so your doctor may recommend ongoing testing for either condition.

We have the ability to monitor our health down to the T-cells and bacteria counts in our bloodstream. Hopefully, the more we can normalize self-awareness surrounding sexual health and transparent conversations between sexual or potentially sexual partners, the more accessible the health services will become.