What is Syphilis? What are the Different Stages of Syphilis?

Syphilis is a sexually transmitted bacterial infection caused by the bacterium Treponema pallidum. If not treated properly can get worse over time and cause serious health problems.

Active and Inactive Syphilis 

The infection can be either active and not active. Symptoms are often shown in the active phase only. If the infection is not active, symptoms are not shown, even though the patient still has Syphilis.

Transfer of Syphilis 

Patients with not active Syphilis (don’t have symptoms) can pass Syphilis to others.

Syphilis is not just transferred by sexual intercourse but just being in close contact with an infected person’s genitals, mouth, or rectum can increase the risk of contracting the infection.

Syphilis is presented in four stages: 

1. Primary 2. Secondary 3. Latent (hidden) 4. Tertiary (late)

Primary stage Syphilis 

A person is known to be highly contagious during the primary stage of syphilis. The primary stage of Syphilis is characterized by a painless sore ( chancre) at the site of infection. This commonly occurs within 3 weeks of exposure but can range from around 10 to 90 days.

A chancre in men often appears on the penis. In women, chancres can develop anywhere on the outer genitals or on the inner part of the vagina. A chancre is often unnoticed if it occurs inside the vagina or at the cervix, as the sores are painless and not easily visible.

Near the area of the sore, swelling of the lymph nodes may occur. A chancre may also occur in any part of the body other than the genitals.

The chancre lasts for around 3 to 6 weeks, heals without treatment, and may leave a thin scar. However, Syphilis is still present and a person is still contagious.

Secondary stage Syphilis 

A person is highly contagious during the secondary stage of syphilis. This phase is usually characterized by a rash that appears from 2 to 8 weeks after the chancre develops and even before it heals.

A rash usually develops on the palms of the hands and the soles of the feet. It consists of a reddish-brown, small, solid, flat, or raised skin sore or sores that are less than 2 cm (0.8 in.) across. The rash often looks like other common skin problems.

Apart from that small, open sores may be present on mucous membranes. They may contain pus or moist sores that look like warts.

The sores may appear lighter than the surrounding skin in dark-skinned people.

The skin rash heals without scarring within 2 months. They heal without a scar but skin discoloration may develop. However, syphilis is still present and the person is contagious.

When Syphilis has spread throughout the body, the person may have symptoms like:

  1. A fever of usually less than 101°F (38°C)

  2. A sore throat

  3. A vague feeling of weakness or discomfort throughout the body

  4. Weight loss

  5. Patchy hair loss, especially in the eyebrows, eyelashes, and scalp hair

  6. Swelling of the lymph nodes

  7. Nervous system symptoms of secondary syphilis, which can include neck stiffness, headaches, irritability, paralysis, unequal reflexes, and irregular pupils

Latent (hidden) stage Syphilis 

If untreated, an infected person will progress to the latent (hidden) stage of Syphilis. After the secondary-stage rash goes away, the person will not have any symptoms for a time (latent period). The latent period may be as brief as 1 year or range from 5 to 20 years.

Often during this stage, an accurate diagnosis can only be made through blood testing, the person’s history, or the birth of a child with congenital Syphilis.

A person is contagious during the early part of the latent stage and may be contagious during the latent period when no symptoms are present.

Relapses of secondary Syphilis

About 20-30% of people with Syphilis have a relapse of the secondary stage of Syphilis during the latent stage. A relapse means the person had passed through the second stage, had no symptoms, then began to experience secondary-stage symptoms again. Relapses can occur several times.

When relapses no longer occur, a person is not contagious through contact. But a woman in the latent stage of syphilis may still pass the disease to her developing baby and may have a miscarriage, a stillbirth, or give birth to a baby infected with congenital Syphilis.

Tertiary (late) stage Syphilis 

Stage 4 is the most destructive stage of Syphilis. If untreated, the tertiary stage may begin as early as 1 year after infection or at any time during a person’s lifetime. A person may never experience this stage of the illness.

The symptoms of tertiary (late) Syphilis depend on the complications that occur which include:

  1. Gummata, which are large sores inside the body or on the skin

  2. Cardiovascular syphilis, which affects the heart and blood vessels

  3. Neurosyphilis, which affects the nervous system

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