Syphilis

Treatment

Syphilis is a bacterial infection caused by the bacterium Treponema pallidum. It's a sexually transmitted infection (STI) that has been known historically as "the great imitator" due to its wide variety of possible symptoms, which can resemble many other diseases. It is primarily transferred between sexual partners. However, congenital syphilis can also appear in babies of mothers who had syphilis while pregnant. It can affect men and women of all ages.

The infection is treatable and curable, primarily with antibiotics. If left untreated, it can progress to more severe stages, causing serious and sometimes irreversible damage to major organs. For most people, the syphilis bacteria can stay dormant in their body for years, never causing any noticeable symptoms. If you are sexually active, it is vital to regularly get tested for syphilis, especially if you have a new partner.

Once syphilis shows symptoms, its severity typically progresses in three stages: primary, secondary, and tertiary. Syphilis and herpes have similar signs and symptoms; however, the main indicator between herpes and syphilis depends on if you’re experiencing pain. If symptoms are present but painless, this is a sign of syphilis, whereas if sores/blisters are painful, this is a sign of herpes.

Untreated syphilis can result in neurosyphilis, an infection of the central nervous system whose symptoms include paralysis, sensory deficits and loss of coordination; or otosyphilis, a medical condition affecting the cochleovestibular system whose symptoms include hearing loss, tinnitus, and vertigo.

Syphilis in men can often be asymptomatic, making it difficult to detect without proper testing. However, when symptoms do occur, they may include:

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Sores or ulcers on the genitals or around the mouth

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Skin rashes on various parts of the body

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Fever and fatigue

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Penile discharge

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Swollen lymph nodes

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Patchy hair loss on the scalp, eyebrows, and beard

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Headaches and meningitis-like symptoms

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Changes in vision or eye pain

Syphilis in women may also be asymptomatic in many cases. When symptoms do manifest, they can include:

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Genital or mouth sores

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Skin rashes

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Fever and fatigue

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Vaginal discharge

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Swollen lymph nodes

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Unexplained weight loss

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Patchy hair loss, including on the scalp and eyebrows

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Headaches or meningitis-like symptoms 

Syphilis is caused by the bacterium Treponema pallidum. The bacterium is primarily transmitted through sexual contact, including vaginal, anal, and oral sex, with an infected person. It can spread during sexual contact even if there is no ejaculation. The bacterium can enter the body through small cuts in the skin or mucous membrane. Syphilis can also be transmitted from an infected mother to her baby during pregnancy or childbirth, leading to congenital syphilis. 

The risk of acquiring syphilis increases with having multiple sexual partners, unprotected sex, and having a history of sexually transmitted infections. It is a highly contagious infection during its primary and secondary stages. 

A syphilis diagnosis generally relies on the use of laboratory testing for confirmation, as some symptoms are shared with other sexually transmitted diseases. The tests used include: 

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Blood tests

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Dark-field microscopy

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Nucleic acid amplification tests

Syphilis is typically treated with antibiotics. The choice of antibiotic and duration of treatment depend on the stage of the infection and the severity of the symptoms. It is essential to complete the full course of antibiotics to ensure the complete eradication of the bacterium. Sexual partners should also be treated to prevent reinfection.

Syphilis medication, particularly penicillin, is typically administered through an intramuscular injection. Alternatively, oral antibiotics like doxycycline or azithromycin may be prescribed, although they may not be as effective for certain stages of syphilis or in pregnant women. 

NOTE: Lab testing IS required prior to treatment if you have been exposed or are experiencing symptoms.
Call-On-Doc offers both at-home test kits and in-person lab testing. After treatment, we recommend a test of cure 2-3 weeks after completing treatment to confirm clearing the infection.

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Benzathine penicillin

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Doxycycline

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Azithromycin 

Note: We recommend repeating the Syphilis test 3-6 months after treatment to ensure that your infection has resolved. Treatment failure occurs if syphilis titer level does not decline 6 months after treatment

Ongoing management of syphilis involves several key steps. First and foremost, individuals should complete their prescribed medication treatment to ensure the infection is entirely cleared from their system. During the time of treatment and weeks after, patients should abstain from sexual activity until receiving a negative confirmation test. It is also crucial for sexual partners to be treated simultaneously to prevent reinfection, as syphilis can easily be transmitted during sexual contact. 

Follow-up testing after prescription treatment is heavily recommended to confirm the eradication of the bacterium. Patients should follow up with their healthcare providers for repeat blood tests. These tests monitor the response to treatment by measuring the levels of syphilis antibodies in the blood. The frequency and duration of follow-up depend on the stage of syphilis at diagnosis and the individual's response to treatment. It's common for follow-up to continue for at least a year, with more prolonged monitoring for later stages of the disease. 

Preventing syphilis involves a combination of safe sexual practices and regular health screenings. The use of latex or polyurethane condoms during sexual intercourse, including vaginal, anal, and oral sex, significantly reduces the risk of transmitting syphilis and other sexually transmitted infections (STIs). Condoms act as a barrier that prevents direct contact with sores, which can occur in areas not covered by condoms, so additional precautions and awareness are essential. 

Limiting the number of sexual partners and maintaining mutually monogamous relationships can further decrease the risk of syphilis exposure. Regular STI screenings are crucial, especially for those with multiple sexual partners, as early detection allows for timely treatment and prevents the spread of the infection.

In addition to personal protective measures, education and awareness about syphilis and other STIs play a key role in prevention. Understanding the symptoms, transmission methods, and consequences of untreated infections can encourage individuals to seek medical advice and testing when needed. Pregnant women should be routinely tested for syphilis, as congenital syphilis can pose serious risks to the unborn child. Healthcare providers can offer guidance on prevention strategies tailored to individual lifestyles and risks. 

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