Secondary Syphilis

Syphilis is a sexually transmitted infection (STI). There are four stages of the disease: primary, secondary, latent, and tertiary. Primary syphilis is the first stage of the disease. It causes one or more small, painless sores in or around the genitals, anus, or mouth.

If you do not get treatment for the primary stage of the disease, it will progress to the second stage, which is secondary syphilis. If you are not treated for secondary syphilis, the disease will progress to the latent stage and may progress to the tertiary stage.

The secondary stage of syphilis is curable with medical treatment. It is important to get treatment to prevent the tertiary stage of the disease, which may not be curable, and can cause damage to your organs, as well as dementia (memory loss), paralysis, or death.

Syphilis is caused by a spirochete (a spiral-shaped bacteria) called Treponema pallidum. You can get the bacteria in the following ways:

• direct contact with a syphilis sore (usually found on the vagina, anus, rectum, in the mouth, or on the lips)
• during vaginal, anal, or oral sex with an infected person
• an infected mother can pass syphilis to her unborn child, which can result in serious complications or even death in the unborn child

You cannot catch syphilis from doorknobs, toilet seats, swimming pools, clothing, bathtubs, or silverware.

There is a high correlation between syphilis and HIV, since HIV can be transmitted through syphilitic sores. Since the behaviors that lead to the spread of STIs are the same for both syphilis and HIV, having syphilis is an indicator that you are also at risk for contracting HIV.

According to MedlinePlus, syphilis is most widespread in urban areas among young adults between the ages of 15 and 25 (MedlinePlus).

Primary syphilis usually presents itself as a single sore. This sore typically appears three weeks after the initial infection, but could show as soon as 10 days or as late as 90 days. This sore, called a chancre, is small, firm, round and painless. It appears at the infection site, usually the mouth, anus, or genitals. You may not even notice it. Untreated, the initial sore heals in a month or so.

If you don’t receive treatment during this initial appearance of symptoms, the bacterium that caused this STI will spread through your bloodstream. and you’ll soon have secondary syphilis.

The symptoms of secondary syphilis develop two to eight weeks after a person first becomes infected with primary syphilis. The secondary stage is usually marked by a non-itchy rash.

The rash might be confined to one part of your body, or it could spread over several parts. The appearance of the rash varies. One common manifestation is rough, reddish-brown dots on the bottoms of your feet and on the palms of your hands. Usually, the rash feels scaly, but it could also be smooth. Sometimes, the rash looks like one caused by another disease, making diagnosis trickier. It may also be so faint that it is overlooked.

Other symptoms of secondary syphilis include:

• sore throat
• fever
• swollen lymph glands
• headaches
• hair loss
• weight loss
• fatigue
• muscle aches
• wart-like patches around skin folds or genitals
• loss of appetite
• joint pain
• enlarged lymph nodes (swelling around your jawline)
• changes in vision

If you have sores, your doctor might use a microscope to examine material taken from your sores. The syphilis bacteria will show up under the microscope.

Testing your blood is also a reliable, inexpensive way for your doctor to determine whether you have syphilis. Your body makes antibodies, proteins that try to fight off infections. If the blood test reveals these syphilis antibodies, then you have been infected with syphilis. This test is important for pregnant women, as undiagnosed syphilis can be passed on to your unborn child, and could lead to his or her death.

Your doctor can also determine whether you have syphilis by testing your spinal fluid.

The primary and secondary stages of syphilis are extremely contagious. Tell your previous sexual partners if you are diagnosed with syphilis so that they can get tested to see if they have the disease.

Syphilis cannot be cured by over-the-counter treatments or home remedies. If it’s caught early enough, however, you’ll only need one penicillin injection. If you’ve had the STI for a longer period of time, several doses will be necessary. People with penicillin allergies can use other antibiotics, such as doxycycline or tetracycline. Penicillin is the best drug if you’re pregnant, however, since other antibiotics may harm your developing baby or fail to protect him or her from syphilis.

Antibiotics will kill the syphilis bacterium and stop it from further damaging your body. Common antibiotics used include penicillin G benzathine, doxycycline, and tetracycline. However, antibiotics cannot repair any damage that has already occurred.

If you’re receiving treatment for syphilis, do not have sex until your sores heal completely and you have completed your full course of antibiotic treatment. Let your sexual partners know about your condition so they can also get help and not continue to spread the infection.

Without treatment, your syphilis will continue to progress. It can be 10 or 20 years before you experience the worst effects. Eventually, untreated syphilis will lead to damage to the brain, eyes, heart, nerves, bones, joints, and liver. You could also become paralyzed, blind, demented, or lose feeling in the body. Untreated syphilis can also lead to stillborn or developmentally delayed babies.

Even if you have been cured of syphilis, you could still get it again.

People being treated for syphilis are also at risk for Jarisch-Herxheimer reaction. As your body breaks down the syphilis bacteria, a reaction may be triggered. Symptoms of Jarisch-Herxheimer include:

• chills
• rash
• fever of up to 104 F
• headache
• muscle aches
• joint pain
• rashes
• nausea

This reaction is very common. Usually, these symptoms are gone within a day. Talk to your doctor if you have any worries or concerns.

Open syphilis wounds increase your chances of contracting HIV and other STIs. Because of this, it is a good idea to get tested for HIV and other STIs if you have secondary syphilis.

You can prevent getting secondary syphilis by getting treatment for primary syphilis before it develops into the secondary stage. You can also prevent getting primary syphilis by either avoiding sexual activity, or by practicing safe sex practices, such as using a condom.

You should be regularly tested for syphilis and other STIs if you are sexually active and not in a long-term, monogamous relationship.

If you are pregnant, you should get tested for syphilis because the disease can cause serious complications or even death to your unborn child. Early treatment is critical for your unborn child’s health and survival.

If you notice any unusual sore or rash, especially near your genitals or anal area, stop having sex and go see a doctor. The earlier syphilis is caught, the easier it is to treat and the better your outcome. Notify all your sexual partners immediately so that they, too, can be treated. Syphilis is a very contagious disease.

If syphilis is diagnosed and treated early enough, it can be thoroughly cured. With treatment, secondary syphilis will most likely go away within a few weeks to a year.

If secondary syphilis goes untreated and your symptoms go away, you will still have the latent form of syphilis. The latent stage is a symptom-free period that can last for many years. You may never again develop symptoms.

Without treatment, however, you have a one in four chance of progressing to the tertiary stage of syphilis, according to the New York State Department of Health (NYSDH). As stated earlier, this can lead to many serious complications, including brain damage and death.