Syphilis is one of the most alarming sexually transmitted diseases, posing a serious threat to the health and lives of affected individuals. Without timely medical care, patients may face numerous dangerous complications.
Essential Information About Syphilis
So, what causes syphilis? What are its transmission routes and how can one recognize the symptoms?
Understanding Syphilis
Syphilis is a bacterial infection caused by the spirochete Treponema pallidum. The bacteria enter the body directly through unprotected sexual intercourse (vaginal, anal, or oral), through skin abrasions or mucous membranes when in contact with secretions from syphilitic lesions.
The spirochete can also be transmitted from mother to child during pregnancy starting from the fourth month, as it can enter the fetal bloodstream via the umbilical cord.
Due to the open structure of the female genitalia, women are more susceptible to sexually transmitted infections than men, including syphilis. If left untreated, syphilis in women can cause damage to various body parts, leading to symptoms such as genital ulcers, skin rashes, musculoskeletal pain, and even affecting internal organs.
Causes of Syphilis
The causative agent of syphilis is the spirochete (Treponema pallidum), discovered by Schaudinn and Hauffman in 1905. This bacterium has a spiral shape, consisting of 6-14 helical turns. Its resistance is very weak; outside the body, it survives only a few hours. In ice, it retains its mobility for a long time, but at 45 degrees Celsius, it dies within 30 minutes. Disinfectants and soaps can kill this spirochete within minutes.
Signs and Symptoms of Syphilis
The signs and symptoms of syphilis occur in three stages:
- Stage 1: This is the incubation period, which typically lasts about three weeks. After this period, symptoms such as sores and swollen lymph nodes begin to appear. A syphilitic sore is a shallow, round or oval lesion with a clear and even border, measuring about 0.5 – 2cm, with a clean red base resembling fresh meat, and a firm foundation (thus called a hard sore) that does not cause pain upon palpation. The most common locations for syphilitic sores are on the genital mucosa. In women, these sores are often found on the labia majora, labia minora, and vulva. In men, they are often located on the glans, urethra, scrotum, and penis. Additionally, syphilitic sores can also appear in the mouth, lips, and tongue. Lymph nodes will appear 5 – 6 days after the sore, particularly swelling in the groin area, forming clusters, with one larger node referred to as the ‘king’ lymph node.
- Stage 2: This stage occurs 45 days after the appearance of the sore and can last for 2 – 3 years. Skin and mucosal lesions appear, but they generally do not leave scars after healing. The spirochete can easily cause systemic infection with symptoms such as fever and swollen lymph nodes. This stage often presents clinical manifestations such as: scattered reddish-pink spots on the torso, syphilitic papules with various forms (red-pink papules, infiltrative with possible scaly borders, psoriasis-like papules, acne-like papules, necrotic papules…), and enlarged papules commonly found around the anus and genitals, diffuse lymphadenopathy, and hair loss resembling a thinning forest.
- Stage 3: This stage typically occurs 5, 10, or 15 years after the appearance of the sore, showing symptoms like deep sores, gummas on the skin, bones, internal organs, cardiovascular system, and nervous system. In this stage, the patient is less likely to transmit the infection to partners as the spirochete has invaded and localized to the internal organs, and is no longer present on the skin or mucous membranes.
Note: Between stages 1 and 2, and between stages 2 and 3, there may be no clinical symptoms. This is known as latent syphilis, which is only detected through serological tests.
Syphilis can manifest in the mouth area.
Complications of Syphilis
Syphilis can cause several dangerous complications such as:
- The spirochete can damage all vital organs in the body.
- Syphilis adversely affects the skin, mucous membranes, eyes, and internal organs such as the liver, cardiovascular system, and nervous system.
- The disease can lead to dangerous complications like aortic inflammation, aortic aneurysm, complete paralysis, mental disorders, and hepatitis.
- Congenital syphilis can cause fetal death or congenital deformities after birth.
What is Malignant Syphilis?
Malignant syphilis has a short incubation period, starting with systemic symptoms such as fever, chills, muscle pain, and joint pain. Skin manifestations progress from nodules and pustules to ulcerated lesions, with exudate forming a thick crust resembling a shell, in brown or black color.
Malignant syphilis is very rare; if not diagnosed and treated early, the disease can progress systemically, affecting the cardiovascular system, central nervous system, vision, hearing, joints, digestion, and urinary systems, posing a life-threatening risk.
This condition often appears in patients infected with HIV, those with a history of same-sex sexual relations, presenting with ulcerative or necrotic lesions alongside systemic symptoms. Prognosis is favorable when treated early, correctly, and with adequate antibiotic dosage as per protocols.
Currently, syphilis is not unfamiliar to the people of Vietnam, and effective treatment regimens are available. Individuals infected with the syphilis spirochete may exhibit symptoms on the skin and systemically, or they may not. Among them, malignant syphilis is a rare severe form of secondary syphilis.
How is Syphilis Transmitted?
The syphilis spirochete is often abundant in lesions (sore, mucosal patches, lymph nodes…). Therefore, the disease easily spreads during unprotected sexual intercourse with an infected person. Transmission is most potent during stages 1 and 2 when skin and mucosal lesions contain a high concentration of the syphilis spirochete.
The disease is primarily spread through unprotected sexual relations. The spirochete enters through the damaged skin or mucous membranes of the genital area during intercourse, causing localized infection (sore), entering the bloodstream, and disseminating throughout the body. Factors that increase the risk of transmission include being infected with HIV/AIDS, having other sexually transmitted diseases or genital lesions, and engaging in unprotected sexual behaviors (oral-genital or same-sex intercourse).
Syphilis can also be transmitted through blood transfusion (i.e., transfusion of contaminated blood or sharing non-sterilized needles) and indirectly through contaminated items or utensils.
Preventing Syphilis
- Adopt a healthy lifestyle, practicing monogamy.
- Engage in safe sexual practices, using protective measures (such as condoms).
- To prevent congenital syphilis, it is essential to detect and treat mothers who are infected during pregnancy promptly. Routine serological testing should be conducted for all pregnant women.
- If diagnosed with the disease, seek immediate medical attention for examination and treatment; do not self-medicate.
If you encounter or have not yet experienced any of the aforementioned symptoms, you should still undergo screening for sexually transmitted infections to facilitate early detection and effective treatment, preventing complications.
