Syphilis is a sexually transmitted infection caused by the bacterium Treponema Pallidum.

What is syphilis?

Syphilis is a sexually transmitted infection caused by the bacterium Treponema Pallidum. It is also known as “the great imitator” because the infection can cause a variety of symptoms. You can have syphilis without having symptoms, but a blood test will be able to detect the infection.

How is syphilis transmitted?

The syphilis bacteria can be transmitted by contact between skin and mucous membranes. The risk of infection is greatest if you have had unprotected intercourse or unprotected oral sex. Syphilis can also be transmitted by deep kissing. The infection can also be transmitted to the fetus during pregnancy.

What are the symptoms?

Asymptomatic infection:

You can have syphilis without having symptoms, but a blood test will be able to detect the infection. It can take up to 12 weeks from the time of infection until a blood test can confirm syphilis. Even if you do not have symptoms, you should be treated if a test is positive for syphilis.

Sores:

In the first stage of syphilis infection, a sore, called a chancre, may develop where the bacteria entered the body. The sore typically appears about 2-4 weeks after infection but can also appear later.

A typical syphilis sore will often be painless and located on the penis or vulva. A syphilis sore can also occur in the vagina, rectum or mouth, where it rarely causes symptoms and can therefore go unnoticed. In many cases, the sore will be accompanied by swollen lymph nodes in the groin or neck. Sometimes there may be multiple sores and the sores can also be painful. A syphilis sore is very contagious to sexual partners. A swab from the wound will be able to show whether it is a syphilis sore.

Rash and other symptoms from the skin and mucous membranes:

Symptoms of the infection typically develop during the secondary stage of syphilis. A red confluent skin rash may occur, such a rash is often localized to the upper body.

Occasionally, red spots are also seen on the palms of the hands and soles of the feet. Wart-like bumps in the genital area or in the mouth and swollen lymph glands. Rarely, patchy hair loss is seen.

Syphilis in the second stage is highly contagious through all sexual contact.

Neurosyphilis

In rare cases, syphilis can spread to the central nervous system in the brain and cause symptoms such as dizziness, headache, visual and hearing disorders, e.g. tinnitus and flashes of light before the eyes.

If syphilis is detected in a spinal cord examination, treatment takes place during hospitalization in our inpatient department.

Untreated syphilis

If syphilis is not treated, symptoms from both organs, the central nervous system and/or the cardiovascular system may occur after several years.

Pregnant women and newborns

A pregnant woman with syphilis can infect the fetus, which can cause permanent damage and, in the worst case, miscarriage. It is important that the treatment is started as early as possible in pregnancy.

Syphilis in the unborn child can develop very differently. Some newborns develop life-threatening disease shortly after birth. Others develop symptoms later in life, when permanent damage may have occurred.

How is syphilis treated?

Syphilis is typically treated with penicillin in the form of benzathine benzylpenicillin, which is given as 2 injections – one in each hips/buttock. After the injection, you must stay in the clinic for observation for 20 minutes.

If you have had syphilis for a long time and do not have any symptoms, three treatments are given at one-week intervals. It is important that you have all the injections. If the treatment plan is not followed, you will have to start over.

In case of allergy to penicillin, a broad-spectrum antibiotic called doxycycline is used.

Reactions to the treatment

About half of the patients treated for syphilis will experience chills and a rise in temperature 4-6 hours after the injection. The reaction is called the Jarish-Herxheimer reaction and is due to the decay of the syphilis bacteria. The symptoms stop within 24 hours.

The symptoms can be relieved with 1 gram of paracetamol (e.g. Pinex, Panodil or Pamol), no more than 4 times a day.

Possible side effects of the treatment

Most people will experience soreness in the area where the injections was given. In a few cases, discomfort from the gastrointestinal system may occur.

In rare cases, allergic reactions can occur in the form of skin rashes, hives, etc. Therefore, you must stay in the clinic for observation for 20 minutes after treatment with an injection.

Check-up after treatment

To ensure that the treatment has been effective, blood tests must be done 3, 6 and 12 months after completing treatment.

How long will you be contagious?

It can take up to 3 weeks after treatment before you are clear of infection, and you should therefore avoid sexual contact and deep kisses for 3 weeks. If you still have sores or rashes after 3 weeks, sexual contact should wait until these have healed. Syphilis can be contracted several times, even shortly after treatment.

Sexual partners should be examined

It is important that your partners are informed that they may be infected with syphilis and should therefore be examined.

You can get counseling from the clinic on how to inform your former and current partners.