Symptoms of Syphilis

The variety of different symptoms that may be associated with syphilis can present themselves in a number of ways depending upon how far along the infection has progressed. Many of the symptoms present due to a syphilis infection are also present within many other medical conditions, from other sexually transmitted infections (STI), such as genital warts or gonorrhoea, to more common ailments like flu.  The exact stages that a syphilis infection will progress through are highly dependent on whether your infection was acquired, in that you caught it from someone else, or congenital such as it being passed on via child birth or in utero. Acquired syphilis is usually categorised into four different stages. These are primary stage, secondary stage, latent stage and tertiary stage syphilis.  Not all stages of a syphilis infection may appear and in terms of the later stages, the latent stage may not always occur and it is possible to go straight from secondary to tertiary stage infection. Upon entry into the body, the bacteria must multiply before the infection itself is established. As a result, there is a period of between ten and ninety days before symptoms occur, called the incubation period.

Primary stage syphilis

Primary syphilis is characterised by the presence of a syphilis caused sore, also known as a chancre.  Although a key feature of syphilis, this sore may seem very similar to those caused by other sexually transmitted infections. As a result syphilis can be very difficult to identify at this stage. This sore will appear at the point where the bacteria causing the syphilis entered the body, therefore most commonly on the genital regions. More often than not, the sore does not elicit any symptoms of pain so people may not even realise that it is present. In terms of appearance, the sore is usually quite round and firm to the touch. If treatment is not given at this stage, the sore tends to heal within 6 weeks but the infection will progress to the secondary stage.

Furthermore, lymphatic nodes around the site of initial infection may be inflamed, showing that the body is attempting to elicit an immune response. Lymphatic nodes are vital components of the immune system, that function as a filter to remove dead bacteria or viruses from the lymphatic fluid then remove them from the body. As a result, it is very common to see swollen lymphatic nodes within all manner of different infections, not just during a syphilis infection. A swollen lymph node will simply just appear as a small lump in certain regions of the body, such as the neck, armpits, groin and other places where lymph nodes exist.

Secondary stage syphilis

Within secondary syphilis, more sores occur but these are accompanied by rashes also. Unlike in primary syphilis, these sores and rashes are more widespread and can therefore be present in multiple areas of the body. Generally the rashes are not irritable or itchy. Appearance wise, the rash caused by the syphilis bacteria does not have the same clinical presentation within every patient and there can be a great deal of variety, for example it may be spotted, rough, red or brown depending on the individual. In terms of areas, the rash is common on the palms of the hands and soles of the feet. Again, these rashes may resemble rashes that can also be caused as symptoms of other viral infections such as mononucleosis, also known as glandular fever, for example.  Another sign that may indicate this stage of infection is the development of lesions within moist places of the body such as the mouth and in certain regions of skin like under the arms. These usually appear as white or grey and can also be large and raised. Furthermore, your lymphatic nodes may become swollen. These are present in various places on the body, such as the armpits, groin and neck just to list a few, and they have a vital role within your immune system.  A fever may be also present along with fatigue and a general feeling of ill health. 

There are a number of other symptoms that can occur from having syphilis that are considered to be rare, in that only a small percentage of the population experience these symptoms.  One such example is hair loss, also referred to as alopecia. Hair follicles below the surface of the skin or scalp may become damaged, leading to a patchy hair loss effect being seen. Furthermore, if the follicle remains undamaged, inflammation of the soft tissue within that area may cause you to be so itchy that you essentially scratch out your hair.

Another rare complaint of syphilis is vasculitis, which is considered to be the destruction of the blood vessels as a result of inflammation. As well as the problems vasculitis causes alone, the inflamed blood vessels in themselves may lead to more serious medical complications such as swollen eyes, swollen liver or central nervous system problems. These symptoms tend only to be prevalent in one in ten people from the wider population who have secondary syphilis, but if you feel you are getting any of these symptoms, it is vital that you seek immediate medical attention.  As with the primary stage, the majority of the less severe symptoms tend to disappear by their own accord if treatment is not given although the infection remains within the body and therefore will progress to latent or tertiary stages.

Tertiary/late stage and latent syphilis

The syphilis infection is considered to be latent when the infection remains dormant within the body for a substantial period of time, so as a result no symptoms that are present within the primary or secondary stages that can be seen.  Although there are usually no problems within a latent infection, there is a potential risk that you may develop a tertiary or late stage syphilis infection which carries with it more severe complications than the previous stages of the syphilis infection. If this does occur, it often happens many years after the onset of the original syphilis infection, ranging from between 10 and 30 years after onset.

In tertiary, or late stage, syphilis many of the organs of the body can be affected, such as the kidneys, cardiovascular system, skeleton, brain and liver. Syphilis in the brain, also called neurosyphilis, is characterised by symptoms such as personality changes, seizures, unexplained pain and loss of body co-ordination.  A well documented characteristic of syphilis in history is the madness experienced by those who suffered from it. This is undoubtedly linked to neurosyphilis but is rarely seen in this day and age due to improved health care and antibiotic treatments. If the infection was to reach this point however, it can be so severe that it is life threatening therefore resulting in the possibility of death.   Syphilis affecting the heart can be also as deadly in its symptoms, risking pathologies of the heart such as a heart attack, angina or an aneurysm.

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