Syphilis on male private part

Overview

Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on your genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores.

After the initial infection, the syphilis bacteria can remain inactive (dormant) in your body for decades before becoming active again. Early syphilis can be cured, sometimes with a single shot (injection) of penicillin. Without treatment, syphilis can severely damage your heart, brain or other organs, and can be life-threatening. Syphilis can also be passed from mothers to unborn children.

Symptoms

Syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don't always occur in the same order. You may be infected with syphilis and not notice any symptoms for years.

Primary syphilis

The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them.

The chancre usually develops about three weeks after exposure. Many people who have syphilis don't notice the chancre because it's usually painless, and it may be hidden within the vagina or rectum. The chancre will heal on its own within three to six weeks.

Secondary syphilis

Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wartlike sores in your mouth or genital area. Some people also experience hair loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Latent syphilis

If you aren't treated for syphilis, the disease moves from the secondary stage to the hidden (latent) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the third (tertiary) stage.

Tertiary syphilis

About 15% to 30% of people infected with syphilis who don't get treatment will develop complications known as late (tertiary) syphilis. In the late stage, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.

Neurosyphilis

At any stage, syphilis can spread and, among other damage, cause damage to the brain and nervous system (neurosyphilis) and the eye (ocular syphilis).

Congenital syphilis

Babies born to women who have syphilis can become infected through the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash on the palms of their hands and the soles of their feet. Later signs and symptoms may include deafness, teeth deformities and saddle nose — where the bridge of the nose collapses.

However, babies born with syphilis can also be born too early, be born dead (stillborn) or die after birth.

When to see a doctor

Call your doctor if you or your child experiences any unusual discharge, sore or rash — particularly if it occurs in the groin area.

Causes

The cause of syphilis is a bacterium called Treponema pallidum. The most common route of transmission is through contact with an infected person's sore during sexual activity. The bacteria enter your body through minor cuts or abrasions in your skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period.

Less commonly, syphilis may spread through direct unprotected close contact with an active lesion (such as during kissing) or through infected mothers to their babies during pregnancy or childbirth (congenital syphilis).

Syphilis can't be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs.

Once cured, syphilis doesn't recur on its own. However, you can become reinfected if you have contact with someone's syphilis sore.

Risk factors

You face an increased risk of acquiring syphilis if you:

  • Engage in unprotected sex
  • Have sex with multiple partners
  • Are a man who has sex with men
  • Are infected with HIV, the virus that causes AIDS

Complications

Without treatment, syphilis can lead to damage throughout your body. Syphilis also increases the risk of HIV infection and, for women, can cause problems during pregnancy. Treatment can help prevent future damage but can't repair or reverse damage that's already occurred.

Small bumps or tumors

Called gummas, these bumps can develop on your skin, bones, liver or any other organ in the late stage of syphilis. Gummas usually disappear after treatment with antibiotics.

Neurological problems

Syphilis can cause a number of problems with your nervous system, including:

  • Headache
  • Stroke
  • Meningitis
  • Hearing loss
  • Visual problems, including blindness
  • Dementia
  • Loss of pain and temperature sensations
  • Sexual dysfunction in men (impotence)
  • Bladder incontinence

Cardiovascular problems

These may include bulging (aneurysm) and inflammation of the aorta — your body's major artery — and of other blood vessels. Syphilis may also damage heart valves.

HIV infection

Adults with sexually transmitted syphilis or other genital ulcers have an estimated two- to fivefold increased risk of contracting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter your bloodstream during sexual activity.

Pregnancy and childbirth complications

If you're pregnant, you may pass syphilis to your unborn baby. Congenital syphilis greatly increases the risk of miscarriage, stillbirth or your newborn's death within a few days after birth.

Prevention

There is no vaccine for syphilis. To help prevent the spread of syphilis, follow these suggestions:

  • Abstain or be monogamous. The only certain way to avoid syphilis is to not have (abstain from) sex. The next-best option is to have mutually monogamous sex in which both people have sex only with each other and neither partner is infected.
  • Use a latex condom. Condoms can reduce your risk of contracting syphilis, but only if the condom covers the syphilis sores.
  • Avoid recreational drugs. Misuse of alcohol or other drugs can inhibit your judgment and lead to unsafe sexual practices.

Partner notification and preventive treatment

If tests show that you have syphilis, your sex partners — including your current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested. If they're infected, they can then be treated.

Official, confidential partner notification can help limit the spread of syphilis. The practice also steers those at risk toward counseling and the right treatment. And since you can contract syphilis more than once, partner notification reduces your risk of getting reinfected.

Screening for pregnant women

People can be infected with syphilis and not know it. In light of the often deadly effects syphilis can have on unborn children, health officials recommend that all pregnant women be screened for the disease.

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Diagnosis

Tests

Syphilis can be diagnosed by testing samples of:

  • Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the syphilis-causing bacteria remain in your body for years, so the test can be used to determine a current or past infection.
  • Cerebrospinal fluid. If it's suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap). 

Through the Centers for Disease Control and Prevention, your local health department offers partner services, which will help you notify your sexual partners that they may be infected. That way, your partners can be tested and treated and the spread of syphilis can be limited.

Treatment

Medication

When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin desensitization.

If you are diagnosed with primary, secondary or early-stage latent syphilis (by definition, less than a year), the recommended treatment is a single injection of penicillin. If you've had syphilis for longer than a year, you may need additional doses.

Penicillin is the only recommended treatment for pregnant women with syphilis. Women who are allergic to penicillin can undergo a desensitization process that may allow them to take penicillin. Even if you're treated for syphilis during your pregnancy, your newborn child should be tested for congenital syphilis and if infected, receive antibiotic treatment.

The first day you receive treatment you may experience what's known as the Jarisch-Herxheimer reaction. Signs and symptoms include a fever, chills, nausea, achy pain and a headache. This reaction usually doesn't last more than one day.

Treatment follow-up

After you're treated for syphilis, your doctor will ask you to:

  • Have periodic blood tests and exams to make sure you're responding to the usual dosage of penicillin. Your specific follow-up will depend on the stage of syphilis you're diagnosed with.
  • Avoid sexual contact with new partners until the treatment is completed and blood tests indicate the infection has been cured.
  • Notify your sex partners so that they can be tested and get treatment if necessary.
  • Be tested for HIV infection.

Coping and support

Finding out you have syphilis can be extremely upsetting. You might experience anger if you feel you've been betrayed, or shame if you think you've infected others.

However, hold off placing blame. Don't assume that your partner has been unfaithful to you. One (or both) of you may have been infected by a past partner.

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