Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. This infection progresses through distinct stages, each characterized by different symptoms. Identifying these signs is important for effective management and preventing the disease from advancing. The infection can remain asymptomatic for extended periods, making early detection challenging as many people may not notice symptoms.
Primary Syphilis Manifestations
The first symptom of syphilis is a chancre, a small sore that appears at the site where the bacteria entered the body. These chancres are usually firm, round, and painless, a characteristic that often leads to them going unnoticed. They can develop on the genitals, such as the penis, vagina, or cervix, but also commonly appear around the anus, rectum, lips, or inside the mouth.
The chancre lasts for 3 to 6 weeks and heals on its own. Its painless nature and potential location in less visible areas, like within the vagina or rectum, contribute to it being easily overlooked. The incubation period from exposure to the appearance of a chancre ranges from 10 to 90 days.
Secondary Syphilis Manifestations
Symptoms of secondary syphilis emerge 2 to 12 weeks after the primary chancre has healed. A common sign is a widespread skin rash, which is non-itchy and appears as rough, red, or reddish-brown spots. This rash often covers the body, affecting the palms of the hands and soles of the feet.
The appearance of this rash can vary significantly; it might be faint or resemble other skin conditions, making it subtle and sometimes difficult to recognize without medical evaluation. Other signs of secondary syphilis include moist, flat, grayish-white sores known as mucous patches. These patches can form in the mouth, throat, or genital areas and are highly contagious due to the presence of Treponema pallidum bacteria.
Another manifestation is condyloma lata, which are moist, wart-like lesions commonly found in warm, moist areas such as the groin, underarms, or anal region. These lesions are flat-topped, raised, and can be gray, whitish, or pink, sometimes confused with genital warts. Condyloma lata are also highly infectious, containing a high concentration of bacteria.
Why Early Recognition Matters
The sores and rashes characteristic of primary and secondary syphilis can disappear on their own. However, this spontaneous resolution does not mean the infection has cleared; instead, it indicates the disease has progressed to later, more serious stages, such as latent and tertiary syphilis. During the latent stage, individuals experience no visible symptoms, but the bacteria remain active.
Untreated syphilis can lead to severe, long-term health complications, causing irreversible damage to various organs. These complications may affect the heart, brain, nerves, eyes, bones, and joints, manifesting years or decades after the initial infection. This can result in serious health issues, including blindness, paralysis, or cognitive impairments like dementia.
Early diagnosis and prompt treatment are important to prevent this progression and avoid permanent organ damage. Syphilis is highly treatable with antibiotics, particularly penicillin, especially when detected in its early stages. If you suspect you have syphilis or have been exposed, seek medical attention promptly for testing and appropriate treatment. The initial symptoms can be subtle and easily overlooked, making timely medical consultation important for preventing severe outcomes.