Syphilis is a bacterial infection that can affect various parts of the body, including the tongue. Recognizing early signs on the tongue helps ensure timely medical attention and prevents the infection from progressing.
Manifestations on the Tongue
The appearance of syphilis on the tongue varies depending on the stage of the infection. During primary syphilis, a lesion known as a chancre can develop at the site where the bacteria entered the body. This chancre typically presents as a firm, round, and often painless reddish sore or ulcer. It can be found on the tip, sides, or dorsal surface of the tongue, and its lack of pain may cause it to go unnoticed.
As the infection progresses to secondary syphilis, different types of lesions may appear on the tongue, known as mucous patches. These patches are typically grayish-white, moist, and slightly raised, sometimes described as resembling a snail’s track. Mucous patches are highly contagious and indicate a widespread presence of the bacteria in the body.
Understanding Syphilis Transmission
Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. The infection spreads through direct contact with a syphilitic sore, such as a chancre or mucous patch, during sexual activity, including vaginal, anal, or oral sex. The bacterium can enter the body through microscopic breaks in the skin or mucous membranes.
Following initial exposure, Treponema pallidum replicates locally, leading to the development of the primary chancre, which usually appears about three weeks after infection, though it can range from 10 to 90 days. Even if the chancre heals on its own within three to six weeks, the infection remains in the body and can progress to the secondary stage. During secondary syphilis, the bacteria have disseminated throughout the body, leading to more widespread symptoms, including those on the tongue.
Diagnosis
Diagnosing syphilis involves a combination of physical examination and laboratory tests. A healthcare professional will visually inspect any suspected lesions, including those on the tongue, to assess their characteristics. This initial examination helps guide further diagnostic steps.
Blood tests are the primary method for confirming a syphilis infection. These include screening tests, such as the Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests, used for screening and monitoring. If a screening test is positive, confirmatory tests like the Fluorescent Treponemal Antibody Absorption (FTA-ABS) or Treponema pallidum Particle Agglutination (TP-PA) tests are used to confirm the presence of specific antibodies. In some cases, a sample from a sore may be examined under a dark-field microscope to directly visualize the spiral-shaped Treponema pallidum bacteria, particularly useful for diagnosing primary chancres.
Treatment and Why It Matters
Early-stage syphilis is curable with antibiotics, with penicillin being the primary treatment. For primary, secondary, or early-stage latent syphilis, a single intramuscular injection of penicillin is typically recommended. Penicillin works by disrupting the bacterium’s cell wall synthesis, effectively killing Treponema pallidum.
Prompt diagnosis and treatment prevent the disease from progressing to later, more severe stages. Without treatment, syphilis can advance to tertiary syphilis, causing serious and irreversible damage to various organ systems, including the brain (neurosyphilis) and heart (cardiovascular syphilis). Individuals diagnosed with syphilis should also inform their sexual partners for testing and treatment, helping to prevent further spread and reinfection.