Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. While commonly associated with genital sores, this infection can also produce signs within the mouth. The tongue is a frequent site for these oral manifestations, which vary in appearance depending on the stage of the infection. Understanding these signs is a step toward recognizing the need for a medical evaluation.
Oral Manifestations of Syphilis
The initial sign of syphilis on the tongue appears during the primary stage, marked by a sore known as a chancre. The chancre presents as a single, firm, and round ulcer that is painless. This lesion develops at the site where bacteria entered the body, appearing 10 to 90 days after exposure. Although it heals on its own in three to six weeks, the infection remains and will progress if not treated.
Should the infection advance to the secondary stage, new oral symptoms can emerge. This phase may involve mucous patches on the tongue, which are flat, grayish-white lesions. In some instances, moist, raised sores that look like warts, called condylomata lata, may also develop. These oral signs are accompanied by other systemic symptoms, including a non-itchy skin rash that appears on the palms and soles.
In its late, or tertiary, stage, syphilis can cause more severe damage to the tongue. A lesion of this stage is the gumma, a soft, tumor-like growth that is not cancerous but can be destructive to surrounding tissue. A gumma on the tongue can lead to luetic glossitis, causing the tongue to become swollen and red. This stage can occur years after the initial infection if left untreated.
Transmission and Diagnosis
Transmission of syphilis to the tongue occurs through direct contact with an infectious sore, most commonly during oral sex with an infected partner. The bacteria, Treponema pallidum, can pass through small cuts or abrasions in the mouth to establish an infection. The primary chancre then develops at this point of entry. Because the initial sore is painless, transmission can occur without either person being aware of the infection.
Diagnosing syphilis requires evaluation by a healthcare professional, starting with a physical examination of the sore. To confirm the presence of the bacteria, a fluid sample may be taken from the chancre. This sample is examined under a dark-field microscope for direct visualization of the Treponema pallidum bacteria.
Blood tests are also a standard part of the diagnostic process. These tests do not look for the bacterium itself but instead detect antibodies the body produces to fight the infection. Different types of blood tests can be used to screen for and confirm a syphilis diagnosis.
Treatment and Medical Consultation
Syphilis is a curable infection, and the standard treatment is antibiotics. Penicillin, administered as an injection, is the primary medication used to eliminate the Treponema pallidum bacteria. The dosage and length of the treatment plan depend on the stage of the infection at diagnosis. Earlier stage infections require a less intensive treatment course than those diagnosed in later stages.
If any symptoms of syphilis are observed, a medical consultation is important. A healthcare provider can perform the necessary tests for an accurate diagnosis and prescribe the appropriate treatment. Prompt medical attention prevents the infection from progressing to advanced stages, which can lead to serious health complications affecting the heart and nervous system. Treating the infection also prevents its transmission to others.