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November 24, 2009
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Syphilis In Women (cont.)

What is syphilis?

Syphilis is an STD that has been around for centuries. It is caused by a microscopic bacterial organism called a spirochete. The scientific name for the organism is Treponema pallidum. The spirochete is a wormlike, spiral-shaped organism that wiggles vigorously when viewed under a microscope. It infects the person by burrowing into the moist, mucous-covered lining of the mouth or genitals. The spirochete produces a classic, painless ulcer known as a chancre.

What are the symptoms of syphilis?

There are three stages of syphilis, along with an inactive (latent) stage. Formation of an ulcer (chancre) is the first stage. The chancre develops any time from 10 to 90 days after infection, with an average time of 21 days following infection until the first symptoms develop. Syphilis is highly contagious when the ulcer is present.

The infection can be transmitted from contact with the ulcer which teems with spirochetes. If the ulcer is outside of the vagina or on the male's scrotum, condoms may not prevent transmission of the infection by contact. Similarly, if the ulcer is in the mouth, merely kissing the infected individual can spread the infection. The ulcer can resolve without treatment after three to six weeks, but the disease can recur months later as secondary syphilis if the primary stage is not treated.

In most women, an early infection resolves on its own, even without treatment. However, 25% will proceed to the second stage of the infection called "secondary" syphilis, which develops weeks to months after the primary stage and lasts from four to six weeks. Secondary syphilis is a systemic stage of the disease, meaning that it can involve various organ systems of the body. In this stage, patients can initially experience many different symptoms, but most commonly they develop a skin rash, typically appearing on the palms of the hands or the bottoms of the feet, that does not itch. Sometimes the skin rash of secondary syphilis is very faint and hard to recognize; it may not even be noticed in all cases. This secondary stage can also include hair loss, sore throat, white patches in the nose, mouth, and vagina, fever, and headaches. There can be lesions on the genitals that look like genital warts but are caused by spirochetes rather than the wart virus. These wartlike lesions, as well as the skin rash, are highly contagious. The rash can occur on the palms of the hands, and the infection can be transmitted by casual contact.

Subsequent to secondary syphilis, some patients will continue to carry the infection in their body without symptoms. This is the so-called latent stage of the infection. Then, with or without a latent stage, which can last as long as 20 or more years, the third (tertiary) stage of the disease can develop. At this stage, syphilis usually is no longer contagious. Tertiary syphilis is also a systemic stage of the disease and can cause a variety of problems throughout the body including:

  1. abnormal bulging of the large vessel leaving the heart (the aorta), resulting in heart problems;

  2. the development of large nodules (gummas) in various organs of the body;

  3. infection of the brain, causing a stroke, mental confusion, meningitis (type of brain infection), problems with sensation, or weakness (neurosyphilis);

  4. involvement of the eyes leading to sight deterioration; or

  5. involvement of the ears resulting in deafness. The damage sustained by the body during the tertiary stage of syphilis is severe and can even be fatal.


Next: How is syphilis diagnosed? »

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