Gynecological conditions and HIV / AIDS

October 2005     View PDF     En español

Syphilis

Syphilis is a sexually transmitted infection caused by the bacteria, Treponema pallidum. It enters the body through tiny scratches in the skin, where it multiplies and then spreads.

Early diagnosis and treatment is important to keep the infection from progressing. In adults, genital sores from syphilis also make it easier to get or pass on HIV. There is a 2- to 5-fold higher risk of getting HIV when syphilis is present. Syphilis progresses in three stages: primary, secondary and tertiary syphilis.

Primary syphilis occurs about three weeks after an exposure. The first symptom is a hard, painless, red-rimmed sore at the site of sexual contact. It disappears after 2–6 weeks.

Secondary syphilis occurs one week to six months after the sore heals. Symptoms include widespread painless lesions, swollen lymph glands and a rash especially on the palms of the hands and soles of the feet.

Tertiary syphilis may show up years later when an infected person was not treated, even people who never had symptoms. It remains in the body and may begin to damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Late stage symptoms include poor muscle movements, paralysis, numbness, gradual blindness and dementia. This damage may cause death.

Standard treatment for syphilis is an injection of Benzathine penicillin. The dosage will depend on the stage of syphilis. For patients who are allergic to penicillin, doxcycline and tetracycline are prescribed.

A single dose of penicillin can cure a person who has syphilis for less than a year. Penicillin will kill the bacteria and prevent further damage, but it will not repair any damage already done. Several studies report that treating primary syphilis with a single dose of penicillin may fail in HIV-positive persons. Therefore, it may be necessary to treat it with higher doses or require longer courses of antibiotics. Some people have no symptoms of syphilis despite infection, so it’s important to routinely screen for this and other STDs, even when symptoms are not present.