How to cure syphilis infection?

The four stages of syphilis are:

Syphilis is most infectious during the first two stages.

When syphilis is in the hidden, or latent, stage, the disease remains active but often doesn’t cause symptoms. Tertiary syphilis is the most destructive to health.

The primary stage of syphilis occurs about 3 to 4 weeks after a person contracts the bacteria. It begins with a small, round sore called a chancre. A chancre is painless, but it’s highly infectious. People may not even notice when they have one. This sore may appear wherever the bacteria entered the body, such as on or inside the mouth, genitals, or rectum.

On average, the sore shows up around 3 weeks after infection, but it can take between 10 to 90 days to appear. The sore remains for 2 to 6 weeks. Sometimes the only symptom will be swollen lymph nodes.

Syphilis is transmitted by direct contact with a sore. This usually occurs during sexual activity, including oral sex.

Skin rashes and a sore throat may develop during the second stage of syphilis. The rash won’t itch and is usually found on the palms and soles, but it may occur anywhere on the body. Some people don’t notice the rash before it goes away.

Other symptoms of secondary syphilis may include:

These symptoms will go away whether treatment is received. However, without treatment, a person still has syphilis.

Secondary syphilis is often mistaken for other conditions, such as:

For this reason, syphilis has been known as the “great imitator.” Because the symptoms can be so nonspecific, people experiencing symptoms may ignore them, or sometimes clinicians don’t suspect the presence of the infection.

The third stage of syphilis is the latent, or hidden, stage. The primary and secondary symptoms disappear, and there won’t be any noticeable symptoms at this stage. However, the bacteria remain in the body. This stage could last for years before progressing to tertiary syphilis.

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms.

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.

Syphilis can spread from a mother with syphilis to her unborn baby.

You cannot get syphilis through casual contact with objects, such as:

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with a partner who has syphilis. If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for syphilis or other STDs.

You should get tested regularly for syphilis if you are sexually active and

All pregnant people should receive syphilis testing at their first prenatal visit. Some pregnant people need to receive syphilis testing again during the third trimester at 28 weeks and at delivery.

If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should receive syphilis testing at least once during your pregnancy. Receive treatment right away if you test positive.

At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems within a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and can die.

There are four stages of syphilis (primary, secondary, latent, and tertiary). Each stage has different signs and symptoms.

During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the

Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look

The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other symptoms may include:

The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

Signs and symptoms of neurosyphilis can include:

Signs and symptoms of ocular syphilis can include:

Signs and symptoms of otosyphilis may include:

Most of the time, healthcare providers will use a blood test to test for syphilis. Some will diagnose syphilis by testing fluid from a syphilis sore.

A single injection of long-acting Benzathine penicillin G can cure the early stages of syphilis. This includes primary, secondary, or early latent syphilis. CDC recommends three doses of long-acting Benzathine penicillin G at weekly intervals for late latent syphilis or latent syphilis of unknown duration.

Syphilis symptoms vary depending on the stage of the infection. You’re most contagious in the early stages, when you’re most likely to notice symptoms. During the first stage, one or more sores develop on your genitals. You may not notice them or mistake them for a pimple or other skin lesion.

During the second stage, you may get a rash and experience flu-like symptoms, such as fatigue, fever, sore throat and muscles aches.

After the second stage, the symptoms of syphilis are hidden (latent stage). Just because you don’t have symptoms doesn’t mean the infection is gone. The only thing that cures the infection and prevents it from progressing is treatment with medication.

In the first stage of syphilis, a small, smooth sore develops on your genitals, mouth or lips. It may resemble a pimple and be so small and harmless that you don’t even notice. This sore goes away on its own in about six weeks.

In the second stage of syphilis, a rough, red or brown rash develops. It begins in one area but will eventually cover your entire body — including the bottom of your feet and palms. You may have skin rashes and/or sores in your mouth, vagina or anus.

Syphilis affects your entire body. However, the first sign of syphilis is an ulcer-like sore. It develops where the bacteria came into contact with your skin during sex. The following areas are where you’re most likely to find a syphilis sore (chancre):

The bacteria Treponema pallidum causes syphilis. An infected person spreads the bacteria through vaginal, anal or oral sex. The bacteria can enter your body through your anus, vagina, penis, mouth or broken skin. The bacteria continues to spread throughout your body, which can eventually damage certain organs.

Syphilis is contagious, especially in the primary and secondary stages when you have sores, ulcers or a rash. Syphilis typically spreads from person to person during sexual contact, even if there’s no penetration or ejaculation. However, you can get it if any part of your body touches the sore or rash of someone with syphilis.

If you have syphilis and have sex, you can infect your partner. If you’re pregnant and have syphilis, you can pass it to the fetus. But, you can’t get syphilis by touching objects like toilet seats, utensils and doorknobs. This is because the bacteria that cause syphilis can’t survive on objects.

Even if you don’t have outward symptoms of syphilis (like a sore or rash), the infection is still in your body until you take antibiotics. If you have syphilis and don’t get treatment, you’re contagious whether you notice a sore or not. If you have symptoms of infection or believe you’ve been exposed, contact a healthcare provider for treatment right away.

Yes. While it’s rare to get syphilis from kissing, you can get syphilis by having direct contact with a syphilis sore. This means if you kiss your partner’s sore, you’re putting yourself at risk of infection. You can even get syphilis through broken skin. This is why getting treatment is important if you think you have syphilis or were exposed to it.

Yes. If you have syphilis and don’t get treatment, you can pass the infection to your child. Up to 40% of babies born to people with untreated syphilis die from the infection. It’s most common to spread the infection to the fetus during pregnancy. But, it can also happen during delivery if your baby has direct contact with a syphilis sore on your vagina. If a baby’s born with syphilis, it’s called congenital syphilis.

Syphilis during pregnancy can also cause:

These potential complications are why attending your prenatal visits and getting tested for STIs is so important. Treatment before 26 weeks of pregnancy leads to the best outcomes.

Penicillin was established as an effective treatment for syphilis before the widespread use of randomized clinical trials. The treatment guidelines published by the CDC (see current CDC recommendations) are based largely on uncontrolled trials and expert opinion. Guidelines are based on staging, with later stages requiring longer courses of treatment due to the slower rate of bacterial replication.

Penicillin remains the mainstay of treatment and the standard by which other modes of therapy are judged. The 2015 CDC STD treatment guidelines support the use of penicillin as the preferred drug for treating all stages of syphilis. Penicillin is the only recommended therapy for neurosyphilis, congenital syphilis, or syphilis during pregnancy. Rarely, T pallidum has been found to persist following adequate penicillin therapy; however, there is no indication that the organism has acquired resistance to penicillin.

The following regimens are recommended for penicillin treatment:

Clinicians should be aware that only benzathine penicillin product (Bicillin L-A) should be used, not benzathine-procaine penicillin (Bicillin C-R). In addition, oral penicillin is never appropriate for the treatment of syphilis.

If the patient arrives late for subsequent doses, clinical experience suggests that an interval of 10-14 days between doses of benzathine penicillin for latent syphilis might be acceptable before restarting the sequence of injections; however, according to pharmacokinetics/pharmacodynamics, an interval of 7-9 days between doses is more optimal. In pregnancy, missed doses are not acceptable. Pregnant patients must repeat the full course of therapy.

In patients with a history of penicillin allergy, desensitization may be necessary in cases of pregnancy, neurosyphilis, congenital syphilis, or tertiary syphilis.

According to the 2015 CDC STD guidelines, no treatment regimens for syphilis have been shown to be more effective in preventing neurosyphilis in patients who are HIV positive than the syphilis regimens recommended for patients who are HIV negative. Careful monitoring after therapy is required, as patients with HIV infection are at higher risk for reinfection and have a slower serologic response than patients without HIV infection.

As stated in the 2015 CDC guidelines, several therapies exist that might be effective in nonpregnant, penicillin-allergic patients with primary or secondary syphilis.

Tetracycline, erythromycin, and ceftriaxone have shown antitreponemal activity in clinical trials; however, they currently are recommended only as alternative treatment regimens in patients allergic to penicillin. A 10- to 14-day trial of ceftriaxone is effective for treating early syphilis, although the optimal dose and duration have not been established. Doxycycline and tetracycline for 28 days have been used for many years and are the only acceptable alternatives to penicillin for the treatment of latent syphilis. Doxycycline is the preferred alternative to penicillin owing to its tolerability.

Azithromycin has also been studied. A meta-analysis of randomized clinical trials comparing azithromycin to benzathine penicillin G for early syphilis was published in 2008 showing favorable results for azithromycin. A 2010 study by Hook et al showed a single dose of azithromycin (2 g PO) to be equivalent to the treatment of choice, benzathine penicillin G (2.4 million units IM) in patients with early syphilis without HIV. Serological cure after 6 months of follow-up was not significant between the 2 treatments, although azithromycin recipients had a higher incidence of adverse effects (mostly self-limited gastrointestinal symptoms). Although azithromycin is effective, resistance is increasing in the United States, with some areas reporting up to 84% resistance; therefore, azithromycin should be used only in areas of low resistance or in early syphilis with close clinical follow-up.

Following the initiation of treatment, the dying treponemes release inflammatory molecules that trigger a cytokine cascade possibly leading to a response known as the Jarisch-Herxheimer reaction. Symptoms include myalgias, fever, headache, and tachycardia, sometimes with exacerbation of whatever current syphilitic lesions are manifested (eg, rash or chancre).

The reaction is common, develops within several hours after beginning antibiotic treatment, and usually clears within 24 hours after onset. Its exact etiology is unclear, although it may be due to an immunological reaction to the rupture of spirochetes.

Management of this reaction often involves symptomatic treatment (eg, with antipyretics and analgesics) and observation. In pregnant women, treatment may induce early labor or cause fetal distress. Patients should be informed of the possibility of this reaction before undergoing antibiotic therapy. As stated in the CDC 2015 STD treatment guidelines, although the Jarisch-Herxheimer reaction might induce obstetric complications such as early labor or fetal distress, this risk should not preclude or delay therapy for syphilis. Women are advised to seek obstetric care after treatment if they notice any fever, uterine contractions, or a decrease in fetal movement.

Some patients experience severe anxiety and other psychological disturbances after the administration of procaine penicillin. Fever, hallucinations, hyperventilation, and convulsions characterize the reaction. Circulatory collapse is occasionally reported.