Understanding Syphilis - Symptoms I Diagnosis I Treatment & Prevention

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It can have serious health implications if left untreated. Here we'll delve into the symptoms, diagnosis, treatment, and prevention strategies for syphilis.
Currently , there has been a resurgence of this old disease and increasing coinfection with HIV is also been encountered.
Symptoms of Syphilis include
1. Primary Stage: A painless sore or ulcer (chancre) usually appears at the site of infection 9-90 days after the exposure, often on the genitals, rectum, or mouth. It heals within a few weeks. Other STDs like Herpes, chancroid, lymphogranum venereum (LGV) , granuloma inguinale should be ruled out.
2. Secondary Stage: If left untreated, the infection progresses to the secondary stage, marked by a rash, mucous membrane lesions, and flu-like symptoms. These symptoms can come and go over a span of weeks to months.
3. Latent Stage: Without treatment, syphilis enters a latent stage where there are no visible symptoms, but the bacteria remain in the body.
4. Tertiary Stage: In some cases, syphilis can progress to the tertiary stage, which can damage organs like the heart, brain, and nervous system. This stage can be life-threatening.

Diagnosis: Syphilis can be diagnosed through several methods:
1. Blood Tests: Blood tests, such as the serological (Rapid Plasma Reagin (RPR) test , VDRL (Venereal Disease Research Laboratory) and the Treponemal Pallidum Hemagglutination (TPHA) test, can detect antibodies produced in response to the infection. Each differs the others in the precise substance being measured, complexity, and specificity.
2. Direct Testing: If a sore is present, a sample can be taken and examined under a microscope to identify the bacteria. This is usually practically not feasible.

Whenever a screening test (RPR, VDRL) is positive, a more specific test (FTA-ABS, TP-MHA) should be used to confirm the test and rule out a "biologic false positive."
TPHA remains positive for life & hence, prior syphilis treatment history and sexual history is needed for right interpretation if TPHA is positive.

Treatment:
Syphilis is treated with antibiotics, primarily penicillin. The type and duration of treatment depend on the stage of syphilis and the individual's medical history. It's essential to complete the full course of antibiotics even if symptoms disappear. Benzathine penicillin, Crystalline penicillin , ceftriaxone & doxycycline can be used for the treatment depending upon the stage of syphilis infection , associated HIV infection, feasibility of intravenous or intramuscular injection, allergy to antibiotics and affordability.
Prevention
1. Safe Sex: Using condoms consistently and correctly can reduce the risk of syphilis transmission.
2. Regular STI Testing: Regular STI screenings, especially for individuals with multiple partners, can help detect syphilis and other infections early.
3. Partner Communication: Openly discussing sexual health with partners can promote informed decisions and safer practices.
4. Avoidance of Risky Behaviors: Avoiding high-risk sexual behaviors can lower the likelihood of exposure to syphilis.
5. Vaccination: While no vaccine for syphilis currently exists, some research is being conducted in this area.

Syphilis is a serious infection that can have severe consequences if not diagnosed and treated promptly. Being aware of its symptoms, understanding its diagnosis and treatment options, and adopting preventive measures can contribute to a healthier and safer sexual life. Remember, practicing safe sex and maintaining open communication with partners and healthcare providers are crucial steps in preventing the spread of syphilis and other STIs. If you suspect you might have syphilis or any other STI, seek medical advice and get tested promptly.