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Secondary syphilis rash

Syphilis ulcer

Syphilis(sif-ah-lis) is a sexually transmitted disease (STD) caused by Treponema (trep-ah-nee-mah) pallidum (pal-lid-um).

What is going on in the body?
Syphilis is a disease that is spread from one person to another through vaginal, anal or oral sex. An infected woman also can pass the disease on to her baby during pregnancy or childbirth. Syphilis that is passed on this way is called congenital syphilis.

The incubation period for syphilis can range from 1 to 13 weeks, but the average incubation period is about 3 weeks. The first stage of this disease, when acquired sexually, is called primary syphilis. If symptoms are not treated at this point, the disease will spread throughout the body. This is called secondary syphilis and usually occurs 2 to 8 weeks after symptoms are first noticed. Symptoms left untreated will usually go away on their own, but may recur later. This is called latent syphilis. Years after secondary syphilis, tertiary syphilis may occur causing very serious problems.

What are the signs and symptoms of the disease?
The main sign of primary syphilis is painless ulcers or broken skin like open sores around the site of the infection, usually the genitals.

Secondary syphilis involves a generalised rash usually on the palms and soles. The usual rash appears as red spots that can be flat or raised, but many different skin rashes can occur. Other symptoms of secondary syphilis include:
  • swollen lymph nodes
  • fever
  • sore throat
  • headache
  • joint pain
  • loss of appetite
  • weight loss
Sometimes people can develop meningitis (men-in-jie-tis), which is an inflammation of the membrane that surrounds the brain and spinal cord, or eye, kidney or liver problems.

Tertiary syphilis can involve any organ of the body. When the brain is involved it is called neurosyphilis (new-roh-sif-ah-lis). Neurosyphilis can cause many problems, including:
  • weakness or paralysis
    • loss of speech
    • seizures, which occur when a group of muscles in the body suddenly shake violently and uncontrollably
    • deafness
    • blindness
    • psychiatric disturbances
    The heart and the aorta can also be involved in tertiary syphilis, as can the skin and bones.

    People with congenital syphilis can either have no symptoms or very severe symptoms. It can even cause death. As with syphilis acquired sexually, it can affect any organ in the body. The usual symptoms of congenital syphilis include:
    • enlarged lymph nodes
    • rash
    • enlarged liver and spleen
    • bone abnormalities
    • low blood count
    If left untreated, the late signs of congenital syphilis include subtle bone malformations, malformed teeth, and eye and brain problems.

    What are the causes and risks of the disease?
    • Treponema pallidum is the cause of syphilis.
    Unprotected sexual intercourse increases the chance of acquiring syphilis.

    What can be done to prevent the disease?
    To prevent syphilis, use a barrier method such as a latex or plastic condom or a female condom when having sex. Some male condoms are made with the spermicide nonoxynol-9, which helps kill some organisms that cause STDs. Anyone diagnosed with syphilis should encourage his or her recent sexual partners to be screened and treated. Also, people infected with the AIDS virus, as well as certain other STDs, should be tested for syphilis. To prevent congenital syphilis, all women should be screened for the disease during pregnancy and treated if positive.

    How is the disease diagnosed?
    Doctors usually diagnose the disease by testing the blood for antibodies (chemicals produced by the body to fight germs and other foreign substances) to Treponema pallidum. The doctor can look for the organism in a sample of genital secretion under a microscope.

    What are the long-term effects of the disease?
    If left untreated, syphilis is very serious. It can result in neurosyphilis, cardiovascular syphilis and tumours of the skin, bones and other organs.

    What are the risks to others?
    Infected people can spread the disease to others through sexual contact. Infected women can pass it to their foetuses during pregnancy and childbirth.

    What are the treatments for the disease?
    Penicillin is used to treat syphilis. Other antibiotics are effective in patients who cannot take penicillin.

    What are the side effects of the treatments?
    Side effects of penicillin include rash, diarrhoea, nausea and allergic reactions.

    Author: Danielle Zerr, MD
    Reviewer: HealthAnswers Australia Medical Review Panel
    Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
    Last Updated: 1/10/2001
    Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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