Syphilis treatment journey in adults

Overview

Syphilis is a sexually transmitted infection (STI) caused by bacteria. It can affect many parts of the body and goes through different stages. With early treatment, it is curable.

Syphilis is less common than some other STIs, but rates have been increasing in many countries, especially among men who have sex with men.

Anyone who is sexually active can get syphilis. It is more common in people with multiple sexual partners, men who have sex with men, and people living with HIV.

Symptoms

Common symptoms

• A painless sore (chancre) on the genitals, mouth, or rectum
• A rash on the body, especially on the palms and soles
• Fever, sore throat, fatigue, swollen lymph nodes
• Patchy hair loss

Symptoms in children

• Syphilis in children is rare and is usually passed from mother to baby during pregnancy (congenital syphilis).
• Symptoms may include rash, fever, failure to thrive, and bone problems.

Symptoms in older adults

• Older adults can get syphilis, and symptoms may be similar to younger adults.
• Sometimes symptoms are mistaken for other age-related conditions, so testing is important.

Causes

Main causes

• Infection with the bacterium Treponema pallidum
• Transmitted through direct contact with a syphilis sore during vaginal, anal, or oral sex

Risk factors

• Having unprotected sex
• Having multiple sexual partners
• Being a man who has sex with men
• Living with HIV or other STIs
• Engaging in sex work

When to see a doctor

See a doctor urgently if:

• If you have symptoms of syphilis, such as a sore or rash.
• If you have been exposed to someone with syphilis.
• If you are pregnant and think you may have syphilis.

Book a routine appointment if:

• Even without symptoms, consider regular STI screening if you are at higher risk.

Diagnosis

Your doctor will ask about your symptoms and sexual history, examine any sores or rashes, and order blood tests to check for antibodies to the syphilis bacteria.

Tests that may be done

• Blood test (serology)
• Fluid from a sore (if present) can be examined under a microscope

What to expect at your appointment

The blood test results usually come back within a few days. If the test is positive, your doctor will discuss treatment options and may also recommend testing for other STIs like HIV.

Treatment

Syphilis is treated with antibiotics, usually given as an injection or a course of pills. The exact treatment depends on the stage of the infection and your general health. It is important to finish all of the treatment, even if you feel better. Your doctor will also ask you to avoid sexual contact until the infection is completely cleared.

Self-care at home

• Avoid sexual activity until your doctor confirms the infection is gone.
• Tell your sexual partners so they can get tested and treated.
• Complete the full course of treatment as prescribed.

Medical treatments

The standard treatment for syphilis is a course of antibiotics, usually given as an injection into a muscle. For people with early-stage syphilis, a single injection may be enough. For later stages or if the infection has spread to the nervous system, a longer course of treatment (injections or pills) is needed. Your healthcare provider will choose the best treatment for your situation.

Living with this condition

During treatment, you should rest and follow your doctor's advice. Avoid sex until follow-up blood tests show the infection is cured. Syphilis can make you feel tired or feverish, but most people feel better quickly after starting treatment.

Lifestyle tips

• Use condoms correctly every time you have sex to prevent new infections.
• Get tested regularly for STIs if you are at higher risk.
• Avoid alcohol or drugs that might affect judgment about safe sex.

Diet and exercise

Eating a balanced diet and staying active can help your body fight infection. Drink plenty of fluids and get enough sleep.

Mental health and emotional wellbeing

A diagnosis of syphilis can cause anxiety, shame, or stress. It is important to remember that it is a treatable infection. Talking to a counselor, support group, or trusted friend can help. You are not alone.

Prevention

Yes, syphilis can be prevented by using condoms consistently and correctly, having fewer sexual partners, and getting regular STI screenings if you are at higher risk.

Screening programmes

Routine screening for syphilis is recommended for people at higher risk, such as men who have sex with men, people with HIV, and pregnant women. Talk to your doctor about whether screening is right for you.

Complications

If left untreated

• The infection can progress to later stages that damage the heart, brain, nerves, eyes, and other organs.
• It can increase the risk of getting or spreading HIV.
• In pregnant women, it can cause miscarriage, stillbirth, or severe birth defects in the baby.

Long-term outlook

With prompt treatment, syphilis is completely curable. Early-stage syphilis is easily treated, and most people recover without lasting effects. Even late-stage syphilis can be treated, though some damage may be permanent. The key is to get tested and treated as soon as possible.

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