SYPHILIS: WHAT ARE THE SYMPTOMS?
The symptoms of syphilis are numerous and varied. Any organ system can be affected. Those who have compromised immune systems, such as persons with acquired immunodeficiency syndrome (AIDS), may have a more aggressive course of infection and less typical symptoms.
Syphilis is divided into early and late stages of infection. Early infection is further subdivided into primary syphilis, secondary syphilis, and early latent syphilis. Late infection is also subdivided, into late latent syphilis, tertiary syphilis, and neurosyphilis. How long the infection has been present and the nature of the symptoms determine which stage of infection is present, what type of treatment is necessary, and for how long it must be administered.
After infection with syphilis, symptoms of primary syphilis can take between ten and ninety days to appear, with the average interval being around three weeks. The first symptom is an ulcer, called a chancre, which is usually painless. There is usually only one chancre, which occurs at the site where infection took place. This can be on any area of the skin or on any mucous membrane. Rarely, the lesion is slightly painful, especially if there is a secondary infection with skin bacteria. (Other STDs that can cause similar symptoms are herpes, chancroid, and granuloma inguinale. A swab taken from the chancre is usually seen to contain the syphilis-causing bacterium, Treponema pallidum, when examined under the microscope. There is usually a nonpainful swelling of the lymph nodes in the area of the infection. Often the infected person does not realize that he or she is infected, especially since a painless lesion is easy to miss, particularly if it is in the vagina or on the cervix for a woman or in the urethra for a man. The lesion usually disappears on its own after a few weeks without treatment.
If a person is not diagnosed and treated at this point, then, several months later, symptoms of secondary syphilis can appear. This stage occurs when the syphilis-causing bacterium enters the bloodstream from the lesion. It can seed any organ and cause a variety of symptoms, including
—A red, flat, nonitching rash over the whole body, including the palms and soles
— Swelling of the lymph nodes throughout the body
— Sore throat —Joint aches
— Headaches
— Patchy hair loss
—Wart-like lesions in the genital area that are not warts but manifestations of secondary syphilis
There can also be painless lesions on the mucous membranes and neurological changes, among other symptoms. People with secondary syphilis may also feel like they have the flu, and in fact these symptoms are so vague that they can easily be mistaken for other medical problems. All of these symptoms will eventually resolve without causing further problems, but this does not mean that the infection has gone away.
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