Secondary Syphilis Symptoms, Underlying Causes, and Diagnostic Approaches
Secondary syphilis is a stage of the sexually transmitted infection (STI) syphilis, characterised by a distinctive rash, systemic symptoms, and mucocutaneous lesions. This article aims to provide a comprehensive overview of secondary syphilis, its diagnosis, treatment, and prevalence.
People who are sexually active, particularly those living with HIV or taking PrEP, are advised to consider regular testing for syphilis. Pregnant individuals are also recommended to have blood tests for syphilis as a safety precaution.
Secondary syphilis typically presents between 4 and 10 weeks after the initial infection. The key symptoms include a rash that often involves the palms of the hands and soles of the feet, but can also appear on the chest, back, limbs, and other body areas. Other symptoms may include white or grey lesions, fever, fatigue, headache, enlarged lymph nodes, hair loss, and malaise.
Diagnosis of secondary syphilis usually begins with a clinical evaluation of the rash and other symptoms, a review of the individual's medical history, and a discussion of their sexual activity. This is followed by blood tests that detect antibodies to *Treponema pallidum*, the bacterium that causes syphilis. In some cases, direct detection techniques such as dark-field microscopy from lesion exudate or PCR testing may be used.
Treatment for secondary syphilis consists of the antibiotic penicillin, usually given as an intramuscular injection of benzathine penicillin G. This remains the first-line, highly effective treatment. Alternative antibiotics may be used for those allergic to penicillin, but penicillin is preferred, especially in pregnant women and for preventing late-stage complications.
Early treatment typically resolves symptoms and prevents progression to latent or tertiary syphilis. Follow-up blood tests are recommended to monitor treatment response and ensure complete cure.
In recent years, 58 percent of new primary and secondary syphilis diagnoses occurred in men who have sex with men. However, syphilis is still prevalent in sexually active heterosexual couples and in females. It is crucial to note that syphilis passes between people through direct contact with syphilis sores.
With early detection and treatment, the syphilis infection will clear up relatively quickly. However, it is possible for a person to catch the infection again. Using latex condoms can help prevent spreading syphilis infections in some cases.
It is important to remember that syphilis is a serious STI that can lead to life-threatening complications if left untreated. Regular testing and open discussions about sexual health are key to preventing the spread of syphilis and other STIs. If you have open sores on your genitals, anus, or mouth, it is advisable to see a doctor immediately.
References: [1] Centers for Disease Control and Prevention. (2020). Syphilis. Retrieved from https://www.cdc.gov/std/syphilis/ [2] World Health Organization. (2020). Syphilis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/syphilis [3] Mayo Clinic. (2020). Syphilis. Retrieved from https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20353320 [4] National Institute of Allergy and Infectious Diseases. (2020). Syphilis. Retrieved from https://www.niaid.nih.gov/diseases-conditions/syphilis
- Despite the rash being a key symptom of secondary syphilis, skin-care products do not provide protection against the sexually transmitted infection.
- The Centers for Disease Control and Prevention (CDC) advise people who are sexually active, particularly those living with HIV or taking PrEP, to consider regular testing for syphilis as part of their overall health-and-wellness regime.
- Mental-health awareness is crucial, as the stigma surrounding STIs like syphilis can lead to delayed treatment, which may result in serious health complications.
- Regular skin-care practices should not replace regular health checks and safe sexual practices, as the best defense against syphilis is knowledge, prevention, and early treatment.
