The bacteria cannot survive too long in outside conditions (airborne) and necessitates one to be in direct contact with infectious lesions. These bacterium rapidly circulate through mucous membranes after penetrating the skin, simultaneously spreading itself in blood vessels and the lymphatic system. It can be viewed only through dark field microscopy, given its small size.
Signs and Symptoms of Syphilis in Women
The four broad stages of syphilis characterized by its advancement are:
- Latent (Hidden)
- Tertiary (Last)
The first stage, known as primary syphilis, is when the infected area creates a highly infectious sore, known as a Chancre. This is usually a stiff, small and round protrusion that doesn't hurt when touched. This spot appears where the bacteria has pierced the skin area on one's body. This ulcer-like bulge is highly contagious and lasts up to 5 weeks and can heal on its own. The ulcer is saturated with bacteria which can be transmitted on contact. The use of condoms cancels out its effectiveness if the ulcer is present away from the main genital area; this also applies when contact is made with the ulcer present in the mouth region if two were to kiss. The time between exposure to the contagious ulcer and the start of the first symptoms can range from 10-90 days.
The second stage, known as secondary syphilis, is when the infected surface of the skin area forms a rash-like appearance that isn't itchy. The chancre can last up to 4-10 weeks or could be the signs of it fading away. Spots can appear on the back of your feet or the palms of your hands, seemingly rough like that of a coin's surface. Variations on the characteristics of these ulcers range from white patches in one's mouth to dark circular patches or those that resemble chickenpox. Symptoms later in this stage include genital warts, headaches, weight loss, sore throat, hair loss in patchy sections on one's head, random acne breakout, feeling lethargic, and swelling of glands. Other skin lesions that are witnessed in secondary syphilis are condylomata latum and patchy alopecia. Condylomata latum aren't painful but are highly infectious gray-white lesions that develop in warm, damp areas of the body.
If not diagnosed on time, the infection builds up to the third stage, which is a latent stage where the symptoms aren't discernible and are no longer transmittable. The bacterium remains within the body and starts attacking vital organs. The internal damage done to the body can be witnessed even years later. These include dementia, impotence, heart vessels bloating due to blockages, blindness, paralysis, knee joint fractures and even tumors; these are serious enough to result in death. Gummatous syphilis or granulomatous lesions, called gummas, are prone to appear in the skin layer, bones or liver but can still affect other organs. These lesions though are non-infectious, and can be fibrotic in nature, that is, excessive fibrous tissue in the connective tissue in the organs.
Types of Syphilis and Their Characteristics
Syphilis tends to branch out into many variations of what the disease can do, that correspond to damage done on the body. Some of these are explained in the following table.
|Cardiovascular Syphilis||Can occur 10 years after the initial stage. This causes chronic inflammatory degeneration of the vasa vasorum, that is, the penetrating vessels that nourish large artery walls.|
|Meningovascular Syphilis||It results in the damage of the blood vessels of the meninges, spinal cord and brain. This can lead to neurological impairments. Disruption in the dorsal roots of the spinal cord can lead to loss of sensations like pain, temperature, and areflexia, which is the inability to use one's reflexes. Impairment of memory, personality changes, psychotic behavior and loss of speech are also destructive symptoms.|
|Congenital Syphilis||This causes the bacteria to pass through the placental barrier affecting the fetus in the womb of the mother, usually resulting in stillbirth. Termed 'Snuffles', this leads to mucopurulent rhinitis (inflammation), which involves the nasal mucosae - the mucus-secreting membrane lining the organ.|
|Miscellaneous||Syphilis then advances, leading to teeth and bone deformities which include Hutchinson's teeth, where the upper incisors are spaced wide apart and jagged; saddle nose, where the nasal septum deteriorates; Clutton's joints, where the knee joints start to swell up; and mulberry molars, where the teeth are pointed higher than their normal elevation.|
To diagnose if one has syphilis, there are many ways in which it can be recognized by a doctor, done by a series of tests. These include:
- Swab / Scraping Test
- Syphilis Blood Testing
- RPR Test (Rapid Plasma Reagin Test)
- VDRL Test (Veneral Disease Research Laboratory Test)
- CSF Syphilis Test (Cerebrospinal Fluid; fluid that surrounds the spinal cord)
- Lumbar Puncture (Spinal Tap) Test - to check if syphilis has spread through the CSF
- Swab of Chancre - during the first and secondary syphilis stages
- Syphilis Antibody Evaluation Test - Treponema Pallidum Hemagglutination Assay (TPHA) AND Fluorescent Treponemal Antibody-Absorption Test (FTA-ABS)
Symptoms of Syphilis in Women Who Are Pregnant
Women experiencing symptoms during pregnancy show similar symptoms to that of other women; with the added risk of infecting newborns as well. Women expecting can experience miscarriages, stillbirths and even premature births, if suffering from syphilis. Babies with syphilis may experience the following symptoms:
- Skin sores
- Swollen liver and spleen
- Slow development
- Death due to severe damage done by the disease