Syphilis Symptoms in Men

A common sexually transmitted infection (STI), syphilis has different stages. And the symptoms of this infection vary with each of these stages. This article gives you an elaborate guide on the symptoms of syphilis, and their importance in determining the severity of the infection.
Syphilis is caused by the bacterium Treponema pallidum, and it infects the genital area, mouth, lips, rectum or anus. A healthy person can contract this infection by coming in close contact with a sore of an infected person. This mostly occurs during vaginal, anal or oral sex. Syphilis may also spread by sharing items such as sex toys. The infection may spread from a pregnant mother to her unborn baby during pregnancy or birth. It, however, cannot be transmitted by sharing items like utensils, clothing, etc. Most people infected with syphilis do not notice any symptoms even for years. Furthermore, the symptoms that syphilis exhibits may easily mimic those of other diseases thus, making the infection difficult to be diagnosed early.

Commonly Exhibited Symptoms of Syphilis
Symptoms of syphilis may vary with each stage of the infection. The infection has its time of activity and inactivity. When it is active, it may cause bouts of symptoms, and not when otherwise. In some cases, the stages may overlap, and the symptoms may not surface in an usual manner.

First Stage

The first stage or the primary stage of syphilis is characterized by a painless sore that occurs in the area that gets infected by the syphilis bacterium. In both men and women, the sore is commonly found in the rectal region, anus, tongue and lips. In men, the sore typically occurs near the head of the penis, and in women, within the vaginal region. This sore is usually small, round and firm, and clinically it is called a
. Most people with syphilis develop only one chancre, but some may have more. A chancre usually disappears on its own within a span of 6 weeks, without the help of any treatment. But this does not signify that the infection has resolved, and it only indicates clearance of the syphilis bacteria locally. So if the infected person does not receive proper or timely treatment, syphilis goes on to its next stage.

: Given its painless nature and petiteness, a syphilis sore, in most cases, remains inconspicuous to an infected person. This is especially true when the sore occurs somewhere inside the rectal region, and inside the vagina in case of women. This makes it difficult for syphilis to get detected during its primary stage.

Time of Occurrence
: On an average, the syphilis sore usually occurs about 3-6 weeks after a person gets infected by the syphilis bacterium. For some people, it may take 10-90 days for the sore to surface.

Mode of Transmission/Contagiousness
: Direct contact of a chancre with skin or mucous membranes.

Second Stage

Few or several weeks after the chancre has disappeared on its own or is healing, syphilis triggers a
red or reddish brown rash
that may be localized or spread to the entire body. Most people develop the syphilis rash on their palms and soles. Unlike most other skin rashes, a syphilis rash does not itch. Also, in most people, sores similar to warts occur along with this rash. The occurrence of such a rash indicates that the syphilis bacterium has entered the bloodstream, and is spreading throughout the body while multiplying rampantly. And this is why, the rash may be accompanied by other symptoms such as:
  • Swollen lymph nodes; commonly in the groin area, and also in the neck and armpit region
  • Fever
  • Poor appetite, accompanied by weight loss
  • Tiredness
  • Hair loss
  • Muscle aches
At one point of time, all these symptoms may cease to occur only to recur and disappear again. For some people, this can go on for about a year. If the infection is not detected and treated, it goes on to its next stage where it becomes latent.

: In some people, the syphilis rash may be too faint to become conspicuous, and thus may go unnoticed like a chancre.

Time of Occurrence
: On an average, the syphilis rash may occur 2-10 weeks after a chancre has healed.

Mode of Transmission/Contagiousness
: Touching any part of the rash may transmit the infection. Syphilis is the most contagious at this stage.

Latent Stage

When syphilis symptoms gradually disappear, and do not recur at all for years, the odds are, the infected person has entered the latent stage of the infection. In this stage, the syphilis bacteria goes into a "
hidden mode
", and the patient may remain symptom-free for about a year. Although present in the body, syphilis is not evident and that is why it is called "latent syphilis" in this stage. For some people, this period of latency may be as long as 5-10 years or even 20 years. If left untreated at this stage, syphilis begins to damage the internal organs of the body and moves on to its final and the most severe stage.

: Given its asymptomatic nature, syphilis is extremely difficult to detect in the latent stage. It can be diagnosed only with the help of blood tests.

Time of Occurrence
: Latent syphilis may begin 2-30 years after initial exposure to the syphilis bacterium.

Mode of Transmission/Contagiousness
: During the early latent phase that may last for about a year, an infected person remains contagious. But in the late latent phase, the risk of transmitting the infection to others is extremely low or not present.

Tertiary Stage

People who do not receive any treatment when they are still in the early stages of syphilis, may develop serious complications. Such people are then said to be in the final stage of the infection. This occurs in 15% of patients. Here, syphilis begins to spread to any part of the body including organs such as:
  • Heart and blood vessels; causing heart disease, stroke
  • Eyes; causing blindness
  • Nerves; causing paralysis, numbness
  • Brain; causing dementia, memory loss, loss of coordination
  • Joint and bone diseases
  • Liver problems
: HIV infected people who contract syphilis are more likely to reach the tertiary stage, and more rapidly than others who are not. Although syphilis in this stage is curable, the damage that it has caused cannot be reversed with any treatment. The treatment, however, may prevent any further damage. Syphilis could be fatal at this stage.

Time of Occurrence
: 10-20 years after initial exposure to infection.

Mode of Transmission/Contagiousness
: Syphilis has zero transmission rate once it enters the tertiary stage.

Congenital Syphilis

Symptoms of congenital syphilis are seen in babies who get the infection from their mother. The infection may be transmitted through the placenta to an unborn baby, or during birth. Common symptoms seen in babies born with syphilis may include:
  • Skin rash on palms and soles, and on the genitals, mouth and anus
  • Underweight
  • Saddle nose
At a later age, the infected child may develop hearing impairment, deformed teeth, and swollen joints.

: The longer a pregnant woman has syphilis, the higher are the chances for her baby dying shortly before or after birth. As syphilis shows no symptoms in its latency, infected women may only know about their condition when they give birth to a child having the same infection. In a recent study it was found that 50% of stillbirths that took place in Tanzania was due to syphilis.

Mode of Transmission/Contagiousness
: An infected mother can transmit the infection to her child during pregnancy or birth when she is in her primary or secondary stage.

Time of Occurrence
: Most babies born with syphilis may show no symptoms as then the infection may be in a hidden stage. However, the infection may reactivate later in childhood or in the adult years, causing complications.

Information on the Bacterium Treponema pallidum (T. pallidum):
  • Syphilis can only be transmitted through direct contact and not through items like utensils, towels, toilet seats, etc., because its causal bacterium, T. pallidum requires nutrients to survive and for that it needs a mammalian host.
  • Given the inability of the T. pallidum to survive outside mammalian cells, the bacterium cannot be cultured in labs, or genetically modified. And this makes it difficult to study the immune response of the mammalian host to the invasion of the bacterium in the body.
  • Syphilis is researched upon by using animal models. Rabbits are mostly used for the purpose, as they tend to show symptoms similar to the primary and secondary syphilis in humans.
  • T. pallidum survives on carbohydrates obtained from the cells in its host.
  • During initial infection, T. pallidum undergoes cell-division every 30-33 hours.
  • The bacterium spreads in the body by propelling itself in a corkscrew-like method.
Syphilis, when gets diagnosed and treated early, is easily curable. In all stages the treatment plan involves the use of penicillin - an antibiotic that helps in eliminating the causal bacteria from the body. People who have been suffering from syphilis for less than a year, require a single shot of penicillin injection to curb the infection from progressing any further. On the other hand, additional doses are required, if the infection had been in progress for more than a year.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.
By Rajib Singha
Last Updated: 8/2/2012
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