Long-Term Effects of Untreated Syphilis

Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, has been a significant public health concern for centuries. While the advent of antibiotics like penicillin has made syphilis relatively easy to treat in its early stages, untreated syphilis can lead to a wide range of severe and long-term health consequences. In this article, we will explore the lingering shadow cast by syphilis when left untreated.

The Stages of Syphilis

Syphilis typically progresses through four stages:

Primary Syphilis: This stage is characterized by the appearance of a painless sore or ulcer, known as a chancre, at the site of infection. The chancre often goes unnoticed, making it crucial to seek medical attention and testing after engaging in risky sexual behaviours. These sores usually occur in, on, or around the

  • penis;
  • vagina;
  • anus;
  • rectum; and
  • lips or in the mouth.

Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.


Secondary Syphilis: During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look

  • rough;
  • red; or
  • reddish-brown.

The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other symptoms may include:

  • fever;
  • swollen lymph glands;
  • sore throat;
  • patchy hair loss;
  • headaches;
  • weight loss;
  • muscle aches; and
  • fatigue (feeling very tired).

The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.


Latent Syphilis: During the latent stage, the bacterium remains in the body but does not cause any noticeable symptoms. This stage can last for years.

Tertiary Syphilis:  Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.


The Long-Term Effects of Untreated Syphilis

Cardiovascular Syphilis: One of the most severe consequences of untreated syphilis is cardiovascular syphilis. This condition can damage the aorta, the largest artery in the body, leading to aneurysms or aortic regurgitation, a heart valve disorder. These complications can be fatal if left unaddressed.

Neurosyphilis: Untreated syphilis can infect the central nervous system, leading to neurosyphilis. This can result in various neurological symptoms, including personality changes, confusion, memory problems, and even paralysis. In advanced cases, it can cause blindness, paralysis, and dementia.

Gummatous Syphilis: Gummas are soft, tumour-like growths that can develop in various parts of the body, including the skin, bones, and internal organs. Gummatous syphilis is a rare but serious complication of untreated syphilis, and it can lead to tissue destruction and severe deformities.

Congenital Syphilis: Pregnant women with untreated syphilis can transmit the infection to their unborn child. Congenital syphilis can result in stillbirth, neonatal death, or severe health problems in infants, including developmental delays and bone deformities.

Vision Impairment: Ocular syphilis can lead to vision problems or even blindness. This condition can occur at any stage of syphilis, including the primary and secondary stages.

Prevention and Treatment

The most effective way to prevent the long-term effects of syphilis is early detection and treatment. Routine screening and prompt administration of antibiotics, primarily penicillin, are highly effective in curing syphilis and preventing its progression to the later stages.

Syphilis is a curable infection, and its long-term consequences are entirely preventable through early detection and appropriate medical treatment. Regular testing, safe sexual practices, and open communication with healthcare providers are vital in reducing the incidence of syphilis and its potentially devastating effects. Understanding the gravity of untreated syphilis and its consequences is a crucial step towards its prevention and control, emphasizing the importance of sexual health education and responsible behaviour.

Having syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is necessary to make sure your treatment is successful. It may not be obvious that a sex partner has syphilis. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis, can be hard to see. You may get syphilis again if your sex partner(s) does not receive testing and treatment.

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