What is Secondary Syphilis?

Secondary syphilis is the second stage of syphilis infection. It will occur in patients with untreated syphilis and if the disease continues to remain untreated, it can either convert to a latent phase in the patient or develop into tertiary syphilis. The signs and symptoms of secondary syphilis are distinctive and easy to identify, and treatment can be provided to resolve it and prevent the progression of the disease.

Syphilis is a sexually transmitted infection caused by bacteria known as spirochetes. In primary syphilis, the first stage, a sore known as a chancre occurs. Sometimes the sore is relatively discreet, and it may be missed or mistaken for something else. Around two weeks to as much as six months after the sore resolves, the patient develops secondary syphilis, caused by the spread of the bacteria through the body.

In a patient with secondary syphilis, a rash develops. The rash may be localized or widespread and it is highly infectious. The rash is bright red with raised lumps and can be very uncomfortable. Patients can also have fevers, chills, headaches, fatigue, hair loss, swollen lymph nodes, and other flu-like symptoms. If a patient presents with these symptoms and has a history of a sore, a doctor can go ahead and start providing syphilis treatment. The rash can also be scraped and cultured to look for bacteria. Once the rash starts to heal, the patient will no longer be infectious.

Treatment for secondary syphilis involves the administration of antibiotics to kill the bacteria. Once the bacteria are dead, the rash will resolve. People with syphilis are at risk of a medication reaction called a Herxheimer reaction, believed to be caused by the mass release of toxins by dying bacteria. As a result, they may experience a period where they feel much worse after taking medication before they start feeling better. It is important to avoid stopping the antibiotics. If a patient's Herxheimer reaction is extreme, another course of medication can be tried.

Untreated syphilis can become dangerous, and this disease often goes unnoticed. For people who are sexually active, an annual sexually transmitted infection screening is recommended to identify syphilis, gonorrhea, chlamydia, and other conditions commonly passed through sexual contact. People who engage in risky behavior may want to consider more frequent screenings for sexually transmitted infections. If the test is positive, treatment can be provided to resolve the condition before it has an opportunity to cause complications.