Untreated Syphilis Can Cause Neurological Problems: Understanding Neurosyphilis

Sexually Transmitted Infections (STIs) have become a widespread health problem, accounting for an estimated 37.4 crore new infections each year, according to the World Health Organization (WHO). This includes syphilis, a bacterial STI caused by Treponema pallidum. Unfortunately, most infections with syphilis are asymptomatic or unrecognised, leading to delayed diagnosis and treatment, which in turn gives rise to other health issues.

We spoke to Dr Rahul Agarwal, Consultant-Internal Medicine, CARE Hospitals, Hitech City, Hyderabad, to discuss one such complication associated with the neurological system.

Also Read: Syphilis: Expert Shares Treatment Options and Vital Preventive Measures

How Does Syphilis Spread?

Syphilis is an STI that can spread through sexual contact involving vaginal, anal, or oral sex, says Dr Agarwal.

It can also be transmitted when an infected person with a syphilitic sore (also called chancres) comes into close skin contact with another person.

Additionally, an infected pregnant woman is also prone to passing on the infection to the foetus. In fact, the WHO suggests that mother-to-child transmission of syphilis, also called congenital syphilis, can be ‘devastating to the foetus,’ especially if it isn’t detected and treated sufficiently early in the pregnancy, resulting in a high burden of morbidity and mortality.

In 2016 alone, WHO estimated 6.61 lakh total congenital syphilis cases globally, which included 1.43 lakh early foetal deaths and stillbirths, 61,000 neonatal deaths, 41,000 preterm or low-birth-weight births, and 1.09 lakh infants with a clinical diagnosis of congenital syphilis.

Untreated Syphilis May Cause Complications

According to Dr Agarwal, if syphilis is not treated during the initial stages, it can cause severe complications affecting the body. These complications include:

• Increased risk of Human Immunodeficiency Virus (HIV) infection
• Gummatous syphilis causes the development of tumour-like growth in different organs, which are soft in nature; these can target the skin, bones, brain, or liver.
• For pregnant women, it may cause stillbirth, prematurity, and other birth defects.
• Neurosyphilis can cause a major risk to the nervous system, potentially leading to stroke, dementia, psychiatric symptoms, hearing loss, and more.

What Is Neurosyphilis?

Neurosyphilis refers to an infection involving the Central Nervous System (CNS) and usually occurs in individuals who have left syphilis untreated for years, says Dr Agarwal.

According to the doctor, this primarily affects the brain and the spinal cord, increasing the risk of serious consequences like meningitis, stroke, or paralysis.

Common symptoms of syphilis include:

• A sore that can develop in your groyne area, mouth, or lips
• A rash, which might not itch
• Fever
• Fatigue
• Sore throat
• Unusual vaginal discharge

Symptoms of neurosyphilis include:

• Mood disturbances such as irritability
• Personality changes
• Changes in sleep habits
• Forgetfulness
• Memory and judgement impairment
• Confusion
• Delusions
• Seizures

Treatment Options

Treatment for syphilis depends on the stage of the infection, says Dr Agarwal.

He adds, “It can primarily be treated through the use of antibiotics like benzathine penicillin G, which is administered through injection. Later stages of syphilis will require a longer course of antibiotics or other medications, depending on the severity of the infection and its effects.”

On Preventing Syphilis And Other Sexually Transmitted Infections

Some of the most effective ways to prevent syphilis or other STIs include:

• Practising safe sex by using condoms, vaginal condoms, and dental dams
• Getting regular sexual health checkups or tests done by a medical professional
• Seeking immediate medical assistance for any syphilis-related symptoms
• Finishing your treatment and the prescribed dose for the infection
• Communicating with your sexual partner and suggesting getting tested before any infection

Conclusion

Syphilis is a condition that spreads through sexual contact. It can lead to symptoms, but many remain asymptomatic for years, which leads to delayed diagnosis and treatment. Untreated syphilis can lead to complications, including neurosyphilis, which affects the CNS and causes neurological problems. This is a potentially life-threatening condition, and one must take all the preventive measures against it.