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General Practice 2023

Sífilis primária: what é, symptoms and treatment

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Sífilis primária: what é, symptoms and treatment
Sífilis primária: what é, symptoms and treatment

Primary syphilis is the first stage of syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum. In this first stage of syphilis, the disease is characterized by the appearance of a wound that does not hurt, does not itch and does not cause discomfort, healing naturally and without needing treatment.

Because it causes a wound that heals without treatment, it is common that syphilis is not identified or treated during the primary phase. This causes the bacteria to continue circulating in the body and manage to reach other organs, resulting in the appearance of symptoms related to secondary and tertiary syphilis. Learn more about syphilis and its stages.

Ideally, primary syphilis should be treated as soon as it is diagnosed, even if there are still no symptoms other than a small sore in the genital area. For this, an antibiotic is usually used, usually penicillin.

Symptoms of primary syphilis

The main symptom of primary syphilis is the appearance of a lesion/wound that:

  • Does not itch;
  • It doesn't hurt;
  • Does not cause discomfort;
  • Releases a clear liquid;
  • In women, it can appear on the labia minora and on the wall of the vagina, making it difficult to identify;
  • In men, may appear around the foreskin;
  • If there has been unprotected oral or anal sex, it may appear in the anus, mouth, tongue or throat.

Primary syphilis lesion is also called hard chancre and usually appears about 3 weeks after contact with the bacteria, which tends to happen due to unprotected sexual intercourse or direct contact with other people's lesions infected.

Although hard chancre is quite characteristic of the disease, it is often not identified due to the location where it appears, or it is not given much importance because it does not hurt or cause discomfort and disappears after 4 to 5 weeks without leave scars.

However, even with the disappearance of the hard chancre, it does not mean that the bacteria has been eliminated from the body and that there is no risk of transmission. On the contrary, the bacteria reach the circulation and travel to other parts of the body, giving rise to other symptoms, such as swelling, the appearance of red spots on the skin, headache, fever and malaise. Know how to recognize the main symptoms of syphilis.

How to confirm the diagnosis

The diagnosis of syphilis still in the primary phase is very important, as it is possible for the treatment to be started immediately afterwards, preventing the bacteria from multiplying and spreading to the body and also preventing complications. Thus, the most recommended thing is that as soon as the person notices the appearance of a wound in the genital, anal or oral region that does not hurt or itch, go to the gynecologist, urologist, infectious disease specialist or general practitioner to be evaluated.

If the person has had a risky behavior, that is, has had sexual intercourse without a condom, the doctor may indicate the performance of tests for syphilis, which is the rapid test and the non-treponemal test, also called VDRL.From these tests, it is possible to know if the person has the infection by the bacterium Treponema pallidum and in what quantity, which is given by the VDRL test, which is important for the doctor to define the treatment. Understand what the VDRL exam is and how to interpret the result.

How the treatment is done

Treatment for syphilis should be started as soon as the diagnosis is made and it should be done by the couple, even if there are no symptoms, since the bacteria can remain in the body for years without causing signs or symptoms. Treatment is usually done with the use of antibiotic injections, usually Benzathine Penicillin. However, in some cases, the doctor may recommend using Doxycycline or Tetracycline.

Treatment time and medication dose vary according to the severity and time of contamination by the bacteria. Understand better how the treatment for syphilis is done.

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