Is cervical lymphadenopathy related to syphilis?

Written by Li Chang Yue
General Surgery
Updated on January 29, 2025
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Enlargement of cervical lymph nodes is somewhat related to syphilis. Although cervical lymph node enlargement is not necessarily solely caused by syphilis, if syphilis progresses to its secondary or tertiary stages, it tends to cause lymph node enlargement, and severe cases may even lead to ulceration. This happens because after a syphilis infection, immune responses in the lymph cells are triggered by the Treponema pallidum, leading to the enlargement of cervical lymph nodes, and also possibly the lymph nodes under the arms and in the groin area. In such cases, it is advised to seek timely medical attention, complete the necessary immunological testing, and ensure an accurate diagnosis of syphilis. If cervical lymph node enlargement occurs, prolonged treatment with penicillin should be administered, as it effectively controls the Treponema pallidum and can help reduce the severity of the lymph node enlargement.

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Can third-stage syphilis be completely cured?

Whether tertiary syphilis can be completely cured depends on the specific conditions of different patients. If tertiary syphilis has not caused serious complications, then timely and standard syphilis treatment at this stage can potentially lead to a cure. However, if it has been a long time and the condition has been neglected, it might cause severe damage to tissue and organ functions and can be life-threatening. At this point, it cannot be completely cured; even using anti-inflammatory drugs to treat syphilis cannot reverse the complications and greatly affects the quality of life.

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What are the early symptoms of syphilis?

Syphilis is divided into overt and latent syphilis. Latent syphilis, regardless of whether it is early or late stage, shows no symptoms at all and can only be confirmed by blood testing. The symptoms in the early stage are mainly those of overt syphilis, primarily manifestations of primary syphilis. The stages of primary, secondary, and tertiary syphilis begin with the appearance of a lesion at the site of infection, typically about 0.5 to 1 centimeter in diameter, with a hard, dark red nodule that feels like cartilage. The surface may have ulcers; it may be painless, or there may be no pain at all. Subsequently, nearby lymph nodes may become enlarged. This swelling of the lymph nodes is characterized by being painless, usually unilateral, with no redness or rupture. These are the clear symptoms of overt primary syphilis. If treated properly at this stage, recovery is generally rapid.

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Written by Kang Jian Hua
Reproductive Center
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Can the eugenic five-item test detect syphilis?

To know whether the eugenic five-item test includes syphilis, it is first necessary to clarify the components of this test. The eugenic five-item test includes screenings for toxoplasmosis, rubella virus, cytomegalovirus, and herpes simplex virus types 1 and 2, and it does not include a test for syphilis. Therefore, the eugenic five-item test does not cover syphilis. These five tests are mainly aimed at checking for viral infections before or during early pregnancy. The presence of any of these infections can be harmful to the fetus, potentially leading to early miscarriage, stillbirth, or congenital malformations. Thus, the eugenic five-item test does not include a syphilis test, which falls under sexually transmitted disease screenings.

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Can syphilis be completely cured?

Syphilis can generally be completely cured nowadays, except neurosyphilis which is somewhat harder to treat, as ordinary syphilis is curable and neurosyphilis may relapse occasionally. However, most current cases of syphilis fall into categories of latent, primary, or secondary syphilis. Tertiary syphilis is less common, and forms such as neurosyphilis and osteal syphilis belong to this stage. Therefore, when treated at a regular hospital with a standard treatment regimen, primarily using penicillin, administered as a long-acting intramuscular injection once a week, the recommended course of treatment usually consists of three to four weeks. If there is an allergy to penicillin, doxycycline can be used as an oral substitute for half a month.

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Symptoms of tertiary syphilis

Tertiary syphilis is the most severe stage of syphilis. The most common skin and mucosal damage in tertiary syphilis appears on the scalp, scapula, back, and the extensor sides of the limbs, where nodular syphilitic rashes can be observed, and gummatous swellings can also be seen on the lower legs. Apart from damaging the skin and mucous membranes, tertiary syphilis can also harm the cardiovascular and nervous systems. If the cardiovascular system is affected, it can cause problems in the aortic arch, leading to aortic valve insufficiency and syphilitic heart disease. If the nervous system is involved, it can cause neurosyphilis, manifesting as syphilitic meningitis, cerebrovascular syphilis, meningeal gumma, paralytic dementia, and more. In summary, once afflicted with tertiary syphilis, patients can exhibit a variety of clinical symptoms such as increased intracranial pressure, headaches, sensory abnormalities, ataxia, paralytic dementia, and localized brain compression, among other symptoms.