Syphilis is a sexually transmitted disease (STD). If left untreated, syphilis can cause brain, nerve, tissue damage, and death. Fortunately, syphilis can be treated with antibiotics.
Syphilis is caused by specific bacteria. It is transmitted through direct contact with a syphilis lesion. This may occur when: There is vaginal, anal, or oral sexual contact with an infected person
A pregnant woman passes the infection to her unborn baby—congenital syphilis
Factors that may increase your chance of getting syphilis include: Having sex with a person infected with syphilisHaving multiple sex partnersNot using a latex condom during vaginal, anal, or oral sexTouching a syphilis lesionHaving other sexually transmitted diseases
Symptoms will depend on what stage the syphilis is in. There are 3 main stages as well as a resting phase.
A single lesion will usually appear. It will occur in the area where the infection was originally passed. Common sites include the genitals, rectum, tongue, inside of the mouth, or lips.
It will start as a raised and painless lesion called a chancre. It will gradually break down to form an ulcer. It usually lasts for 3-6 weeks. The ulcer will heal on its own.
Without treatment, the infection may move to the secondary stage. This can happen even if the ulcers are no longer visible.
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This stage is marked by the appearance of a non-itchy rash. This rash may appear as rough, red, or reddish brown spots on the palms of the hands or soles of the feet. It is also possible for different rashes to appear in other places on the body. These rashes may appear as: Small blotches, pustules, or scalesMoist warts in the groin areaSlimy white patches in the mouth
The rash may be accompanied by flu-like symptoms, such as: Sore throatSwollen lymph nodes throughout the bodyFeverHeadacheFatigueMuscle aches
Untreated secondary symptoms will disappear within a few weeks, but there may be repeated episodes during the next few years.
The infection is still present but there are no symptoms. It may or may not progress to the third stage. Blood tests for syphilis will be positive during this stage.
This stage may begin years after the initial infection. This stage has become rare in developed countries. In this stage, the infection begins to damage: Brain and nervesEyesHeart and blood vesselsLiverBones and joints
Damage can be serious enough to cause death. Symptoms include the following: Small bumps called gummas on the skin, bones, or internal organsBlindnessCentral nervous system damage, including weakness, numbness, trouble walking, difficulty with balance, memory and psychiatric problems, and loss of bladder control
Babies born with this infection can have problems, such as deafness, cataracts, brain and nerve damage, and seizures. It can also cause premature births or stillbirths.
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You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids will be tested. This can be done with: Samples taken from lesionsBlood tests
A spinal tap
Syphilis testing is part of routine prenatal care. This is done to treat and prevent congenital syphilis.
All people who have syphilis should also be tested for HIV.
Syphilis can be treated with antibiotics. The type of antibiotic and length of treatment will depend on how long you have been infected. Half of those being treated for syphilis will have fever with headache, muscle aches, and other symptoms during the first 24 hours of treatment.
If you have syphilis of any stage, avoid sexual contact until treatment is complete and the infection is gone. All sex partners should be notified. They will need to be treated as well.
To reduce your chance of getting syphilis: Abstain from vaginal, anal, and oral sex.Have a mutually monogamous sexual relationship with an uninfected partner.
Use a latex
during vaginal, anal, and oral sex. This is especially important if you are unsure of your partner's status.
Have regular testing for sexually transmitted diseases, especially if you are at increased risk.Make sure your sexual partner is also treated if you have primary, secondary, or early latent syphilis.
It may not be obvious that a sex partner has syphilis. Do not assume your partner is healthy just because you do not see lesions.
Syphilis. National Institute of Allergy and Infectious Diseases website. Available at:
http://www.niaid.nih.gov/topics/syphilis/Pages/default.aspx. Updated October 27, 2014. Accessed June 7, 2016.
Syphilis-CDC fact sheet. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm. Updated May 20, 2016. Accessed June 7, 2016.
Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010.
7/13/2016 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2016 Jun 7;315(21):2321-2327.
Last reviewed June 2016 by Marcie Sidman, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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