What is Syphilis, Diagnosis and Treatment.

What is Syphilis?

Syphilis (syphilis) is a sexually transmitted infection (STI) caused by a type of bacteria known as Treponema pallidum. In 2016, more than 88,000 cases of syphilis were reported in the United States, according to the Centers for Disease Control and Prevention.

The proportion of women with syphilis in the United States is declining, but the proportion among men is increasing, especially among men who have sex with men.

The first sign of syphilis is a small, painless ache. It can appear on the genitals, rectum, or inside the mouth. This sore is also called a syphilis boil. People often fail to notice right away.

Diagnosing syphilis can be difficult. A person can live for years without showing any symptoms.

However, the earlier syphilis is discovered, the better. Untreated for a long time, syphilis can cause major damage to important organs such as the heart and brain.

Syphilis is spread only by direct contact with syphilis. It is not transmitted by sharing a toilet with another person, wearing someone else’s clothes, or sharing someone else’s food.

Stages of Syphilis Infection

Syphilis consists of four stages:

  • Primary
  • Secondary
  • Hidden
  • Third

Syphilis is most contagious in the first two stages.

When syphilis is in the latent or latent stage, the disease remains active but often has no symptoms. Tertiary syphilis is the most damaging to health.

Primary Syphilis

The primary stage of syphilis occurs about three to four weeks after a person is infected with the bacteria. It appears as a small, round sore called a boil. This sore can occur wherever bacteria enter the body, for example, in the mouth or genitals, or in the rectum.

On average, the throat appears about three weeks after infection, but it can take 10 to 90 days to appear. The pain persists for anywhere from two to six weeks.

Syphilis is transmitted through direct contact with a wound. This usually occurs during sexual activity, including oral sex.

Secondary Syphilis

In the second stage of syphilis, skin rashes and sore throat may develop. The rash is not itchy and is usually found on the palms and soles, but can occur anywhere on the body. Some people do not notice the redness before it disappears.

Other symptoms of secondary syphilis may include:

  • Headache
  • swollen lymph nodes
  • Tiredness
  • Fire
  • weight loss
  • hair loss
  • aching joints

These symptoms disappear with treatment. However, without treatment, the person still has syphilis.

Secondary syphilis is often confused with another condition.

Hidden Syphilis

The third stage of syphilis is the invisible stage or latent stage. Primary and secondary symptoms disappear and there are no visible symptoms at this stage. However, the bacteria remain in the body. This stage can last for years before tertiary syphilis progresses.

Tertiary Syphilis

The final stage of infection is tertiary syphilis. According to the Mayo Clinic, about 15 to 30 percent of those who do not receive treatment for syphilis will enter this stage. Tertiary syphilis can occur years or decades after initial infection. Tertiary syphilis can be life-threatening. Some other potential consequences of tertiary syphilis include:

  • Blindness
  • Deafness
  • mental illness
  • Loss of memory
  • Destruction of soft tissue and bone
  • Neurological disorders such as stroke or meningitis
  • Heart disease
  • neurosyphilis, which is an infection of the brain or spinal cord

How Is Syphilis Diagnosed?

If you think you may have syphilis, go to the doctor as soon as possible. They will take a blood sample to run tests and also do a thorough physical exam. If there is a wound, your doctor may take a sample from the throat to determine if syphilis bacteria are present.

If your doctor suspects you have nervous system problems due to tertiary syphilis, you may need a lumbar puncture or spinal tap. During this procedure, spinal fluid is collected so your doctor can test for syphilis bacteria.

If you’re pregnant, your doctor may screen you for syphilis because the bacteria may be in your body without you knowing. This is to prevent the fetus from becoming infected with congenital syphilis. Congenital rheumatoid arthritis can cause serious damage to the newborn and can even be fatal.

Syphilis Treatment

Primary and secondary syphilis are easy to treat with penicillin injection. Penicillin is one of the most widely used antibiotics and is generally effective in the treatment of syphilis. People who are allergic to penicillin will likely be treated with a different antibiotic such as:


If you have neurosyphilis, your doctor may recommend that you take a daily dose of penicillin. This usually requires a short hospital stay. Unfortunately, the damage from late syphilis is irreversible. Bacteria can be killed, but treatment will most likely focus on relieving pain and discomfort.

During treatment, be sure to refrain from sexual contact until all wounds on your body have healed and your doctor has told you it is safe to continue with sexual intercourse. If you are sexually active, your partner should also be checked. Do not resume sexual activity until you and your partner have completed treatment.

How to Prevent Syphilis

The best way to prevent syphilis is to practice safe sex. Use condoms for any sexual contact. Additionally, the following may help:

  • Use a barrier (a square piece of latex) or a condom during oral sex.
  • Avoid sharing sex toys.
  • Syphilis can also be transmitted through shared needles. Avoid sharing needles if you are using injectable medications.

Complications Related to Syphilis

Pregnant Mothers and Newborns

Mothers infected with syphilis are at risk of miscarriage or premature birth. A mother with syphilis also has a risk of transmitting the disease to her fetus. This is known as congenital syphilis.

Congenital syphilis can be life-threatening. Babies born with congenital syphilis may also:

  • deformities
  • Developmental delays
  • seizures
  • rashes
  • Fire
  • swollen liver or spleen
  • Anemia
  • Jaundice
  • contagious wounds

If the baby has congenital syphilis and is not detected, late-stage syphilis may develop. This can cause damage to the following areas:

  • bones
  • Tooth
  • Eyes
  • Ears
  • Brain
  • HIV

People with syphilis have a significantly increased risk of contracting HIV. Wounds caused by the disease make it easier for HIV to enter the body.

It is also important to note that people with HIV may experience different symptoms of syphilis than those without HIV. If you have HIV, talk to your doctor about how to recognize the symptoms of syphilis.

When Should I Test for Syphilis?

The first stage of syphilis is not easily detected. Symptoms in the second stage are common symptoms of other diseases. That means if any of the following apply to you, consider getting tested for syphilis. It doesn’t matter if you have any symptoms or not. Check yourself if:

  • Having sex without a condom with someone who has syphilis
  • If you have had intercourse with a sex worker
  • If you had sex in prison
  • If you have had condomless sex with more than one person
  • If you have had a partner who had sex with more than one person without a condom
  • If you have had sex with or have had a relationship with men

If the test is positive again, it is important to complete all treatment. Be sure to complete the full course of antibiotics, even if symptoms disappear. Also, avoid all sexual activities until your doctor tells you it’s safe. Consider getting tested for HIV as well.

People who test positive for syphilis should also test their last sexual partner and inform them so they can receive treatment.

Source: Healthline, Syphilis, 2017.


  • Mayo Clinic Staff. (2016). syphilis
  • syphilis (2014).
  • syphilis (2017).
  • Syphilis: CDC fact sheet (detailed) [Fact sheet]. (2017).

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