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 a specific bacteria. It is passed through direct contact with a syphilis lesion, which may happen through:
Factors that may increase your chance of getting syphilis include:
Symptoms will depend on what stage the syphilis is in. There are four main stages.
Primary (First) Stage within 10-90 days of exposure
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. It will gradually break down to form an ulcer. The ulcer is painless at first with raised edges. They usually last for 3-6 weeks. The ulcers will heal on their own.
Without treatment, the infection may move to the secondary stage. This can happen even if the ulcers are no longer visible.
Secondary Stage Several Weeks to Months after the Original Lesion
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:
The rash may be accompanied by flu-like symptoms, such as:
Untreated secondary symptoms will disappear within a few weeks, but there may be repeated episodes during the next few years.
Latency (Resting) Stage May Last for 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.
Tertiary (Third or Late) Stage
This stage may begin years after the initial infection. This stage has become very rare in developed countries. In this stage, the infection begins to damage:
Damage can be serious enough to cause death. Symptoms include the following:
Babies born with this infection can have problems, such as deafness, cataracts, and seizures. It can also cause premature births or stillbirths.
The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
Syphilis testing is part of routine prenatal care. This is done to treat and prevent congenital syphilis.
Syphilis can be treated with antibiotics. The type of antibiotic and length of treatment will depend on how long you have been infected.
If you have syphilis, avoid sexual relations until treatment is complete and the infection is cleared up. All sex partners should be notified. They will need to get treated as well.
To reduce your chance of getting syphilis, take these steps:
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.
American Social Health Association
Centers for Disease Control and Prevention
Health Canada Sexually Transmitted Infections
Sex Information and Education Council of Canada
Congenital syphilis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated October 24, 2011. Accessed May 16, 2013.
Latent syphilis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated September 6, 2012. Accessed May 16, 2013.
Syphilis. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.n... . Updated December 17, 2010. Accessed May 16, 2013.
Syphilis-CDC Fact Sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm . Updated February 11, 2013. Accessed May 16, 2013.
Syphilis (primary phase). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated October 16, 2012. Accessed May 16, 2013.
Syphilis (secondary phase). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated October 16, 2012. Accessed May 16, 2013.
Syphilis (tertiary phase). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated March 12, 2012. Accessed May 16, 2013.
Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.
Last reviewed June 2013 by Brian Randall, MD