Syphilis

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It has often been called "the great imitator" because so many of the signs and symptoms are the same as for other diseases.

Prevention

You can protect yourself and others from syphilis by practicing safer sex. (more)

Symptoms

Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated. Although transmission occurs from persons with sores who are in the primary or secondary stage, many of these sores are unrecognized. Thus, transmission may occur from persons who are unaware of their infection.

  • Primary Stage: A person with the primary stage of syphilis usually has a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre sore is usually firm, round, small, and painless. It appears at the spot where syphilis bacteria entered the body. The chancre sore lasts three to six weeks, and it will heal without treatment. However, if treatment is not given, the infection progresses to the secondary stage.
  • Secondary Stage: A person in secondary stage syphilis has a skin rash and mucous membrane lesions. This stage typically starts with a rash on one or more parts of the body. The rash usually does not cause itching. Secondary syphilis rashes can appear as the chancre sore is healing or several weeks after the chancre sore has healed. The rash of secondary syphilis usually is rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. Sometimes, rashes with a different appearance appear on other parts of the body and can look like rashes caused by other diseases. Sometimes secondary syphilis rashes are so faint that they are not noticed. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will clear up with or without treatment. If it is not treated, the infection will progress to the latent or late stages of disease.
  • Late and Latent Stages: The latent (hidden) stage of syphilis begins when primary and secondary symptoms go away. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms. The infection stays in the body. This latent stage can last for years.  The late stages of syphilis develops in about 15% of people who have not been treated for syphilis. It can appear 10–20 years after the syphilis infection first entered the body. In the late stages of syphilis, the disease may harm the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include trouble coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

Testing & Diagnosis

In order to diagnose and treat syphilis, your doctor will take a detailed sexual history, do a thorough physical examination, and order several laboratory tests, including a test for HIV. Your doctor will also give you detailed information about how to prevent the spread of syphilis to any of your sexual partners. You should tell your sex partner(s) if you have an STD so that your partner(s) can seek medical attention too. People who are diagnosed with an STD may be contacted by public health professionals in order to make sure that their sex partners are counseled, evaluated, and treated.

Treatment

Syphilis is easy to cure in its early stages. One injection of penicillin, (an antibiotic), will cure a person who has had syphilis for less than a year. Additional injections are needed to treat someone who has had syphilis for more than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacteria and prevent further damage, but it will not repair damage already done.