Syphilis is a sexually transmitted infection (STI). If left untreated, syphilis can cause brain, nerve, and tissue damage. It can also cause death. It can be treated with antibiotics.
Syphilis is caused by bacteria. It is spread through contact with a syphilis sore. This may happen during vaginal, anal, or oral sex with an infected person
Factors that may raise your chance of getting syphilis are:
- Not using a latex condom during vaginal, anal, or oral sex
- Having more than one sex partner
- Having other STIs
Symptoms will depend on what stage the syphilis is in. There are 3 main stages as well as a resting phase.
Primary Stage: 7 to 90 Days After Infection
A single sore appears. It will happen in the area where the infection was passed. Common sites are the external genitals, rectum, tongue, inside of the mouth, or lips.
It will start as a raised and painless sore called a chancre. It will break down to form an ulcer. It lasts for 3 to 6 weeks. The ulcer will heal on its own.
Without treatment, the infection may move to the secondary stage. This can happen even if you can’t see the ulcers anymore.
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Secondary Stage: Several Weeks to Months after the Original Sore
This stage features a non-itchy rash. The rash may appear as rough, red, or reddish brown spots on the palms of the hands or soles of the feet. Other rashes may also appear in other places on the body. These rashes may appear as:
- Small blotches, blisters, or scales
- Moist warts in the groin
- Slimy white patches in the mouth
The rash may happen with flu-like symptoms, such as:
- Sore throat
- Swollen glands throughout the body
- Muscle aches
Without treatment, the symptoms will go away 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 starts years after the initial infection. This stage has become rare in developed countries. In this stage, the infection damages the:
- Brain and nerves
- Heart and blood vessels
- Bones and joints
Damage can be harsh enough to cause death. Symptoms are:
- Small bumps called gummas on the skin, bones, or internal organs
- Central nervous system damage, such as weakness, numbness, trouble walking, problems with balance, memory and mental health problems, and loss of bladder control
You will be asked about your symptoms and health history. A physical exam will be done.
You will have:
- Samples taken from lesions
- Blood tests
- A spinal tap
All people who have syphilis should also be tested for HIV.
Syphilis can be treated with antibiotics. The type of antibiotic and length of time you take it will depend on how long you have been infected.
If you have syphilis of any stage, avoid sexual contact until treatment is over and the infection is gone. Let your sex partners know. They will also need to be treated.
To lower your chance of getting syphilis:
- Abstain from vaginal, anal, and oral sex.
- Have sex with only one person who is uninfected..
- Use a latex condom during vaginal, anal, and oral sex. This is important if you don't know your partner's status.
American Sexual Health Association
Centers for Disease Control and Prevention
Sex Information and Education Council of Canada
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.
Latent syphilis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115040/Latent-syphilis. Updated May 9, 2018. Accessed August 2, 2018.
Primary syphilis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115619/Primary-syphilis. Updated May 9, 2018. Accessed August 2, 2018.
Secondary syphilis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113985/Secondary-syphilis. Updated May 9, 2018. Accessed August 2, 2018.
Syphilis-CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm. Updated June 13, 2017. Accessed August 2, 2018.
Tertiary syphilis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113669/Tertiary-syphilis. Updated May 9, 2018. Accessed August 2, 2018.
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 May 2018 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG Last Updated: 8/2/2018