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Syphilis Overview

What is syphilis?

Syphilis is a highly contagious bacterial infection caused by the bacterium Treponema pallidum. Syphilis can be contracted during oral, vaginal and anal sex and occurs in stages. The Centers for Disease Control and Prevention (CDC) estimates that more than 55,000 new syphilis infections are contracted annually. Of these new cases, nearly 13,000 are of primary and secondary syphilis, which are the earliest and most infectious stages of the disease. Syphilis is curable in its earlier stages, but can cause very serious and possibly irreversible complications if the infection goes untreated. People who have syphilis may not be aware they have it because many of its symptoms are indistinguishable from other diseases. For this reason, syphilis is often referred to as "the great imitator."

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Common signs and symptoms of syphilis

Syphilis is transmitted sexually, through direct contact with a syphilis sore, rash, or mucous membrane during unprotected oral, vaginal, or anal sex. Sores, or chancres (pronounced SHANG-ker), occur on the lips and mouth, vagina, penis, anus, and/or rectum. Primary syphilis chancres most frequently appear on the genitals, but can also occur on the fingers, mouth, lips, tongue, tonsils, anus and breasts and nipples. Syphilis symptoms can either go unnoticed or be misdiagnosed as the flu for many years. There are three stages to the syphilis infection: Primary, secondary and latent/late. If left untreated during these stages, syphilis becomes deadly.

Syphilis stages:

The primary stage is the first stage of syphilis and usually includes small painless sores known as chancres. These sores occur from about 2 weeks to 3 months after exposure. This makes it possible to have syphilis without being aware of the infection. If a patient has been infected for a year or less, the disease is referred to as an “early case.” Early case syphilis infections are more infectious and easier to spread. That being said, any stage of a syphilis infection makes it easier to transmit or contract HIV. Syphilis-related vision loss and irreversible damage to the brain and other organs can occur in as little as one year.

The secondary stage of syphilis lasts between one and three months and usually begins between six weeks and six months after exposure to the bacteria. Secondary syphilis is characterized by a flat rosy-colored, non- itchy rash that usually covers the palms of the hands and soles of the feet. In some cases, the rashes may occur on other parts of the body or resemble rashes caused by other ailments. Additional signs of secondary syphilis include hair loss, white patches inside the mouth, genital warts, and flu-like symptoms such as fever and swollen lymph glands that last for weeks or even months. Secondary stage symptoms include fever, fatigue, headaches, sore throat, weight loss, muscle aches, swollen lymph glands and patchy hair loss. Although symptoms disappear after the primary and secondary stages, the latent (hidden) and late stages are more severe.

Without treatment during the primary or secondary stages, syphilis progresses to the latent stage, at which time the infection becomes dormant and does not cause symptoms for an extended period of time, up to 20 years. During the latent stage, the infection is still detectable by blood testing, despite the lack of symptoms. A syphilis infection can be treated and cured at this stage, but any damage done to internal organs is irreversible. If the syphilis infection progresses through the latent stage without treatment, it enters the terminal tertiary stage.

The tertiary stage of syphilis typically occurs between 10 and 30 years after the initial infection. At this time, entirely new and life-threatening symptoms occur. Debilitating side-effects include, but are not limited to blindness, loss of motor skills, dementia, and damage to the central nervous system and internal organs, such as the heart, brain, eyes, kidneys, and bones. In most cases, tertiary stage syphilis is distinguished by a descent into mental illness, followed by death.

How syphilis is transmitted

The most common way syphilis is transmitted is through contact with sores of an infected person. This usually occurs during sexual intercourse syphilis sores occur on the external genitals, vagina, anus or in the rectum, and the infection is typically transmitted through oral, vaginal and anal sex. These sores may also occur on the lips and in the mouth. In addition, pregnant women can also transmit the syphilis infection to their unborn children.

How syphilis testing works

The only way to know for sure if you have syphilis is to get tested. Our doctors recommend the RPR (Rapid Plasma Reagin) with Reflex to Quantitative RPR test. This Syphilis Test is a simple blood test that looks for antibodies the body creates to combat syphilis. If test results return positive, a confirmatory TP (Treponema pallidum) test will be done to confirm the initial diagnosis. Our doctors recommend testing for anyone with symptoms of a primary or secondary syphilis infection. Pregnant women in particular should get tested during pregnancy and at delivery, because long-term untreated syphilis infections can lead to death for developing infants.

Where to get tested for syphilis

STDcheck.comhas more than 4,500 testing centers throughout the United States with some locations open on Saturday for your convenience. To find a local testing center near you, simply go to our STD test center location page and enter your zip code. You will be given a list of nearby centers. Choose a location and complete your order. You can also call us at 1-800-456-2323 or use our live chat feature and one of our certified health specialists will be happy to assist you.

Can doctors cure syphilis?

Syphilis can be easily treated and cured with antibiotics when caught early on. In the early stages of syphilis infection, a single dose of penicillin is effective. Treatment will kill the Treponema pallidum bacterium and prevent further damage, but it cannot reverse any damage that has already been done. This is why treating the disease during its primary and secondary stages is so important. If you are being treated for syphilis, abstain from sexual activity until the syphilis sores are completely healed and treatment is finished. Partners should get syphilis treatment together in order to avoid becoming reinfected with the bacteria. Our doctors also recommend follow-up testing to be sure that all of the bacteria that causes syphilis has been cleared from your system.

Effects of untreated syphilis

In the latent or late stages, the effects of syphilis infection can be severe. If left untreated, syphilis can result in damage to the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Also, according to the CDC, a person with syphilis sores is 2 to 5 times more likely to acquire HIV. Pregnant women with syphilis may miscarry or transmit the infection to their babies.

Ways to prevent syphilis

The only way to prevent contracting syphilis 100% is abstinence. Otherwise, practicing safer sex by consistently using latex or polyurethane condoms or dental dams can help avoid contracting syphilis. Condoms lower the risk for spreading syphilis, which is particularly high among men who have sex with men, but do not eliminate the risk of contracting the infection from sores on areas of the body that a condom doesn’t cover. Being in a mutually monogamous relationship with someone who is not infected with syphilis will also prevent infection. Discussing sexually transmitted diseases (STDs) and testing with your new partner before engaging in sexual relationship is another way to help prevent getting syphilis.

Syphilis and pregnancy

Syphilis is very harmful to infants and unborn babies. It can cause a mother to miscarry or the baby to be stillborn. Syphilis can easily be transmitted to a fetus from the placenta or transfer to the baby in the birth canal during delivery. It can cause serious or even fatal infections. Infants with congenital syphilis are often born prematurely and if left untreated, syphilitic babies will likely develop serious issues in internal organs like the heart, brain, skin, eyes, ears, bones and teeth. Syphilis can be treated during pregnancy with antibiotics to both decrease the risk of spreading it to the baby and stop the infection’s progression in the mother.

If a chancre is present on the breast or nipple, mothers should not breastfeed.

  1. "National Congenital Syphilis Crisis." Essential Access. https://www.essentialaccess.org/sites/default/files/files/ca-cs/2-Bolan-National-Congenital-Syphilis-Crisis.pdf
  2. "The Great Imitator, Syphilis." The Western Journal of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1272769/
  3. "Syphilis - CDC Fact Sheet." Centers for Disease Control and Prevention. https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
  4. "Syphilis." American Sexual Health Association. http://www.ashasexualhealth.org/stdsstis/syphilis/
  5. "Syphilis Symptoms & Treatment." AVERT. https://www.avert.org/sex-stis/sexually-transmitted-infections/syphilis
  6. "What Is Syphilis & How Do You Get It?" Planned Parenthood. https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/syphilis

Medically Reviewed by on Jun 18, 2019

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