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.
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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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.
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.
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
during vaginal, anal, and oral sex. This is important if you don't know your partner's status.
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.
Last reviewed June 2018 by
EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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