Syphilis: Causes, Symptoms, Treatment, And Prevention


What you need to know about this bacterial infection

Syphilis is regarded as a bacterial infection that is being transmitted by sexual contact. It is also a sexually transmitted disease (STD) that brings about very severe complications when left untreated but can be cured easily with the appropriate treatment.

The disease begins as a painless sore usually around your genitals, rectum or mouth. This bacterial infection can be transmitted from one person to another through the skin or mucous membrane contact with these sores and it’s caused by the bacteria Treponema pallidum.


Microscopic view of Treponema pallidum

Read Also: Urinary Tract Infection: Symptoms, Causes, And Treatment

Is syphilis common?

Yes, it is common as it was once a major public health menace, commonly causing severe long-term health issues like brain damage, arthritis, and blindness. All efforts in treating it was abortive until the late 1940s, where scientists developed the antibiotics penicillin to curb it.

CDC confirmed that the rate of new cases of syphilis increases in the 1990s and it reaches its all-time low in the year 2000 since reporting began in1941. Notwithstanding, new cases of syphilis doubled between 2005 and 2013 from 8,724 to 16,663. In 2017, its new cases figures rose to 101,567 for all stages.

Furthermore, after being infected in its early stage, this bacterial infection (syphilis) can stay dormant in your body for several years before becoming active again. This sexually transmitted disease can be cured when detected in its early stage, sometimes with a single injection of penicillin. If left untreated, this disease can severely destroy your brain, heart or other organs and can be life-threatening, or be transferred from mother to an unborn child.   

Syphilis can be divided into 4 stages such as primary, secondary, latent, and tertiary stage. Each of these stages has its own signs and symptoms.

How is syphilis being contacted or transferred?

An individual can get this bacteria infection by direct contact with a syphilis sore during unprotected oral, anal, vaginal sex, and prolonged kissing. Some of these sores may be found around the vagina, penis, or anus, or in the rectum, in the mouth, or on the lips.  This disease, known as congenital syphilis, can bring about abnormalities or even death to the child if left untreated.

You cannot get syphilis through doorknobs, toilet seats, hot tubs, swimming pools, shared clothing, bathtubs, or eating utensils.

What does this bacterial infection look like?

Since syphilis is divided into several stages like primary, secondary, latent, and tertiary stages. its stages have different signs and symptoms. An individual with primary syphilis usually has a sore or sores at the main site of infection.

These sores are usually found around the genitals, anus, rectum, or around the mouth. However, these sores are often (but not always) firm, round, and painless. Feeling feverish, having swollen lymph nodes, and skin rashes are some of the symptoms of secondary syphilis.

Both primary and secondary syphilis signs and symptoms could be mild, and may not be noticed easily. There are no signs and symptoms in its latent stage. You can experience severe medical complications in its tertiary syphilis stage. Effective diagnosis of tertiary syphilis is usually performed with the help of multiple tests by your medical doctor.

Signs and symptoms of syphilis

Usually, the signs and symptoms in adults differ by stage:

Primary stage

The primary stage also referred to as the first stage of syphilis, an individual may not notice any sore or multiple sores. The sore is found where syphilis has access to your body. Syphilis first sign which is a small sore is also known as a chancre (SHANG-kur).

These sores are mostly (but not always) firm, round, and painless. Since the sore is painless, it can’t be easily noticed and may stay up to 3 to 6 weeks within your vagina or rectum. Irrespective of whether you treat the sore or not, it may heal on its own. You are advised to still receive treatment even if the sore goes away. This will prevent the bacterial infection from spreading to the secondary stage.

Secondary stage

You may start experiencing skin rashes and/or mucous membrane lesions usually in the secondary stage. These mucous membrane lesions are sores found in your vagina, anus, or mouth. During the secondary stage, you’ll start noticing a rash on one or more areas of your body. The rash can become visible when your primary sore is healing or several weeks after the sore has healed.

The rash appears like rough, red, or reddish-brown spots on the palms of your hands and/or the under of your feet. This rash is not always itchy and may bring about wart-like sores in the mouth or genital area. Other symptoms you may experience include swollen lymph glands, fever, patchy hair loss, sore throat, loss of weight, headaches, feeling very tired, and muscle pains.

Furthermore, the symptoms from this stage usually disappear within a few weeks or incessantly come and go for as long as a year. If you don’t apply the right treatment, your infection will spread to the latent and possibly tertiary stages of syphilis.

Latent stage

If you don’t receive the right treatment for syphilis, the disease moves from the secondary to the latent stage (also known as the hidden stage), when you experience no symptoms. You can continue to experience syphilis in your body for years without any signs or symptoms. The disease may move to the tertiary stage if no adequate treatment is performed.

Tertiary stage

It is estimated that about 15 to 30 percent of people infected with syphilis who don’t receive the right treatment tend to develop complications referred to as tertiary or late syphilis. However, most people with untreated syphilis do not develop tertiary syphilis but when it does occur, it can damage many different organ systems like the heart and blood vessels, the brain and nervous system, bones and joints, eyes, and liver.

Tertiary syphilis is very destructive and would occur 10-30 years after the original, untreated infection.

Since tertiary syphilis can damage your internal organs, it can lead to the death of an individual.

Congenital syphilis

Pregnant women who have syphilis can transfer this disease to their babies during birth or through the placenta. This disease can also result in a low birth weight baby from an infected mother. Syphilis can also make an infected pregnant woman delivers her baby too early or stillborn (a baby delivered dead).

You can protect your unborn baby by going for the syphilis test at least once during your pregnancy. And if you’re positive, immediately receive treatment so as not to put the life of your unborn baby in danger.

Although most newborns with congenital syphilis have no symptoms, some may develop a rash on the palms of their hands and under their feet. Later the child may start experiencing symptoms like teeth deformities, seizures, cataracts, deafness, and saddle nose (this is where the bridge of the nose collapses). If the baby is left untreated with syphilis, it can lead to death.

When to see your medical doctor

If you discover that your child experiences any uncommon discharge, sore or rash; especially around the groin area, immediately visit your doctor for optimal advice and treatment.

Neurosyphilis and ocular syphilis

Syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (known as ocular syphilis) if left untreated. This can occur during any of the stages described above. The following are the symptoms of neurosyphilis:

  • Intense headache
  • Not able to move some parts of your body (known as paralysis)
  • Having mental disorder (called dementia)
  • Finding it difficult to coordinate muscle movements
  • Numbness

In ocular syphilis, its symptoms include changes in your vision and even blindness.

How can I know I have syphilis?

If you experience any of the above symptoms of syphilis, immediately visit your doctor for assistance. Most of the time, your doctor will take your blood sample to check for syphilis. Some health care providers will check for syphilis by testing fluid from syphilis sore for optimal treatment.

How can I reduce my risk of having this disease?

You can reduce your chance of developing syphilis by refraining from unprotected oral, anal, or vaginal sex. A sexually active individual can adhere to the following things to help lower your risk of getting syphilis:

Using latex condoms, the appropriate way every time you have sex. This latex condom helps prevents the spread of syphilis by shielding contact with a sore. Although sores occur in areas not covered by a condom. So care should be taken during lovemaking to avoid contact with these sores which can still transmit this bacterial infection.

Having just a partner who has been tested negative for syphilis and avoid multiple partners.

Avoid the use of recreational drugs like excessive use of alcohol or other drugs can cloud your mind and lead to unsafe sexual practices with infected persons.

Am I at risk of having syphilis?

Usually, any sexually active individual can get syphilis through unprotected oral, anal, or vaginal sex. You can confide in your doctor and ask whether you should be tested for syphilis or other sexually transmitted diseases (STDs).

  • Regularly go for syphilis test if you’re sexually active and
  • Are living with HIV
  • Are a man who indulges in sex with men
  • Have partner(s) who have been tested positive for this disease

A test for this bacterial infection should be conducted for all pregnant women during their first prenatal appointment

The diagnosis

The following are ways you can diagnosed syphilis:

Through blood tests: Here, blood tests can detect the presence of antibodies that the body produces to fight infection. Since the antibodies to the bacteria that bring about syphilis can remain in your body for years, the blood test can help detect a recent or past infection.

Cerebral spinal fluid: Your doctor may recommend the collection of a sample of cerebrospinal fluid through a procedure known as spinal tap (a lumbar puncture) if he or she suspects that you have nervous system complications of syphilis.

Through the Centers for Disease Control and Prevention (CDC), your local health department provides partner services, which will help you notify your sexual partners that they may be vulnerable (infected). From there, your partners can be tested and treated which helps prevent the spread of this disease to other persons.  

Are there any complications having this bacterial infection?

Where syphilis is left untreated, it can damage essential organs and systems in your body. This bacterial infection can also increase the risk of HIV infection and severe problems for infected women during pregnancy. Although treatment can help prevent future damage, it can’t repair or reverse the harm that’s already occurred.

Small tumors or bumps

These bumps known as gummas can develop on your bones, skin, liver or any other organ in the tertiary (late stage of syphilis). Antibiotics can help alleviate gummas or makes them disappear completely.

Cardiovascular problems

Cardiovascular problems may include aneurysm (bulging) and inflammation of the aorta; your body’s main artery and other blood vessels. If this disease is left untreated, it may damage your heart valves.

Neurological problems

The following are the number of problems this bacterial infection can cause while coming in contact with your nervous system:

  • Meningitis
  • Visual problems (inability to see things clearly)
  • Loss of pain and temperature sensations
  • Bladder incontinence
  • Having a stroke
  • Loss of hearing
  • Dementia
  • Being impotent (erectile dysfunction in men)
  • Sudden or lightning-like pains

HIV/AIDS infection

It is known that adults with sexually transmitted syphilis or other genital ulcers have an estimated 2-5 fold increased the chance of having HIV. This is because a syphilis sore can bleed profusely, providing an easy passage for HIV to penetrate your bloodstream during lovemaking.

Pregnancy and childbirth problems

An infected pregnant woman can transfer this bacterial infection to her unborn baby during childbirth or placenta. congenital syphilis as it is commonly called greatly increases the risk of stillbirth or your newborn’s death within a few days after delivery and miscarriage.


When syphilis is diagnosed and treated in its early stages, it’s easy to cure. The major treatment at all stages is penicillin, an antibiotic drug that can kill the organism that causes this disease. You are advised to inform your medical doctor where you’re allergic to penicillin for your doctor to provide alternative antibiotics like doxycycline, tetracycline or another antibiotic can be administered instead.

Usually, a single injection of penicillin can prevent the disease from developing if you’ve been infected for less than a year. Where you are being infected for more than a year, additional doses are required for optimal treatment.

The only recommended treatment for pregnant women with syphilis is penicillin. If a pregnant woman is allergic to penicillin, she will be desensitized to enable her to take penicillin. Your newborn baby should also receive antibiotic treatment, even after you’re being treated for this disease during pregnancy.

Have in mind that you’ll experience what is called the Jarisch-Herxheimer reaction usually on the first day of your treatment. Its signs and symptoms include nausea, fever, headache, chills, and achy pain. The good news is that; this reaction usually doesn’t go beyond more than a day.

Can syphilis be cured completely?

Yes, syphilis can be cured completely with the right antibiotics from your health care provider or doctor. But the treatment cannot change any damage that the infection has already done.

I’ve been treated. Can I have syphilis again?

Having syphilis once doesn’t shield you from getting it again. You can still be re-infected even after being successfully treated. Undergoing laboratory tests from your medical laboratory scientist can confirm if you have this infection or not. For effective successful treatment, follow-up testing by your health care provider or your medical laboratory scientist.

Be careful as a sex partner may not know if he or she has this infection because syphilis sores can be hidden in the anus, vagina, under the foreskin of the penis, or in the mouth. If you don’t confirm whether your sex partner (s) has been tested and treated effectively, you may be at risk of having this disease again from your infected sex partner ignorantly.

Read Also: Herpes Simplex Virus (HSV): Symptoms, Causes & Diagnosis

Follow up treatment

After you are treated for this disease, your medical doctor will recommend you to do the following things:

  • Have regular blood tests and exams to make sure you’re responding to the usual dosage of penicillin given to you
  • Never indulge in sex until the treatment is completed and blood tests show the infection has been cured completely
  • Ask your sex partners to get tested and be treated if necessary
  • Be tested for risk of being infected with HIV
What is the outlook for patients with syphilis?

Syphilis can be cured with prompt diagnosis and treatment. But if it’s treated lately, it may cause permanent damage to the brain and heart even after the infection is destroyed.

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