Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on your genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores.
Syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don’t always occur in the same order. You may be infected with syphilis and not notice any symptoms for years.
The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them.
Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wart-like sores in the mouth or genital area.
If you aren’t treated for syphilis, the disease moves from the secondary to the latent (hidden) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary (third) stage.
Tertiary (late) syphilis
About 15 to 30 percent of people infected with syphilis who don’t get treatment will develop complications known as tertiary (late) syphilis. In the late stages, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.
Babies born to women who have syphilis can become infected through the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash on the palms of their hands and the soles of their feet. Later symptoms may include deafness, teeth deformities and saddle nose — where the bridge of the nose collapses.
When to see a doctor
Call your doctor if you or your child experiences any unusual discharge, sore or rash — particularly if it occurs in the groin area.
The cause of syphilis is a bacterium called Treponema pallidum.
You face an increased risk of acquiring syphilis if you:
- Engage in unprotected sex
- Have sex with multiple partners
- Are a man who has sex with men
- Are infected with HIV, the virus that causes AIDS
Tests and diagnosis
Syphilis can be diagnosed by testing samples of:
- Blood tests can confirm the presence of antibodies that the body produces to fight infection.
- Fluid from sores. The scraping can reveal the presence of bacteria that cause syphilis.
- Cerebral spinal fluid. If it’s suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).
Treatments and drugs
When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you’re allergic to penicillin, your doctor will suggest another antibiotic.
After you’re treated for syphilis, your doctor will ask you to:
- Have periodic blood tests and exams to make sure you’re responding to the usual dosage of penicillin
- Avoid sexual contact until the treatment is completed and blood tests indicate the infection has been cured
- Notify your sex partners so that they can be tested and get treatment if necessary
- Be tested for HIV infection
To help prevent the spread of syphilis, follow these suggestions:
- Abstain or be monogamous.
- Use a latex condom.
- Avoid recreational drugs
Screening for pregnant women
People can be infected with syphilis and not know it. In light of the often deadly effects syphilis can have on unborn children, health officials recommend that all pregnant women be screened for the disease.