Syphilis - symptoms, signs and treatment

What is Syphilis and definition

A sexually transmitted disease (STD) that results from INFECTION with the bacterium Treponema pallidum. Syphilis spreads through vaginal intercourse, anal intercourse, and oral sex. It is not possible to acquire syphilis from objects such as toilet seats or in hot tubs. Syphilis is curable with appropriate antibiotic therapy. Untreated syphilis can cause widespread damage in the body. Congenital syphilis, which a pregnant woman who has syphilis can pass to her unborn child, can cause numerous abnormalities or STILLBIRTH.

Symptoms of Syphilis and Diagnostic Path

Untreated syphilis has four stages: primary, secondary, latent, and tertiary. Symptoms are specific to the stage of illness. Diagnosis typically occurs through BLOOD tests that confirm the presence of antibodies or examination of cell samples (such as from body fluids) under a microscope that reveal the presence of T. pallidum BACTERIA.

Signs and Symptoms of Primary syphilis

Primary syphilis is the first manifestation of illness and occurs two to six weeks after infection with T. pallidum. Its symptom is the formation of a painless, ulcerlike sore (chancre) at the site where the infection entered the body. Because this site may be inside the VAGINA in a woman or within the URETHRA in a man, the chancre often goes undetected and heals.

Signs and Symptoms of Secondary syphilis

Though the chancre heals the T. pallidum bacteria continue to multiply and invade the blood circulation, which carries them throughout the body. The characteristic symptoms of secondary syphilis emerge about two months after the chancre and include

  • skin RASH of brown spots or sores that involves the palms of the hands and soles of the feet as well as other locations on the body
  • mucous patches in the vagina or MOUTH and on the PENIS
  • condylomata lata, which are spongy, wartlike patches that often appear on the labia (women) or SCROTUM (men)
  • low-grade FEVER (around 100ºF)
  • sore THROAT and HEADACHE

Secondary syphilis lasts up to three months, during which the person can spread the infection to others through nonsexual as well as sexual contact because the sores of the rash contain T. pallidum bacteria. Some people experience outbreaks of secondary syphilis symptoms for a year or longer.

Signs and Symptoms of Latent syphilis

In latent syphilis the bacteria remain in the body but cause no symptoms. During this stage the person cannot pass the infection to other people. Latent syphilis may last for decades, during which the bacteria silently attack the NERVOUS SYSTEM, joints, HEART, and other structures.

Signs and Symptoms of Tertiary syphilis

The last stage of syphilis, the tertiary stage, is the emergence of symptoms resulting from the damage that occurred during the latent stage. Damage is often widespread and significant, producing symptoms of cognitive dysfunction, blindness, heart disease, kidney disease, and NEUROPATHY (sometimes called neurosyphilis).

Treatment Options and Outlook

Treatment for syphilis at any stage is penicillin by injection (or doxycycline for people who are allergic to penicillin). Most people who receive treatment for primary or secondary syphilis recover completely. Treatment can still cure tertiary syphilis but the damage the infection has already caused is permanent. Reinfection is possible; there is no IMMUNITY for syphilis. All sexual partners should be tested so they can receive treatment if they have syphilis. Primary syphilis carries increased risk for HIV infection because the chancre gives an easy pathway for the VIRUS to enter the body.

Risk Factors and Preventive Measures

People who have multiple sexual partners and men who have sex with men have the greatest risk for contracting syphilis and other STDs. Precautions such as condom use with all sexual activity reduce the risk for infection. Early diagnosis and treatment are essential to prevent complications and to prevent spreading the infection to other people.


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