Syphilis: Symptoms, Diagnosis, Treatment, Prevention,& More


Syphilis is a serious condition typically spread by sexual contact. It is caused by a bacteria known as Treponema pallidum. It is rare to contract syphilis outside of sexual contact, and it is classified as a sexually transmitted infection (STI) or sexually transmitted disease (STD), depending on medical terminology. In the early 1900s, syphilis was close to being a significant public health crisis, as there was no adequate way to treat the problem. After penicillin and similar antibiotics were developed in the 1940s, cases of syphilis declined. In the early 2000s, cases of syphilis were at an all-time low. However, in recent years, syphilis cases have been on the rise. While cases of syphilis in women are not as prevalent, cases of syphilis in men who engage in sexual contact with other men have been on the rise. Syphilis and other STDs are being reported repeatedly in the Jackson Metro area. Read on to learn more about syphilis, how you contract the disease, the different stages and their symptoms, and what treatment options are available. 

How Do You Get Syphilis?

Syphilis is spread mainly by sexual contact, which includes any type of sexual contact: vaginal, oral, or anal sex. Pregnant women can also spread syphilis to their unborn children. Unlike other bacterial conditions, you cannot contract syphilis from public swimming pools, sharing clothing or eating utensils, or toilet seats. You are at a higher risk of contracting syphilis if you have HIV/AIDS, are a man who has sex with other men, you have unprotected sex, or if you have multiple sex partners. While women are less likely to contract syphilis, cases have been on the rise, and it is still a possibility, as it is with any STI. 

What Are the Different Stages of Syphilis?

Syphilis has four different stages, all with various symptoms and problems. The first two stages are the most contagious, but they are also the easiest to treat and cure. Later stages may not be as infections to other sexual partners but may be harder to treat for the patient. If syphilis goes untreated, it can be deadly. Unfortunately, some patients show no signs or symptoms of syphilis at all, which makes diagnosing the disease a challenge. 

Primary Stage 

During the primary (first) stage of syphilis, a small sore will appear, called a chancre. It may take anywhere from 10 to 90 days to appear after unprotected sex. It will appear at the spot where syphilis was contracted. This could be in the mouth, vagina, or rectum-so, essentially, at the point of sexual contact. The sore is painless, and the patient may not even notice the sore is there. However, it is highly infectious to others at this stage. This sore can remain dormant, yet infectious for anywhere from two to six weeks.

Secondary Stage

The secondary stage of syphilis carries with it more symptoms, but they can be so benign and mild that they still aren’t noticeable. This stage usually accompanies a sore throat and a skin rash, both of which are common occurrences. The rash often appears on the palms of the hands and soles of the feet and doesn’t burn or itch. The sore throat is usually accompanied by other symptoms, which mimic a cold. This is why syphilis can go undiagnosed in the early stages, where it is easily treated. These additional symptoms of secondary syphilis may include:

  • Fatigue
  • Fever
  • Aching or painful joints
  • Unexplained weight loss
  • Headaches
  • Swollen lymph nodes
  • Hair loss

Even if a patient seeks treatment, syphilis can often be missed by healthcare providers because these signs and symptoms are so common to other conditions. 

Latent (Inactive Stage)

At this juncture, syphilis becomes inactive. There are no visible symptoms. The bacteria is still in the body, and a mother could still pass syphilis to her newborn (known as congenital syphilis) during the latent stage. However, it would be uncommon to give syphilis to a partner via sexual contact during the latent phase. This stage could last for months or years. It is unfortunate that it carries no visible stages because the next (tertiary) stage of syphilis is the most serious.

Late (Tertiary) Stage

If patients do not receive treatment for syphilis throughout the first three stages, it’s estimated that 15 to 30 percent will enter the late, or tertiary, stage of syphilis. This stage can occur years, or even decades, after the initial point of contact. This stage can be deadly and carries with it complications such as:

  • Blindness
  • Neurosyphilis (infection of the brain or spinal cord)
  • Stroke
  • Meningitis
  • Mental illness
  • Deafness
  • Memory loss
  • Loss of soft tissue or bone
  • Heart disease

Because of the serious complications associated with this late stage of syphilis, it can be incredibly hard to treat at this point. Because it is at its root a bacterial infection, at this late stage the problem becomes focused intently on treating the complications in addition to the original illness. This is why treating syphilis during the first two stages is paramount.

How Is Syphilis Diagnosed?

Knowing the early signs and symptoms of syphilis can help if you think you may be infected. If you find a sore in the oral, vaginal, or rectal area, visit your doctor as soon as possible. Similarly, if you notice a rash on your hands or feet, particularly if it’s accompanied with cold- or flu-like symptoms, visit your healthcare provider for a checkup. If syphilis is suspected, your doctor will run several tests, the first of which will be a blood test. 

If you have a presenting sore, the doctor may take a sample from it to see if Treponema pallidum is within the sore. 

If your doctor suspects you have late-stage syphilis, he or she may order a spinal tap (also known as a lumbar puncture), to check your cerebrospinal fluid. Tertiary syphilis can infect the brain and spinal cord and cause nervous system problems. This is often classified as a separate type of syphilis known as neurosyphilis. 

Most doctors will order a syphilis screening for pregnant women, whether you’re presenting with symptoms or not. This is because congenital syphilis (the type that can be passed from mother to child) is a serious threat to the fetus and is often fatal. Even if the disease is not fatal, babies born with syphilis often have serious medical complications throughout life, such as intellectual disabilities (ID), or epilepsy (seizures).

What Are the Complications of Syphilis?

There are other complications of syphilis besides the ones present in the late stage, which are severe complications. Patients can see complications throughout the other stages as well, with the exception of the latent stage. Those with syphilis are more likely to have cardiovascular problems, such as conditions that affect the aorta and blood vessels and are also more likely to have nervous system problems, such as brain damage, hearing and vision loss, headaches, and paralysis. Syphilis increases a person’s chance of contracting HIV. It can also cause small bumps to grow on the skin (known as gummas). Not only do gummas grow on the skin, but they can also present on bones and organs, which can destroy tissue. 

How Is Syphilis Treated?

Syphilis is treated with antibiotics. Typically, one dose of penicillin taken intravenously is all that is needed to kill the infection. This holds true for patients who have had the disease less than a year (usually the first two stages). Later stages will need more dosage. For those who are allergic to penicillin, doxycycline is often used as an alternative. For pregnant women who are allergic to penicillin, there is a process known as desensitization, which allows you to take the drug without having an allergic reaction. 

Occasionally, a patient may have an immune system response known as a Jarisch-Herxheimer reaction within 24 hours after treatment that has flu-like symptoms such as fever and chills. These symptoms usually disappear and do not mean that treatment has failed. 

Patients should not engage in sexual contact until they have been evaluated and cleared by a physician to ensure that the infection is gone.

Preventing Syphilis

The best way to prevent syphilis is always to practice safe sex. This includes using a dental dam if engaging in oral sex and wearing a condom if engaging in vaginal or anal sex. Avoid having multiple sex partners, and do not have sex with an infected person, even if using protection. Also, avoid sharing sex toys. 

Syphilis can also be shared via infected needles.If you need more information about syphilis or other STIs or would like to be evaluated by a physician, request an appointment at The Woman’s Clinic today. We provide comprehensive and individualized care for women with every health need, from mammography to obstetrics and gynecology.

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