Diagnosis: syphilis
Diagnosis: syphilis

Syphilis is a sexually transmitted infection caused by a bacterium called “Treponema pallidum”. The first symptom of the disease is a small, painless sore on rectum, sexual organs, or inside the mouth. Syphilis spreads from one person to another via skin or mucous membrane contact with this sore. Often, people don’t notice the disease right away. But the earlier the infection is discovered, the better it can be treated. If syphilis remains untreated for a long time, it may cause major damage to heart and brain, and even be life-threatening.

Symptoms of syphilis

Syphilis has four stages:

  • Primary stage

    • Starts shortly after infection
    • Signs: small, painless, highly infectious, round sore, also known as “chancre”, appearing on or in the mouth or genitals (in the place where the bacteria entered the body)
    • Sore occurs mostly three weeks after infection, and disappears two to six weeks later
    • Disease is transmitted by direct contact with a sore
  • Secondary stage

    • Signs: skin rashes on palms and soles, sore throat
    • Other symptoms: headache, swollen lymph glands, fever, fatigue, hair and weight loss, aching joints
    • Symptoms disappear whether or not the person gets treatment
    • Without treatment, the affected person is still infected
  • Latent (hidden) stage

    • Signs of primary and secondary stage disappear
    • No noticeable symptoms
    • Secondary symptoms may reappear
    • Can take years before progressing to tertiary stage
    • Person is still infected with syphilis
  • Tertiary stage

    • Very serious condition
    • Can occur years or decades after person was infected
    • Outcomes: blindness, deafness, mental illness, memory loss, destruction of soft tissue and bone, stroke, meningitis, heart disease, brain or spinal cord infection
    • May lead to death

Causes and origin of syphilis

The bacterium “Treponema pallidum” causes syphilis. It’s usually transmitted via contact with an infected person's sore during sexual activity. The bacteria enter the body through minor cuts in the skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent (hidden) stage.

Sometimes, the disease might spread through direct unprotected close contact with an active lesion, e.g. during kissing, or through an infected mother to her child during pregnancy or birth. But syphilis cannot be spread by using the same toilet, doorknobs, clothing or eating utensils, or from swimming pools, bath or hot tubs.

Consequences of syphilis

Without treatment, syphilis can result in damages throughout the body. Therapy may prevent future damage but is not able to reverse or repair damage that's already occurred.

The following conditions may develop:

  • Bumps (gummas) on the skin, bones, liver, etc. in the late stage (disappear after treatment with antibiotics)
  • Problems with the nervous system, such as stroke, deafness, dementia, visual problems, meningitis
  • Cardiovascular problems, e.g. aneurysm, inflammation of aorta, other blood vessels, damage of heart valves
  • HIV infection
  • Pregnancy and childbirth complications, such as miscarriage, stillbirth, death of the newborn

Once syphilis is cured, it doesn't recur. But the person can become reinfected if he/she has contact with someone's syphilis sore.

Prevention and therapy of syphilis
Blood test for syphilis
Blood test for syphilis


In its early stages, syphilis is easy to cure. The patient mostly gets penicillin, an antibiotic that kills the organism causing syphilis. However, he/she must be treated with another antibiotic in case of an allergic reaction to penicillin.

One injection of penicillin can already stop syphilis from progressing if the person is infected for less than a year. If the patient had syphilis for more than twelve months, additional doses are probably needed.

Pregnant women with syphilis almost always get penicillin. In case they are allergic, they may undergo a desensitization process in order to take penicillin. The newborn child should also receive antibiotic treatment.
Treatment on the first day may cause the Jarisch-Herxheimer reaction with fever, chills, nausea, achy pain or headache. This reaction, normally, only lasts one day.

Patients who suffer from neurosyphilis get daily doses of IV administered penicillin, and often have to stay in hospital for a short time. The bacteria can be killed, but treatment may focus mainly on easing pain and discomfort. It’s not possible to reverse the damage caused by late syphilis.

After the treatment, the patient must:

  • Have regular blood tests and check-ups to make sure the dosage of penicillin works well
  • Avoid sex until blood tests show the infection has been cured and until treatment is finished
  • Notify his/her sex partners so that they can be tested and treated as well if necessary
  • Be tested for HIV infection

Preventive measures

Practicing safe sex is the best way to prevent syphilis.
Therefore try to avoid:

  • Sex without latex condom – however, a condom can only reduce the risk of contracting syphilis, if it covers the syphilis sores
  • Sex with multiple partners
  • Oral sex without protection, such as dental dam or condom
  • Sharing sex toys
  • Sharing needles in case of drug use
  • Drinking too much or doing recreational drugs – this might result in unsafe sexual decisions

Get screened for sexually transmitted infections and talk to your partner about the results! Screening is especially recommended for pregnant women.