What is Syphilis?

Syphilis is a bacterial infection caused specifically by the spirochete bacterium; it is a contagious disease that is transported from person to person primarily by sexual contact. Syphilis may also be transmitted during pregnancy from mother to child or via the vaginal canal during child birth. Syphilis is very curable when detected in its early stages, but when left untreated can have devastating effects on your brain, heart and other vital organs, even ending in death.

Symptoms and Stages of Syphilis

There are five stages of syphilis that it can present itself in which are:

• Primary Syphilis – In the initial stage, anywhere from 3 to 90 days after having had direct contact with the chancre (sore) of an infected sexual partner, the disease presents itself as a lesion. This usually occurs in the same location as the initial direct contact was made, often appearing on the genitals, vagina, buttocks, anus or mouth. The lesion typically is painless and morphs into a non itchy ulcer, and because of their somewhat hidden location infected people are sometimes unaware of the chancre sore and unknowingly spread the disease to their sexual partners. The sores will resolve themselves on their own in about four to six weeks, even without treatment.
• Secondary Syphilis – In secondary syphilis the disease presents itself in a much more obvious fashion with varying symptoms many of which are skin related, as well as typical symptoms of a bacterial origin. Typically these symptoms begin to appear four to ten weeks after the first chancre sore has presented itself in the primary stage. Although these symptoms may disappear on their own in about one to three months, they may also recur off and on for up to a year. Below is a list of likely and possible symptoms found in secondary syphilis:
  • A pinkish-copper colored non-itchy rash that may cover your entire body including the palms of the hands and soles of the feet.
  • Moist wart-like sores in the mouth and/or genital areas.
  • Hair loss
  • Swollen lymph nodes
  • Extreme fatigue or malaise
  • Sore throat
  • Fever
  • Headache
  • Weight loss

In rare instances of secondary syphilis symptoms may include; joint inflammation, liver inflammation, optic nerve inflammation, kidney disease, periostitis, interstitial keratitis, and uveitis.

• Latent Syphilis – In the latent stage of syphilis (left untreated), there is only diagnostic confirmation of the diagnosis of syphilis and though blood tests confirm the diagnosis of syphilis the disease lays dormant with no symptoms presenting, this stage may last for as many as 15 years. In the United States latent syphilis is divided into two categories described as either early or late stage. Early latent syphilis occurs less than one year after secondary syphilis and during this stage a recurrence of symptoms may appear. Late latent syphilis occurs more than one year after secondary syphilis with no symptoms present, during this stage the disease is less contagious than is in early latent syphilis. The latent syphilis stage may last for numerous years with no signs of the disease, other than serologic proof or it may progress to the next stage which is the tertiary stage.
• Tertiary Syphilis – The tertiary stage of syphilis strikes at approximately 15 to 30 percent of people with untreated syphilis and may occur from 3 to 15 years after having direct contact with the chancre of a person infected with syphilis. People with tertiary syphilis are not contagious. The tertiary (late) syphilis stage is broken into three categories; neurosyphilis, cardiovascular syphilis, and gummatous syphilis; it is in these stages of the disease that complications arise in which the tertiary disease may cause damage to the brain, heart, liver, bones, joints, blood vessels, eyes, and nerves. It is in these stages that many of which may cause life threatening or disfiguring results; such as chronic gummas (soft tumor like balls of varying size) formations, aneurysm formations and other serious life ending processes to occur. This is the final stage of syphilis.
• Congenital Syphilis – Babies whose mothers went untreated for syphilis are often born with congenital syphilis, by means of contamination of the placenta or during the birth canal delivery process. Typically babies are born asymptomatic, but some do show tell tale signs of the disease such as a rash on their palms and soles of their feet.

In the infants born with congenital syphilis during the first two years, symptoms may include the following:

• Fever
• Rash
• Neurosyphilis
• Enlargement of the liver and spleen
• Lung inflammation

If the child goes untreated more dramatic disfiguring symptoms may occur in late congenital syphilis such as:

• Saber shin
• Clutton’s joints
• Saddle nose deformation
• Higoumenakis sign

Diagnosis and Treatment

The diagnosis for syphilis is simple and relatively painless; diagnosis is usually made through diagnostic blood tests or dark field microscopy. Syphilis is easily treated in its early stages with simple antibiotic treatment, sometimes as simple as a single injection of penicillin. Although the symptoms of primary syphilis can some times go unseen and thus treatment not sought, it’s very difficult to develop secondary syphilis without recognizing something is seriously wrong. The earlier you seek treatment the easier syphilis is to resolve and without life altering consequences to your own health and well being, as well as that of others. If you suspect you may have syphilis or that you may have been exposed to it by your partner contact your primary care physician, local health department, or urgent care center immediately. If you have questions or want to prevent getting an STD or AIDS contact:  Kimberly A. Workowski, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Telephone: 404-639-1898; E-mail: kgw2@cdc.gov.