What Is Syphilis?

Syphilis is a sexually transmitted disease caused by small spiral-shaped bacteria called Treponema pallidum. Syphilis once caused devastating epidemics, but it can now be easily diagnosed by a blood test and effectively treated with antibiotics.

Syphilis is spread through sexual or skin-to-skin contact with someone who is in an infectious stage when the symptoms are present. Syphilis spreads through open sores or rashes containing bacteria that can penetrate the mucous membranes of the genitals, mouth or anus. Because the bacterium is very fragile, the infection is almost always spread by sexual contact.

Syphilis occurs in stages. The disease is more easily spread in some stages than in others.

What Are the Symptoms of Syphilis?

Once the bacteria enter the body, the disease may progress through four stages depending on when the treatment is initiated. Left untreated, syphilis can cause blindness, insanity, paralysis, heart disease or death. Symptoms can appear within 10 to 90 days following exposure. The symptoms of syphilis are divided into four stages.

1) Primary Stage

The first sign of syphilis is usually a painless ulcer called a chancre. The chancre may look like a pimple, blister or an open sore. The chancre makes its appearance usually at or near the place where the bacteria entered the body. The chancre may occur inside the body where it will go unnoticed. Only about 10% of the women who develop chancres notice them. The disease is highly contagious during this stage. With or without treatment, the sore will heal (usually within 1 to 5 weeks) but the bacteria within the body will continue to increase and spread. About 1/3 of the people infected will progress to chronic stages.

2) Secondary Syphilis

About 2 weeks to 6 months after the chancre is gone a rash appears consisting of brown sores about the size of a penny. The rash is almost always on the palms of the hands and soles of the feet, but could also appear on other parts of the body. At this stage any physical contact, sexual or nonsexual, with the broken skin of the infected person may spread the disease. The rash usually heals within several weeks to months. Other symptoms that may occur include mild fever, fatigue, headaches, sore throat, swollen lymph glands, loss of appetite, hair loss and muscle, joint or bone pain. The symptoms tend to be mild, may come and go over the next one to two years, and will disappear without treatment.

3) Latent Stage

During this stage the disease is not contagious and there are no symptoms. This stage may last many years. Many people who are not treated will have no further evidence of the disease. Approximately 1/3 of those who have secondary syphilis will go on to develop tertiary syphilis.

4) Tertiary Syphilis

During this stage the bacteria will cause damage to the almost any part of the body, particularly the heart, eyes, brain, nervous system, bones and joints. There can be symptoms such as slurred speech, paralysis, insanity or senility. If left untreated, tertiary syphilis can cause death. This stage can last for years, even decades. This is not an infectious stage.

What Is Neurosyphilis?

The syphilis bacteria frequently invade the nervous system during the early stages of syphilis. Approximately 3% to 7% of untreated persons with syphilis will develop neurosyphilis during the early stages of syphilis. Symptoms may include headache, stiff neck and fever due to the inflammation of the lining of the brain. Some people develop seizures. If the blood vessels are affected, symptoms of a stroke may develop with numbness, weakness or visual complaints. The time from infection to developing neurosyphilis can be as long as 20 years. The course of neurosyphilis and the treatment may be different with patients with HIV infection.

How Is Syphilis Diagnosed?

There are three ways to diagnose syphilis. A physical exam may reveal the presence of an infection. Secondly, the syphilis bacteria collected from a surface scraping of an ulcer or chancre can be identified using a microscope. Finally, a blood test is the most common way to diagnose syphilis. Some other medical conditions may result in a false negative or false positive result. These can be discussed with your physician.

How Is Syphyilis Treated?

Syphilis is usually treated with penicillin given by injection. There are other antibiotics that can be used in patients who are allergic to penicillin. Because some people do not respond to the usual dose of penicillin it is important to have follow up blood tests. Those with neurosyphilis may need to be tested for up to two years following treatment.

The disease usually becomes non-infectious 24 hours after beginning therapy.

Antibiotics can cure syphilis in all stages. However, once the disease reaches the tertiary syphilis stage, organ damage is irreversible.

How Does Syphilis Affect Pregnant Women?

Syphilis infects the fetus after 16-18 weeks gestation. If infection occurs during pregnancy, neonatal death or stillbirth occurs about 25% of the time.

Some infants with syphilis display symptoms at birth, but most will develop symptoms between 2 weeks and 3 months later. The symptoms may include: skin sores, rashes, fever, weakened or hoarse crying sounds, swollen liver and spleen, jaundice (yellow skin and whites of the eyes), anemia and birth defects. If the infant is not treated early, blindness, brain damage and problems with growth and development may appear. As the child grow older and becomes a teenager they may develop late-stage syphilis including damage to their bones, teeth, eyes, ears and brain.