Syphilis

What is syphilis?

Syphilis is a sexually transmitted disease (STD) caused by bacteria.

How is syphilis spread?

Syphilis is spread through direct contact with the sores of an infected person. This usually happens through sexual activity, especially unprotected sex. It can also spread through sharing needles or contact with the blood of an infected person. If you are pregnant, you can give syphilis to your baby.

What are the signs and symptoms of syphilis?

There are 3 stages of syphilis. You may have primary, secondary, or late syphilis:

  • Primary syphilis: During this stage, you may not know you have syphilis and can spread it by accident. You may develop a chancre sore 10 to 90 days after you were exposed to the bacteria:

    • Chancre sore: This is a small sore on your skin where it came into contact with the bacteria. You can have more than one. It can appear anywhere on your body but is most common on the penis, vagina, anus, or inside the mouth. The sore heals without treatment in 3 to 6 weeks.


  • Secondary syphilis: This stage usually develops 3 weeks after the chancre heals and can last for up to 1 year:

    • Rash: A red, bumpy, scaly rash appears on your torso, arms, and legs. It may spread to the palms of your hands and the soles of your feet. This rash does not usually itch.

    • Mouth sores: You may have gray or white sores inside your mouth. These sores may be painful and your mouth may feel swollen. You may have a sore throat. You may have red, open sores at the corners of your mouth.

    • Skin sores: These are large, raised white or gray open wounds found in warm, moist areas of your body.

    • General signs of infection: You have a fever, headache, or swollen glands in your neck.

  • Late syphilis: Without treatment, the infection can slowly spread. You may develop the following medical problems 3 to 15 years after you were first infected:

    • Granulomas: These are lesions that most commonly affect your skin or bone. Upper respiratory lesions may lead to a hole or tear in your nose or roof of the mouth.

    • Meningitis: This is when the meninges (tissue covering the brain) are inflamed. This can cause a stiff neck, headache, nausea, or vomiting.

    • Heart damage: This includes chest pain, shortness of breath, swollen ankles, and severe tiredness.

    • Nerve damage: This can cause hearing loss, facial numbness, or trouble with your vision.

    • Brain damage: This includes trouble with balance, personality changes, or confusion.

How is syphilis diagnosed?

Your caregiver will ask about your medical history and examine you. He will ask if you have had an STD before. He will ask if you have ever had unprotected sex. He will ask if you know whether a sexual partner has syphilis or another STD. You may also need any of the following tests:

  • Blood tests: You may need blood taken from your hand, arm, or IV. The blood will be tested for the bacteria that causes syphilis.

  • Wound culture: Your caregiver may take a sample of tissue or fluid from the sore. This will give caregivers information about your infection.

How is syphilis treated?

  • Ibuprofen or acetaminophen: These medicines decrease pain and lower a fever. They are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and how often to take it. Follow directions. These medicines can cause stomach bleeding if not taken correctly. Ibuprofen can cause kidney damage. Do not take ibuprofen if you have kidney disease, an ulcer, or allergies to aspirin. Too much acetaminophen can cause liver damage. Do not drink alcohol if you take acetaminophen or ibuprofen.

  • Antibiotic: This is given to kill the bacteria that caused your syphilis. It is usually given as a shot. You may need more than one dose.

What are the risks of syphilis?

Your symptoms may not go away, or they may come back. If you are pregnant, you can have a miscarriage or your baby could die shortly after birth. Without treatment, you can develop secondary or late syphilis. Late syphilis can be life-threatening.

How can I prevent the spread of syphilis?

  • Tell your sexual partners about your syphilis: Tell everyone you have had sex with in the past 3 months. They need to be checked for infection and may need treatment.

  • Do not have sex until treatment is complete: This usually takes at least 2 months. Your caregiver will tell you when you can resume sexual activity.

  • Use protection: After your treatment is complete, use condoms and follow safe sex practices. This will help prevent the spread of syphilis and other STDs.

  • Get tested for HIV: You are at increased risk of HIV if you have syphilis.

Where can I find support and more information?

  • Division of STD Prevention, Centers for Disease Control and Prevention
    1600 Clifton Rd.
    Atlanta , GA 30333
    Phone: 1- 800 - 232-4636
    Web Address: http://www.cdc.gov/std

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever or feel weak and achy.

  • You are pregnant and think you have syphilis.

  • You have a new rash, sore throat, or swollen joint.

  • Your symptoms do not go away after treatment, or they come back.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a headache and a stiff neck.

  • You are confused.

  • You have chest pain and pain on your left arm, jaw, or back.

  • You have shortness of breath.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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