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Overview
What Is Syphilis?
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. This transmitted disease can affect people of any sex or age who have sexual contact with an infected person. It can cause symptoms in phases, although some people have no noticeable symptoms. Early testing and treatment are important because untreated std syphilis can remain in the body and lead to serious health problems.
Symptoms
Syphilis Symptoms and Stages
Symptoms can change over time
- Primary syphilis may cause a painless sore called a chancre at the site where the infection entered the body.
- A syphilis sore may heal on its own even though the infection remains untreated.
- Secondary syphilis may cause a widespread skin rash, including on the palms of the hands or soles of the feet.
- Secondary syphilis may cause swollen lymph nodes.
- Secondary syphilis may cause fever.
- Secondary syphilis may cause a sore throat.
- Secondary syphilis may cause patchy hair loss.
- Latent syphilis causes no visible symptoms but the infection remains in the body.
- Tertiary syphilis may cause damage to the brain or spinal cord (neurosyphilis).
- Tertiary syphilis may cause vision changes or vision loss (ocular syphilis).
- Tertiary syphilis may cause hearing loss or ringing in the ears (otosyphilis).
- Tertiary syphilis may cause problems affecting the heart and blood vessels.
How It Spreads
How Syphilis Spreads
Syphilis spreads through direct contact with an infectious sore during vaginal, anal, or oral sex. Sores may occur in places that are difficult to see, and transmission can happen even when a person does not know they are infected. A pregnant person can also pass syphilis to the fetus during pregnancy.
| Can spread syphilis | Does not usually spread syphilis |
|---|---|
| Direct sexual contact with an infectious sore | Toilet seats, swimming pools, or sharing utensils |
| Transmission during pregnancy | Casual household contact without sore contact |
Risk Factors
Syphilis Risk Factors
- Having sex with a partner who has syphilis or whose infection status is unknown can increase exposure risk.
- Having multiple or new sexual partners can increase the chance of contact with an infected partner.
- Inconsistent condom or dental dam use can increase the chance of direct contact with an infectious sore.
- Having HIV or another sexually transmitted infection can be associated with increased syphilis risk.
- Living in or having sexual connections to a community with higher syphilis transmission can increase exposure risk.
- Limited access to healthcare or testing can delay diagnosis and treatment.
Complications
Syphilis Complications
- Neurosyphilis can affect the brain, spinal cord, and nervous system.
- Ocular syphilis can cause vision loss or other lasting eye problems.
- Otosyphilis can cause hearing loss, ringing in the ears, or balance problems.
- Untreated infection can contribute to cardiovascular disease affecting the heart and blood vessels.
- Congenital syphilis can cause serious illness or developmental problems in a newborn.
- Syphilis during pregnancy can contribute to pregnancy loss or severe newborn illness.
- Syphilis can increase the risk of acquiring or transmitting HIV.
Get urgent care
Possible eye, ear, or nervous-system involvement
Sudden vision changes, hearing loss, severe headache, weakness, confusion, or other new neurologic symptoms require urgent medical assessment. These symptoms may need prompt evaluation and specialized treatment.
Diagnosis
How Syphilis Is Diagnosed
Diagnosis combines symptoms and a physical examination with laboratory testing. A clinician may ask about sexual exposure, previous syphilis treatment, pregnancy, HIV or other infections, and the timing of possible exposure. Because symptoms can be absent or change by stage, a syphilis test is often needed even when the examination is normal.
BLOOD TESTS
Blood tests commonly include screening and confirmatory serologic tests. No single test is sufficient in every person or stage, so clinicians interpret results alongside symptoms, examination findings, and exposure history.
EXAMINATION
A clinician may inspect sores, rashes, lymph nodes, and other findings. A sore may sometimes be tested when appropriate, although not every sore can be tested directly.
SPECIALIST EVALUATION
Eye, ear, or neurologic symptoms may require additional testing and assessment by an appropriate specialist. In some situations, evaluation of spinal fluid or other targeted tests may be considered.
Treatment & Management
Syphilis Treatment and Management
Penicillin-based antibiotics are the standard treatment for syphilis. The specific medicine, dose, and number of doses depend on the infection’s stage, pregnancy status, allergy history, and whether the brain, eyes, or ears are involved. A clinician should choose the treatment plan rather than relying on leftover antibiotics or self-treatment.
- Complete every prescribed dose and follow the treatment schedule exactly.
- Avoid sexual contact until a clinician says it is safe and partners have been evaluated as needed.
- Notify sexual partners so they can receive timely testing and treatment.
- Return for recommended follow-up blood tests to check the response to treatment.
- Seek medical care for new or worsening symptoms during or after treatment.
Treatment facts
Treatment works best when started early
Antibiotics cure the infection, but treatment may not reliably undo permanent damage that has already occurred. A person can also become infected again after successful treatment, so prevention and testing remain important.
Prevention & Screening
Syphilis Prevention and Screening
- Use condoms or dental dams consistently to reduce, but not eliminate, the chance of contact with an infectious sore.
- Reducing overlapping sexual partnerships can lower the chance of exposure.
- Discuss mutual testing with new or current partners before sexual contact.
- Avoid sex when you or a partner has a sore, rash, or other possible symptoms until medical advice is obtained.
- Arrange prompt evaluation after a possible exposure, even if symptoms are absent.
Who should be screened and when?
Screening is appropriate for people with symptoms, a sexual partner diagnosed with syphilis, HIV, another sexually transmitted infection, or ongoing exposure risk. Prenatal care includes routine syphilis testing, with repeat testing during pregnancy when risk remains or local guidance recommends it. Ask a clinician or local health department about the right timing for a syphilis test based on exposure and individual risk.
Outlook and Prognosis
Outlook and Prognosis for Syphilis
The outlook is generally very good when syphilis is diagnosed and treated promptly. Early treatment usually prevents the infection from progressing, although it may not reverse damage that has already developed. Without treatment, syphilis can progress over years and cause lasting injury, including complications associated with tertiary syphilis.
When Should You See a Doctor
When Should You See a Doctor for Syphilis?
Seek urgent care
Do not wait with possible complications
Pregnant people with possible exposure or symptoms should contact a clinician promptly. Seek urgent care for vision changes, hearing loss, severe headache, confusion, weakness, or other new neurologic symptoms.
Branches
1 topic
Syphilis
Infectious Diseases
Symptoms
1 topic
Syphilis
Fever
