syphilis symptoms and treatment

Sexually transmitted infections (STIs) affect over 2 million people in the United States. Of that number, approximately 31,000 people were reported to have syphilis. Once known to be a disease with a low number of cases being reported annually, according to the CDC, the rate of syphilis has been “increasing” at significant rates nationwide. However, many cases of syphilis still undiagnosed and unreported. So how can you protect yourself?

What Is Syphilis?

Syphilis is a bacterial infection usually spread through sexual contact. The disease typically starts as a painless sore on your genitals, rectum, or mouth. It can spread from person to person through direct contact with the sore – typically during vaginal, anal, or oral sex. Even Healthcare workers can become infected through lesions unsuspected. It can also spread from mother to baby during pregnancy. Syphilis cases are on the rise, which is why knowing the signs is important for early detection and treatment.

Bacteria called “Treponema pallidum” causes syphilis. The bacteria enters your body through minor cuts or lesions in your skin, or even through sharing contaminated needles. Syphilis cannot be spread simply by using the same toilet, bathtub, clothing, eating utensils, doorknobs, swimming pools, or hot tubs.

You are at a higher risk for contracting syphilis is you:

  • Have unprotected sex
  • Have sex with multiple partners
  • Have anal or oral sex
  • Are infected with HIV, the virus that causes AIDS
  • It should be noted that the disease spares no race or class

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What Are the Symptoms of Syphilis?

Syphilis develops in stages. Symptoms vary in each stage and affect each person differently. During the first and earliest stage of syphilis, also known as primary syphilis, a small sore or “chancre” may develop. The sore(s) appears at the spot where the bacteria enters the body – usually 3 weeks after exposure. It is common to not notice the sore because it is painless and may be hidden within the vagina or rectum, but may also occur in the mouth, on the lips, or within the throat. The sore will heal on its own within 3-6 weeks.

Secondary syphilis

Between 4-8 weeks, fever, sore throat, swollen lymph nodes, may develop. Affected individuals may experience a rash that begins on the stomach and eventually spreads over the entire body. This rash is not itchy and usually accompanies wart-like sores around the mouth or genitals. These symptoms may disappear or come and for the first year. In some individuals, there might NOT be a history of the primary lesion or sore.

Latent syphilis

If you do not seek treatment for the secondary phase, the disease moves to the latent stage where you have no noticeable symptoms. This stage can last for years and symptoms of syphilis may never return. There can be an early or late stage. The early stage occurs after the 1st year of primary or secondary syphilis resolution. The late stage can be defined as: (1) Benign or “gumma,” (2) Cardiovascular affecting the heart and blood vessels, or (3) Neurosyphilis affecting the brain and nervous system.

Tertiary syphilis or late stage syphilis

In the late stage of syphilis, symptoms can occur years after the original infection. Benign syphilis can occur 1-10 years after infection, and involvement of any part of the body can be suspect. However, the benign type responds rapidly to treatment. Cardiovascular syphilis can affect the largest artery in the body, the aorta, and cause damage to other blood vessels. This type can occur 5-30 years after infection. Neurosyphilis affects memory, can cause headaches, personality changes, and even precipitate meningitis.

Congenital syphilis

Syphilis can be passed to a baby from their mother through pregnancy, therefore serologic tested is to be performed in any expectant mom. Babies can become infected through the placenta or during birth. Most newborns have no symptoms, although some may experience a rash on their hands or feet. Later symptoms can include deafness, teeth deformities, and saddle nose – when the bridge of the baby’s nose collapses.

How is syphilis diagnosed?

Syphilis is diagnosed through a technique called dark field examination under a microscope, or serologic testing that detect antibodies, also called CDRL, RPR, or FTA_ABS. Immunoassay testing, or EIA, can also be utilized for screening methods.

If you are diagnosed with syphilis, it is important to alert your sexual partner(s) so he or she can also seek treatment.

How is syphilis treated?

Syphilis is easiest to cure in its early stages. It can be treated with a single injection of penicillin or, if you are allergic, another antibiotic. A single injection can typically stop the disease from progressing, but if you have had syphilis for longer than a year, additional doses may be required.

After you have been treated for syphilis, it is important that you follow up with your provider. Your provider may recommend that you:

  • Have periodic blood tests and exams to make sure you are responding to the penicillin.
  • Avoid sexual contact until your treatment is complete.
  • Notify your sexual partner(s) so he or she can also be testing and seek treatment if necessary.
  • Be tested for HIV, and possibly follow with further VDRL titers

How can I prevent syphilis?

There currently is no vaccine to prevent syphilis like there is to prevent HPV. However, you can help prevent the spread of syphilis by following these tips:

  • Abstain from sex or monogamy. The only certain way to avoid syphilis, like any other STI’s, is to abstain from having sex. Another option is to be mutually monogamous with your partner who is uninfected. Treating the sexual contacts of those encompassing early symptoms with a single penicillin injection is recommended even if no clinical or physical appreciation of the disease is present.
  • Use a latex condom. Condoms can reduce your risk from contracting many sexual diseases. Condoms can reduce your risk of contracting syphilis if the condom covers the syphilis sores.

If you have questions, or would like to be tested for STDs, talk to your family physician. You can find a UPMC Pinnacle family physician near you at

About UPMC Harrisburg

UPMC Harrisburg is a nationally recognized leader in providing high-quality, patient-centered health care services in south central PA. and surrounding rural communities. UPMC Harrisburg includes seven acute care hospitals and over 160 outpatient clinics and ancillary facilities serving Dauphin, Cumberland, Perry, York, Lancaster, Lebanon, Juniata, Franklin, Adams, and parts of Snyder counties. These locations care for more than 1.2 million area residents yearly, providing life-saving emergency care, essential primary care, and leading-edge diagnostic services. Its cardiovascular program is nationally recognized for its innovation and quality. It also leads the region with its cancer, neurology, transplant, obstetrics-gynecology, maternity care, and orthopaedic programs.

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