NYU Langone Medical Center

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Definition

Syphilis is a sexually transmitted disease (STD). If left untreated, syphilis can cause brain, nerve, tissue damage, and death. Fortunately, syphilis can be treated with antibiotics.

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Causes

Syphilis is caused by a specific bacteria. It is passed through direct contact with a syphilis lesion, which may happen through:

Vaginal, anal, or oral sexual contact with an infected person
A pregnant woman who passes the infection to her unborn baby (called congenital syphilis)

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Risk Factors

Factors that may increase your chance of getting syphilis include:

Having sex with a person infected with syphilis
Having multiple sex partners
Not using a latex condom during vaginal, anal, or oral sex
Touching a syphilis lesion
Having other sexually transmitted diseases

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Lymph Nodes

Fetal Infection

Symptoms

Symptoms will depend on what stage the syphilis is in. There are four main stages.

Lymph Nodes

Primary (First) Stage within 10-90 days of exposure

A single lesion will usually appear. It will occur in the area where the infection was originally passed. Common sites include the genitals, rectum, tongue, inside of the mouth, or lips.

It will start as a raised and painless lesion. It will gradually break down to form an ulcer. The ulcer is painless at first with raised edges. They usually last for 3-6 weeks. The ulcers will heal on their own.

Without treatment, the infection may move to the secondary stage. This can happen even if the ulcers are no longer visible.

Secondary Stage Several Weeks to Months after the Original Lesion

This stage is marked by the appearance of a non-itchy rash. This rash may appear as rough, red, or reddish brown spots on the palms of the hands or soles of the feet. It is also possible for different rashes to appear in other places on the body. These rashes may appear as:

Small blotches or scales
Moist warts in the groin area
Slimy white patches in the mouth

The rash may be accompanied by flu-like symptoms, such as:

Sore throat
Swollen lymph nodes throughout the body
Fever
Headache
Fatigue
Muscle aches

Untreated secondary symptoms will disappear within a few weeks, but there may be repeated episodes during the next few years.

Latency (Resting) Stage May Last for Years

The infection is still present but there are no symptoms. It may or may not progress to the third stage. Blood tests for syphilis will be positive during this stage.

Tertiary (Third or Late) Stage

This stage may begin years after the initial infection. This stage has become very rare in developed countries. In this stage, the infection begins to damage:

Brain and nerves
Eyes
Heart and blood vessels
Liver
Bones and joints

Damage can be serious enough to cause death. Symptoms include the following:

Small bumps called gummas on the skin, bones, or internal organs
Blindness
Central nervous system damage, including weakness, numbness, trouble walking, difficulty with balance, memory problems, and loss of bladder control