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Syphilis Signs and Symptoms

A Guide to the Signs and Symptoms of Syphilis

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Updated December 04, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Sexually transmitted diseases (STDs), also called sexually transmitted infections or STIs, are among the most common causes of illness in the world. In some populations, one of those STDs, syphilis, is at epidemic levels. Like many STDs, syphilis increases the risk of HIV infection, as the open sores (chancres) caused by syphilis make an ideal portal for HIV to enter the body. This feature, the first in a four-part STD series, is your guide to syphilis, its signs and symptoms and how it's treated.

Facts About Syphilis

Syphilis was first described in the sixteenth century. It's often called the "Great Imitator" because syphilis signs and symptoms resemble other common infections and diseases. Industrialized countries such as the United States, saw a decline in syphilis during the latter half of the nineteenth century. However, the decline was short-lived, with the infection rate rising sharply after World War I. But following World War II the incidence fell rapidly once again; the decline coinciding with improved diagnostic tests and antibiotics. Since the late 1960s the incidence of syphilis has risen steadily once again. Today, there are about 36,000 new cases of syphilis in the United States each year.

How Do People Get Syphilis?

Syphilis is caused by a bacteria; specifically, a motile (able to move) spirochete (corkscrew-shaped bacteria) known as Treponema pallidum. The spirochete is passed from person to person almost exclusively through oral, anal and vaginal sex. The primary symptom of syphilis is a painless ulcer known as a chancre, which occurs in an area that has been exposed to bacteria. Common locations of chancres include the penis, anus, vagina, and throat. Contact with a chancre during sex allows for transfer of the spirochete from one person to another. Once in the blood stream, syphilis multiplies and if left untreated can even move into the cerebral spinal fluid and brain.

Prevent Syphilis - Use a Condom the Right Way

What are the Symptoms of Syphilis?

As was mentioned earlier, syphilis has been called an "imitator" because its symptoms are very similar to symptoms of other conditions and diseases. People with syphilis can go years without symptoms at all. In fact, in the early stages of the disease, syphilis lesions can go unnoticed. The chancre will heal on its own, but about 25% of people with untreated syphilis experience other symptoms such as a rash, fever, and swollen lymph nodes. Since syphilis symptoms do mimic other diseases and because symptoms can go unnoticed, most syphilis infections occur between people who are unaware that a syphilis infection is present.

The Three Stages of Syphilis Infection

  • Primary Stage
    During this stage a single sore (chancre) erupts on the penis, vagina, or anus. Usually this occurs anywhere from 10 to 90 days after infection. The round painless sore typically appears at the point where syphilis entered the body. This sore will last from 3-6 weeks and heals without treatment. Often, the chancre goes unnoticed and therefore the infection goes untreated. However, if a syphilis chancre is identified, treatment is strongly suggested because without it, syphilis will progress to the secondary stage.
  • Secondary Stage
    The secondary stage of syphilis is characterized by:
    • mucous membrane lesions
    • a red, non-itching rash on the palms of the hands and soles of the feet
    • fever
    • swollen lymph nodes
    • sore throat
    • hair loss
    • weight loss
    • muscle aches
    • fatigue
    With or without treatment, the symptoms of secondary syphilis will heal. But as is the case in the primary stage, if no treatment is given the infection can progress to the next stage, the late stage.
  • Late Stage
    This stage is also known as the "hidden stage", starting when the symptoms of the secondary stage have resolved. It's at this stage that untreated syphilis can cause damage to internal organs, the central nervous system, and to bones and joints. In some cases, late stage syphilis can be fatal. For this reason, treatment of syphilis is essential.

How is Syphilis Treated?

The treatment of choice for syphilis in any stage is the antibiotic penicillin. A single injection of penicillin can prevent syphilis from progressing to later stages if the infection is less than a year old. After one year, treatment consists of three intramuscular penicillin injections given one week apart. In the case of late syphilis or neurosyphilis (syphilis in the central nervous system), several weeks of intravenous penicillin is required.

Important Fact!
Having syphilis once and being successfully treated does not protect the person from future infections. For this reason, safer sex precautions, specifically condoms, must be used and yearly syphilis testing is recommended.

Women Take Control - Use a Female Condom

Prevention and Control of Syphilis

Syphilis is a classic example of a sexually transmitted disease that can be successfully controlled by employing a few prevention measures.
  • Regular syphilis testing, especially in high risk populations to allow for early diagnosis and treatment.
  • Treat all stages of syphilis with penicillin (or other antibiotics for anyone allergic to penicillin).

Important Information! If syphilis is left untreated it can cause nerve damage, arterial wall damage, mental disorientation, and eventually death. For those reasons early diagnosis and treatment is a must.

Prevent STDs By Using Condoms

The HIV and Syphilis Connection

Because HIV and syphilis are transmitted in much the same way and via the same sexual routes, having a syphilis infection does send a red flag to providers that HIV may also be an issue. Also, the genital lesions of syphilis create portals through which HIV can infect and thereby increases the risk of HIV infection in people with syphilis infection.

The syphilis solution is an easy one: using barrier protection with each and every sexual contact. If you think you have been exposed to syphilis, or if you find a genital lesion or experience other syphilis symptoms, contact your doctor right away for testing and treatment.

Source

Centers for Disease Control, "Syphilis - CDC Fact Sheet"; 1 May 2004.

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