Syphilis is a sexually transmitted infection (STI) caused by bacteria. There are four stages of syphilis. The infection is curable, especially with early diagnosis and treatment. Untreated syphilis can lead to serious health complications that affect the heart, brain, and other organs.
In some cases, damage from advanced untreated syphilis can be permanent. Treatment for syphilis involves taking antibiotics such as penicillin. Treatment becomes more difficult as the infection progresses.
Syphilis has four distinct stages: primary, secondary, latent, and tertiary. Although the stages occur in order, the time a person is in each stage varies. If you are sexually active, being aware of the different stages, especially the early ones, can help you seek treatment for syphilis earlier.
Primary Stage
If you are exposed to the bacteria that cause syphilis, it can take about 3-4 weeks for the first symptoms to appear.
In the first stage of syphilis, a type of sore called a chancre develops around the vagina, anus, penis, or mouth. They are usually round and painless.
It can be challenging to recognize that you have syphilis at this stage because you may only develop one sore. These wounds will heal themselves, leading people to think that the underlying problem has been solved.
Secondary Stage
You can enter the secondary stage before or after the primary wound has healed. At this stage, you are likely to develop a skin rash where the sore was or on other areas, such as the palms of the hands and the bottom of the feet. These rashes are usually red and not itchy – you may not even notice you have them.
At this stage, you may experience additional symptoms, such as:
- Fever
- Sore throat
- Pain in the muscles
- Headache
- Fatigue
Like the primary stage, these symptoms usually go away on their own. However, without treatment, you will still have syphilis, and the infection will continue to progress.
Latent phase
When the symptoms of the previous stages disappear, you will enter the latent stage. During this period, you will not experience any symptoms for weeks or years.
You still have syphilis, and if left untreated, the infection can progress to the tertiary stage. For this reason, it’s important to get tested for STDs regularly – even if you don’t have syphilis symptoms, you’ll still test positive.
Tertiary phase
If your syphilis is not treated, you can develop tertiary syphilis up to 30 years after the initial bacterial infection. Tertiary syphilis is a serious medical condition that can affect several parts of your body, including your heart.
Treatment is possible, but more difficult during the tertiary stage, as the underlying damage from the infection can be permanent. In severe cases, syphilis can lead to death.
Syphilis is an infection caused by bacteria Treponema pale and can be diagnosed through several methods. To get a diagnosis of syphilis, you need to do two types of blood tests or a special microscopic test.
If you have symptoms of syphilis in the brain and spinal cord, your healthcare provider may also order a test using your cerebrospinal fluid (the fluid that surrounds the brain and spinal cord).
Non-treponemal tests
A nontreponemal test is a blood test that looks for evidence that the bacteria are syphilis Treponema pale is in your body.
Rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests are two examples of non-treponemal tests. The VDRL test tests your blood sample for the presence of antibodies to syphilis bacteria.
Antibodies are proteins that are formed as an immune response to harmful compounds, such as infectious bacteria. The presence of certain antibodies would signal the presence of an infection.
Treponema tests
Treponemal tests are more advanced blood tests that also ask for the presence Treponema pale in his body. These tests are usually used to confirm a diagnosis of syphilis if you test positive for a non-treponemal test.
These tests can also help determine if you’ve had a previous syphilis infection.
Dark field microscopy test
During this test, a specialist will take a small sample of your blood and put it under a microscope. They will immediately examine the blood through a microscope under special lighting that allows them to detect the bacteria that cause syphilis.
Cerebrospinal fluid test
Some people with syphilis develop symptoms associated with neurosyphilis — a type of syphilis that affects the brain, spinal cord, and eyes. To determine if you have this type of syphilis, you will need to have a cerebrospinal fluid (CSF) test.
For this test, your doctor will inject a local anesthetic into your lower back. They will then use a needle to withdraw a small amount of cerebrospinal fluid between two vertebrae (spinal bones). The laboratory will test this fluid for the presence of the bacteria that cause syphilis.
Because syphilis is a bacterial infection, antibiotics can treat it. Benzathine penicillin G (BPG) is the most effective antibiotic for syphilis. Options such as doxycycline and ceftriaxone are available for those allergic to penicillin.
Syphilis is a curable sexually transmitted disease, especially when diagnosed early. However, untreated syphilis can cause permanent organ damage and, in some cases, can lead to death.
Untreated syphilis can have serious health complications, including neurosyphilis, ocular syphilis, otosyphilis, and congenital syphilis. Untreated tertiary syphilis can also cause organ damage in your heart.
Neurosyphilis
When the bacterial infection reaches the brain and spinal cord, you can develop neurosyphilis, with symptoms including dementia, confusion, muscle weakness and severe headaches. Neurosyphilis can occur at any stage of syphilis, but becomes more likely if the infection is left untreated.
Ocular syphilis
The bacterial infection that causes syphilis can also spread to the eyes, causing inflammation. When this happens, you may experience eye pain or redness, changes in vision, and loss of vision – which can be permanent.
Otosyphilis
Otosyphilis is a complication of ear syphilis. It occurs when the infection spreads to the ear structures and nerves. Symptoms include dizziness, vertigo, hearing loss, and other changes in hearing.
Congenital syphilis
If you are pregnant and have syphilis, it is very important to get treatment right away. Syphilis can be transmitted from the pregnant parent to the fetus through the placenta during pregnancy. Congenital syphilis can cause stillbirth, premature birth, infant death, and long-term health problems.
Syphilis is easily treated in its early stages, and there are strategies you can use to prevent infection. The only 100% effective way to prevent syphilis is abstinence. Other strategies to reduce the chance of infection include:
- Use condoms consistently and correctly
- Have open and honest communication about sexually transmitted infections with your sexual partners
- Get tested for STIs regularly
- Be in long-term monogamous relationships
If you have syphilis, you are not immune to future infections; you can have many new syphilis infections in your lifetime. It’s important to practice safe sex and get tested for STIs regularly, especially since the early stages of syphilis are often overlooked.
Some risk factors increase the risk of syphilis infection. You are more likely to get syphilis if you:
- Have an HIV diagnosis
- They are sexually active with multiple partners
- Is a man who has sex with men
- They are members of a racial or ethnic minority group
- Are you a young woman (24 and under)
If you’re at higher risk for syphilis, regular testing—even when you’re not showing any symptoms—can help identify and treat syphilis infections as early as possible.
Syphilis is a sexually transmitted infection (STI) that progresses through four stages: primary, secondary, latent, and tertiary.
It starts with painless sores, accompanied by a rash, and then enters a latent phase without symptoms. Some people can develop tertiary syphilis, which can cause organ damage and be life-threatening if left untreated.
Diagnosis requires a blood test or a microscope, and treatment is primarily with antibiotics such as penicillin. If left untreated, syphilis can lead to severe complications, including neurosyphilis and congenital syphilis. Condom use, regular testing, and other safe-sex practices can help prevent syphilis.