Syphilis is one of the most widely known sexually transmitted diseases. It is a serious, highly contagious disease that is primarily spread by direct sexual contact. Although in the United States the number of reported cases of the disease fell in the 1940s and '50s, that trend has reversed itself, and the number of cases has steadily grown since then. In addition, many undiagnosed and untreated cases of syphilis are presently believed to exist.

If the disease is untreated and given the time to do damage, it can affect almost every organ system. The brain, bones, spinal cord, heart, and reproductive organs are all subject to severe injury from syphilis. The disease can be fatal if it is allowed to progress. It can also cause blindness, heart disease, and brain damage. One form of neurologic damage that can be caused by syphilis produces psychotic symptoms.


The dire consequences of untreated syphilis can also affect an infected fetus while still in the womb. The disease in this case is called congenital syphilis. Syphilis in a woman who is pregnant must be treated before the 18th week of the pregnancy. This early treatment will prevent the disease from being passed to the fetus.


Syphilis is caused by a spiral-shaped bacteria called a spirochete. The organism travels directly through intact mucous membranes, such as those found in the genital and urinary tract, and enters the bloodstream or lymphatic system. It can also be passed from a pregnant woman to her fetus, causing congenital syphilis. A recently infected pregnant woman has a 75 to 95 percent chance of passing the disease to the fetus. Once in the system of either an adult or a fetus, it can incubate for several weeks before producing any discernable symptoms.

Stages and Symptoms

Syphilis is a progressive disorder that passes through three stages: primary, secondary, and tertiary.

Primary syphilis is characterized by the appearance of a painless, open sore (called a chancre) 10 to 90 days after exposure to the disease. As a rule, there is usually only one sore, appearing most commonly on the genital organs, but also at times on the rectum, cervix, lips, tongue, fingers, or anywhere that direct contact was made. The chancre first appears as a red bump, sometimes surrounded by a red ring that oozes clear fluid; it soon turns into a painless ulcer and disappears within several weeks without treatment. Although the chancre is gone, the disease is still active in the body.

Secondary syphilis usually appears within six weeks to six months of initial contact. Symptoms resembling those of the flu (fever, sore throat, headache, fatigue, aching joints, and enlarged lymph nodes) are common. Secondary syphilis is also characterized by extremely contagious red or reddish-brown erosions that can be seen on the lining of the mouth, the penis, the external female sex organs, the anus, and warm, moist areas, such as the underarms; by growths resembling warts in the genital area (not to be confused with the more common nonsyphilitic genital warts); and by a rash on the palms of the hands or the soles of the feet in the form of round, reddish spots that occur in patches and do not itch. These sores, growths, and rashes heal within three to six weeks without treatment, and the disease enters the third stage.

At the beginning of the third stage, all symptoms disappear, and the disease becomes latent (present but not showing symptoms) for a time. The patient appears to be healthy, and the disease is probably no longer contagious (except in the case of pregnant women, who can still pass it on to their offspring). This latent stage can last indefinitely, but in about one-third of patients the disease will most likely progress, and the entire body may come under siege. The brain, bones, spinal cord, and heart may be affected, resulting in blindness, brain damage, heart disease, or even death.

Now let's consider the diagnosis, treatment and prevention of syphilis. It's all in the next section.


Syphilis: Diagnosis, Treatment, and Prevention

Syphilis is diagnosed on the basis of the patient's medical and sexual history and findings from a physical examination, blood tests, and microscopic examination of a sample taken from the sores or rash areas. Several blood tests may be necessary because the bacteria may not show up on blood tests during the first one to two weeks after exposure to the infection.


Syphilis is treated with antibiotics to kill the infecting organisms. Penicillin is the drug of choice, but other antibiotic drugs are available if the patient is allergic to penicillin. As with all antibiotic treatments, it is important to finish the full course of therapy to ensure that all of the offending organisms are eradicated. The treatment is usually effective; however, some cases are so advanced that they cannot be treated successfully.


A person who has syphilis or any other STD should abstain from sexual activity until all tests have confirmed that the disease is no longer contagious. Every sexual partner of the infected person needs to be tested and treated.


Syphilis can be prevented by avoiding sexual contact with someone who has the disease. Because the chances of contracting this or any other sexually transmitted disease increase with the number of sexual partners a person has, limiting the number of partners is always the first step toward prevention. Using condoms also has been proven to help reduce the risk of contracting syphilis.

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