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Information from Your Family Doctor
Syphilis: What It Is and How It's Treated
Am Fam Physician. 1999 Apr 15;59(8):2245-2246.See related article on syphilis.
What is syphilis?
Syphilis (say: siff-uh-liss) is a serious infection. It's passed from one person to another during sex. It's caused by a bacteria (germ). You could get syphilis by touching the blood or sores of a person who has syphilis, especially sores on the person's mouth, penis, vagina or anus (the opening to the rectum).
What are the signs of syphilis?
In men, the first sign of syphilis may be a sore on the penis. In women, the first sign may be a sore around or inside the vagina. You might not even notice the sore, because syphilis sores don't hurt. The sores go away after three to six weeks.
If you don't treat syphilis early, it spreads from the sore into your blood. When syphilis gets into your blood, it can cause many problems. The most common sign is a rash. The rash may show up, often on the palms of the hands or the soles of the feet, from two weeks to two months after the sore appeared. Other signs of syphilis include fever, sore throat and swollen lymph glands.
After many years, people with syphilis who don't get treatment may begin to have problems in their brain and spinal cord. Syphilis may damage the heart and other organs, too.
Some people with syphilis don't have any signs of infection. In other people, the signs may be very mild. They might not even know they have it. But even if the signs of infection go away on their own, the germs are still alive. They can cause serious health problems many years later.
How does my doctor know I have syphilis?
Blood tests can find out for sure. Sometimes other tests can show how far the syphilis has spread. For example, your doctor may want to look at your spinal fluid. This is a way to see if the syphilis germs have spread to your nervous system.
How did I get syphilis?
Syphilis is almost always passed through sex. It also can be passed from an infected mother to her baby during pregnancy.
Syphilis can sometimes be avoided through safer sex—using condoms, and using “dental dams” during oral sex. Syphilis sores have to be covered up with a bandage to keep the infection from spreading.
Should I tell my sex partner I have syphilis?
Yes. Then your partner can find out if he or she also has syphilis. If you're not comfortable telling your sex partner, your doctor can help you. In some places, the local health department can tell sex partners that they may have syphilis and should get a test. If you wish, your name can be kept secret.
What is the treatment for syphilis?
Syphilis can be treated with penicillin. The penicillin is given as a shot. If you had syphilis for less than one year, you only need to get one shot. If you had syphilis for more than one year, you need three shots—one shot a week for three weeks. If you're allergic to penicillin, be sure to tell your doctor.
If you have an advanced case of syphilis, you may need stronger treatment. You may get shots of penicillin every day for 10 days. This can be done in the doctor's office or at a clinic. A few people have to go to the hospital to get penicillin put into their veins.
If you're pregnant, it's very important to get treated right away. Syphilis can hurt your unborn baby.
How will I know my syphilis has been cured?
After your treatment, your doctor will ask you to come back several times for blood tests. These tests will show if the medicine killed the syphilis germ.
What is the connection between syphilis, HIV and AIDS?
Syphilis can be passed from one person to another during sex. If you got syphilis, you could also have gotten HIV or another sexually transmitted disease, such as chlamydia or gonorrhea. If you have a syphilis sore, it's easier for HIV infection to get into your body through the sore. If you have syphilis, you should be tested for HIV, chlamydia and gonorrhea.
A simple exam and some lab tests can show if you have these infections. If you have HIV and syphilis, make sure your doctor knows about the HIV, so you can get the right treatment and continued care.
Where can I get more information?
For more information about syphilis, call your local health department (look in the Yellow Pages) or call the National STD Hotline at 1-800-227-8922.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1999 by the American Academy of Family Physicians.
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