Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2003;68(2):297

What is syphilis?

Syphilis (say: sif-ih-liss) is a sexually transmitted disease (STD) caused by a bacterium named Treponema pallidum. (say: Trep-oh-nee-mah pal-lih-dum). If syphilis is not treated, it can cause serious problems. The good news is that syphilis usually can be cured with penicillin or another antibiotic.

What are the stages and signs of syphilis?

Syphilis has four stages, depending on how long a person has had the disease. Each stage can have different signs.

Primary syphilis is the first stage. If you were infected recently, you may have a painless sore at the opening to your vagina or on your penis. This sore is called a chancre (say: shan-ker). Usually there is only one chancre, but there can be more.

If primary syphilis is not treated, it turns into secondary syphilis. You may have flu-like symptoms and a rash on your entire body. You may have skin sores called condyloma latum (say: kon-dih-low-mah lah-tum). These warty sores usually develop near your vagina or penis, or near your rectum. You also may have problems with your liver, kidneys, and other organs.

The next stage is latent syphilis. In this stage, you have no signs of syphilis, but blood tests show that you are still infected.

Late syphilis is untreated syphilis that has been present for many years. If you have late syphilis, you may develop gummas (say: gum-mahs). These are rubbery sores on your skin or on organs inside your body. You also can have problems with your heart and blood vessels. One of the most serious problems that can happen is a brain infection called neurosyphilis. This infection can cause abnormal hearing, vision, or thinking, and death.

How is syphilis diagnosed?

If you have a skin sore, scrapings from the sore may be looked at under a microscope.

More often, doctors rely on blood tests. Several blood tests are needed to be sure that syphilis is present.

A spinal tap is done if there is concern that syphilis has spread to your brain. For this test, fluid is taken from around your spinal cord and tested for signs of neurosyphilis.

How is syphilis treated?

Syphilis usually can be cured with penicillin. If you are allergic to penicillin, you might be treated with another type of antibiotic.

What else should I think about if I have syphilis?

Because syphilis is an STD, it is important for all your sexual partners to be tested and treated. It is also important to talk to your doctor about being tested for other STDs. Talk to your doctor about how—and when—to safely resume sexual activity.

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