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Syphilis is spread by contact with open sores (usually during sex). If left untreated it can cause serious health problems, including brain and nervous system damage, blood infection and even death. If early action is taken, syphilis can be cured with antibiotics. Syphilis prevalence is growing in the United States, particularly among men who have sex with men.

Symptom Overview

Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women.
Often, syphilis has no symptoms or has such mild symptoms that a person doesn’t notice them.

There are also several stages of syphilis, which may overlap. The stages may be separated by latent stages, or times when no symptoms are present.

Symptoms vary with each stage. But the syphilis symptoms do not always occur in the same order.

Primary Stage — A painless sore or open, wet ulcer, which is called a chancre, appears. You may have just one chancre or a few. Chancres usually appear about three weeks after infection, but may take up to 90 days. Without treatment, they last 3–6 weeks. Chancres can appear on the genitals, in the vagina, on the cervix, lips, mouth, breasts, or anus. Swollen glands may also occur during the primary phase.

Secondary Stage — Other symptoms often appear 3–6 weeks after the sores appear. These syphilis symptoms may come and go for up to two years. They include body rashes that last 2–6 weeks — often on the palms of the hands and the soles of the feet. There are many other symptoms, including mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache, and muscle pains.

Late Stage — One out of three people who have syphilis that is not treated suffer serious damage to the nervous system, heart, brain, or other organs, and death may result. This can occur 1–20 years after the start of the infection.


In the St. Louis Region in 2011, there were 92 reported cases of primary and secondary Syphilis. Most reported cases of syphilis in the US are in men who have sex with men (MSM).


  • Transmitted from person to person by direct contact with sores
  • Sores occur mostly on the vagina, anus, rectum, lips or mouth
  • Can be transmitted during vaginal, anal, or oral sex
  • Mothers can transmit the disease to their baby during childbirth
  • Oral, anal, vaginal, or penile syphilis sores make it easier to transmit and acquire HIV infection
  • A person is 2 to 5 times more likely to get HIV if exposed when syphilis sores are present


Syphilis can be diagnosed by testing samples of the following:

  • Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the bacteria that cause syphilis remain in your body for years, so the test can be used to determine a current or past infection.
  • Fluid from sores. Your medical provider may scrape a small sample of cells from a sore to be analyzed by microscope in a lab. This test can be done only during primary or secondary syphilis, when sores are present. The scraping can reveal the presence of bacteria that cause syphilis.
  • Cerebral spinal fluid. If it’s suspected that you have nervous system complications of syphilis, your medical provider may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).


Syphilis is curable with antibiotics. Follow up testing is highly recommended at 3 different intervals following initial diagnosis. Treatment cannot repair damage already done.

Living with It

If syphilis is left untreated, you may experience the following:

  • Serious blood vessel and heart problems
  • Mental disorders
  • Blindness
  • Large sores inside the body or on the skin
  • Nervous system problems and even death

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