If left untreated, syphilis can invade multiple systems in the body and damage organs. This can be life-threatening.
Learn more about the symptoms of syphilis, how it is transmitted, its side effects, complications, and treatment options.
What Is Syphilis?
Syphilis is a form of STI. It is curable, but if left untreated, it can lead to serious health complications.
The infection occurs in four stages:
PrimarySecondaryLatentTertiary
The different stages can cause different symptoms. Tertiary syphilis is the most serious stage and can result in a number of complications.
Symptoms of Primary and Secondary Syphilis
During primary syphilis, symptoms may include a single sore or multiple sores. This may occur on or near the:
AnusPenisVaginaRectumLipsMouth
Typically, the sores are painless, firm, and round. In primary syphilis, they may last between three to six weeks and heal even without treatment. Treatment is still necessary, though, to prevent progression to secondary syphilis.
In secondary syphilis, rashes and sores may appear on or near the anus, mouth, or vagina.
The rash may be:
Reddish-brownRoughNot itchy
Other symptoms that may occur in secondary syphilis include:
HeadacheFeverWeight lossSwollen glandsHair lossSore throatFatigueMuscle aches
How It Is Transmitted
Those who are sexually active can get syphilis. It also can be transmitted from an infected mother to her unborn baby.
During oral, anal, or vaginal sex, syphilis spreads through direct contact with a syphilis sore.
Syphilis is not spread through casual contact. This means it can’t be contracted through:
Sharing clothesSharing utensilsToilet seatsHot tubsSwimming poolsBath tubsDoor knobs
Side Effects and Complications
At any stage, a syphilis infection can invade various systems throughout the body. This can lead to side effects and complications.
Neurosyphilis
Neurosyphilis most commonly occurs in people who have had untreated syphilis for years. It typically occurs 10 to 20 years after the initial infection with syphilis.
It is a bacterial infection of the spinal cord and brain. It is caused by the same bacterium that causes syphilis, Treponema pallidum.
Not everyone with syphilis will develop neurosyphilis.
Neurosyphilis can cause a variety of symptoms:
Dementia: This causes behavioral changes or problems with cognition. Meningitis: This is inflammation of the tissues of the spinal cord and brain. It is a life-threatening complication of a syphilis infection. Seizures: The type of seizure can vary. Hallucinations: These may be auditory or visual hallucinations. Tabes dorsalis: This causes abnormal sensations as well as muscle weakness.
Ocular Syphilis
Ocular syphilis occurs when the syphilis infection invades the eye, affecting vision.
Symptoms of ocular syphilis may include:
Sensitivity to lightPain in the eyeRedness in the eyeSeeing spots (called floaters) in field of visionBlurry visionBlindnessChanges to vision
Otosyphilis
Otosyphilis occurs when the syphilis infection invades the vestibular, or auditory (hearing), system of the body.
This can cause a variety of symptoms, including:
DizzinessTrouble balancingVertigoLoss of hearingTinnitus (a hissing, ringing, buzzing, or roaring sound in the ears)
Cardiovascular Syphilis
Cardiovascular syphilis occurs when a syphilis infection invades the cardiovascular system (the heart and blood vessels).
Cardiovascular syphilis can cause a variety of symptoms, including:
Inflammation of the aortaAortic valve insufficiency (when the heart valve doesn’t open properly)Narrowing of the coronary arteriesAortic aneurysm (a bulge in the aorta that may rupture)Obstruction of the coronary arteries
Gummatous Syphilis
During late-stage syphilis (tertiary syphilis), growths similar to tumors can form. These are called gumma and are swollen or dead tissue.
They are caused by the same form of bacterium that causes the syphilis infection. Most commonly, they occur on the liver but may also appear on the:
SkinHeartBrainBoneTestesEyes
Congenital Syphilis
In congenital syphilis, the infection is passed from mother to the fetus in the uterus. This happens when the mother contracts syphilis either prior to pregnancy or during pregnancy.
It is more common for infection to be passed on if the mother is infected during pregnancy, however, infection can still be transmitted from a mother infected prior to pregnancy.
Symptoms of congenital syphilis do not always appear immediately at birth and may take weeks, months, or years following birth to develop.
Early congenital syphilis may cause symptoms between the ages of 3 and 14 weeks, but can also occur up to the age of 5.
Possible symptoms include:
Low birth weightRashInflammation of the umbilical cordFeverHigh cholesterol levels at birthAnemiaJaundiceEnlarged spleen or liverRhinitisHair loss
Late congenital syphilis may cause symptoms after the age of 5. Some people may be undiagnosed even into adulthood.
Possible symptoms include:
Pain in bonesEye painBlurred visionAbnormal level of sensitivity to lightProminent, bony foreheadFissuring (splitting or cracking) around the anus and mouth
How to Test for Syphilis
In the majority of cases, a blood test is used to test for syphilis. Sometimes fluid taken from a syphilis sore is also tested.
If you have symptoms that indicate syphilis, you should be tested. Your sexual partners should also be tested.
Treatment
Syphilis can be successfully treated with antibiotics. However, this won’t be able to reverse the damage already done by the infection.
Even after treatment, it is possible to get syphilis again.
How to Prevent the Risk of Infection
The only way to totally prevent syphilis is by not having sex of any kind. This includes vaginal, anal and oral sex.
If choosing to be sexually active, risk can be reduced by:
Having sex only with a long term monogamous partner who does not have syphilisUsing condoms correctly every time you have sex
Summary
Syphilis is a sexually transmitted infection that occurs in four stages: primary, secondary, latent, and tertiary. It can be spread through sexual contact or from an infected mother to a fetus or baby during birth. If left untreated, the infection can impact multiple systems and organs in the body. This can be life-threatening. Syphilis can be treated with antibiotics, but this will not treat any damage already caused by the infection.
A Word From Verywell
Having an STI can be uncomfortable. If you have symptoms that indicate syphilis, it is important to reach out to a healthcare provider. They can provide testing and treatment that will help prevent dangerous complications.
In secondary syphilis, a rash may also appear that is red, reddish brown, or rough looking.
PrimarySecondaryLatentTertiary
Treatment may be required for weeks or longer.
