Bacterial infection (Treponema pallidum) is the cause of syphilis. Sexual activity with an infected person is the primary method of transmission for syphilis. The sore that marks the beginning of the disease is normally painless and develops on the mouth, rectum, or genitalia. Through direct touch with these sores, syphilis can be transferred from one person to another. Additionally, it can be transmitted to a child during pregnancy, childbirth, and occasionally via breastfeeding.

Syphilis germs (Treponema pallidum) can remain in the body without generating symptoms for many years after the infection has occurred. But the infection can reactivate. Syphilis may harm your heart, brain, or other organs if you don't get treatment. It might even endanger your life.

treponema pallidum
Image Credit: BMJ STIs. Sore on the penis due to syphilis 

Early syphilis can occasionally be healed with a single injection of the antibiotic penicillin. Therefore, it's imperative to seek medical attention as soon as you have any syphilis symptoms. All expectant women should be screened for syphilis at their initial prenatal visit as well.

What are symptoms of syphilis

Syphilis progresses gradually. Every stage has different symptoms. But the stages might cross over. Furthermore, the symptoms do not usually present in the same sequence. Without experiencing any symptoms for years, you could be infected with the syphilis bacteria.

Primary stage

A chancre, pronounced "chan-kur," is a tiny sore that is the earliest sign of syphilis. The sore frequently doesn't hurt. It manifests where the bacterium first entered your body. Most syphilis patients only develop one chancre. Some folks receive multiples.

About three weeks after coming into touch with the syphilis germs, the chancre frequently develops. Many syphilis patients are unaware of the chancre. That is because it typically causes no pain. It might also be concealed inside the vagina or the rectum. Within three to six weeks, the chancre will naturally heal.

Secondary stage

Rash may come as a symptom in secondary stage after the first chancre heals.

Characteristics of  rash that is caused by syphilis:
  • Often is not itchy.
  • May look rough, red or reddish-brown.
  • Might be so faint that it's hard to see.

The body's trunk is where the rash usually first appears. It encompasses the back, pelvis, chest, and midsection. It might eventually show up on the limbs, hands, feet, and palms of the hands.

 Symptoms that may occur together with rash include:

  • Warts-like sores in the mouth or genital area.
  • Muscle aches.
  • Fever.
  • Weight loss.
  • Swollen lymph nodes.
  • Sore throat.
  • Hair loss.
  • Tiredness, also called fatigue.
Secondary syphilis symptoms sometimes go away on their own. However, if left untreated, they could come and go for months or even years.


Syphilis progresses from the secondary stage to the latent stage if you aren't treated for it. Due to the absence of symptoms, this period is also known as the hidden stage. Latent stages can persist for many years. Your symptoms might never return. However, if the disease is left untreated, it may result in serious health issues, often known as complications.

Tertiary stage

Up to 30% to 40% of syphilis patients who don't receive therapy have tertiary syphilis issues after the latent stage. It also goes by the term of late syphilis.

The complications may involve and damage the following body parts:

  • Brain - causing neurosyphilis
  • Nerves.
  • Eyes.
  • Heart.
  • Blood vessels.
  • Liver.
  • Bones and joints.
These syphilis associated problems may show up later in life if the infection was not treated.

What causes Syphilis

Treponema pallidum is the bacteria that causes syphilis. Syphilis is most frequently transmitted by vaginal, oral, or anal sex contact with an infected person's sore.

Through small skin scrapes or cuts, as well as through the wet inner lining of some bodily components, the bacteria enter the body.

During both its main and later stages, syphilis is communicable. The early latent period, which begins within a year of infection, can occasionally be communicable as well.

Syphilis can less frequently be spread through kissing or contact with an open sore on the lips, tongue, mouth, breasts, or genitalia. Additionally, it can be transmitted to infants during pregnancy, childbirth, and occasionally during breastfeeding.

Casual contact with items that an infected person has handled cannot spread syphilis.

Therefore, you cannot contract it via using the same bathroom, bathtub, clothes, dining utensils, doorknobs, or hot tubs or pools.

Syphilis doesn't recur on its own after being treated. However, if you come into contact with a person's syphilis sore, you risk becoming infected once more.

Complications of Syphilis

Syphilis can harm the entire body if it is not treated. Additionally, syphilis increases the risk of contracting HIV and might be problematic during pregnancy. Damage can be avoided with treatment. However, it cannot undo or repair damage that has already been done.


Rarely, gummas, or lumps, can appear on the skin, bones, liver, or any other organ in the late stages of syphilis. The majority of the time, gummas disappear after being treated with antibiotic medication.

Neurological problems

Numerous issues with the brain, its covering, or the spinal cord can be brought on by syphilis. These problems consist of:
  • Bladder problems example, incontinence 
  • Stroke. cardiovascular accident
  • Persistent Headaches.
  • Meningitis. Infection causing the swelling of the tissue covering the brain and spinal cord.
  • Confusion. This characterized with changes in mental status or personality of a patient 
  •  Dementia like symptoms. Memory loss poor decision making and  judgment
  • Paralysis.  Patient unable to move some body parts
  • Men can have  erectile dysfunction (erection problems)
The above are what are called neurosyphilis complications

Eye problems 

When the treponema pallidum infects the eyes as a result of un treated syphilis can cause complications of the eye this may include:

  • Visio issues other than blindness
  • Eye pains 
  • loss of sight ( Blindness)
When the disease attacks the eyes it's commonly named ocular syphilis

Eara problems

Otosyphilis is the name given to complication of syphilis when it attacks the ears. The problems associated may present with the following symptoms:

  • Vertigo. Feeling like  you are spinning.
  • Ringing ears. You may hear a ringing sound in your ears called tinnitus
  • Loss of hearing. unfortunately some patients can lose hearing from syphilis  

Heart and vascular problems

The so called cardiovascular syphilis occurs when the treponema pallidum finally infects the cardiovascular systems compromising the normal work of pumping of blood and delivery in the vessels to target organs. The aorta, the body's main artery, as well as other blood arteries may enlarge and bulge. syphilis can further damage the heart valves leading to heart failure. 

Pregnancy complications

Syphilis can infect the unborn child causing problems like 
  • Premature birth
  • Early infant death
  • Stillbirth
  • Abortion
  • abnormal teeth formation

Prevention of syphilis

Practice safe sex or Avoid it . Avoiding intercourse is the only surefire strategy to avoid coming into touch with the syphilis germs (Treponema pallidum). Abstinence is the term for this. If a person engages in sexual activity, safer sex is defined as a long-term relationship in which you and your partner exclusively engage in sexual activity with one another and are both uninfected. You should both get tested for syphilis and other STIs before engaging in sexual activity with a new person.

Use barrier methods. Syphilis can be prevented from occurring or being spread by using condoms. However, condoms are only effective if they cover a syphilis patient's sores. Other birth control methods do not reduce your risk of contracting syphilis.

Avoid drug abuse. Drug use or excessive alcohol consumption might cloud your judgment. Any of them might result in dangerous sex.

Be cautious when breastfeeding. If sores are present on one or both breasts while breastfeeding, syphilis may be transmitted from mom to child. This may occur if the baby or the pumping apparatus comes in contact with a sore. Pump or manually express breastmilk from the breast with sores to prevent it from happening. Do this until the wounds are healed. Put the milk you just pumped into the trash if your pump touches a sore.

Laboratory tests for syphilis

Blood test. Antibody-like proteins can be detected in blood samples. These are produced by the immune system to combat infections. The body retains the antibodies to the syphilis-causing germs for many years. Consequently, blood testing can be utilized to identify a recent or former infection.

Fluid from sores. To prove that syphilis was the source of the sore, a laboratory can examine this fluid under a microscope.

Fluid from from brain and spinal cord covering. Cerebrospinal fluid is another term for this substance. Your medical team may advise testing this fluid if they believe that you have syphilis-related issues with your nervous system. Cerebrospinal fluid is extracted with a needle from the space between two back bones. Lumbar puncture is the name of this operation.

Treatment of treponema pallidum infection (syphilis)

When syphilis is discovered and treated in its early stages, it is easily treatable. Penicillin is the chosen medication at all stages. The syphilis-causing bacteria can be eliminated by this antibiotic medication.

If you have a penicillin allergy, your medical staff might advise a different antibiotic. Or they might suggest a method that gradually primes your body to tolerate penicillin.

A single dose of penicillin is advised for treating primary, secondary, or early-stage latent syphilis. For those who has the infection greater than a year they may need more doses.

Only penicillin is advised as a treatment for pregnant syphilis patients. Penicillin allergy sufferers might follow a procedure that can enable them to use the medication. The process is known as desensitization to penicillin.

A expert known as an allergist or immunologist performs it. It calls for ingesting very little doses of penicillin spaced out over the course of four hours.

Your newborn should be checked for congenital syphilis even if you received syphilis treatment when you were pregnant. A baby who has the syphilis bacterium is treated with antibiotics.

You can experience what is known as the Jarisch-Herxheimer reaction on the first day of treatment. Fever, chills, nausea, achy pain, and a headache are among the symptoms. This reaction often lasts no more than a day.

Treating syphilis requires also treating all the sexual partners to prevent re-infection just like other STIs.


Syphilis, caused by a bacterium called treponema pallidum is a common sexually transmitted infection that is easy to treat. Prevention needs a consistent use of condoms. However you can get this infection even through contact with the sore on the hands or any other body parts. Make sure to take you sexual partners for treatment so you are assured of no infection again.