Syphilis – Symptoms and causes

Syphilis is a bacterial infection. It can be contracted by people who have sex with people who have HIV or people who have unprotected sex, according to the Centers for Disease Control and Prevention (CDC).

Syphilis is treatable with penicillin. Without treatment, syphilis can progress to the more serious and sometimes fatal late stages.

Symptoms of syphilis

The symptoms of syphilis include:

  • An itchy and/or sore that does not heal
  • Bruising that spreads through the body
  • Warts that may appear on genitals, buttocks, and penis
  • Pus-filled blisters
  • Gums that are red or very sore
  • Bloody discharge
  • Neutropenia
  • The lack of white blood cells

Other Symptoms include:

  • Fatigue
  • Dizziness
  • Tingling or numbness in the hands or feet
  • Frequent headaches
  • Tender lymph nodes
  • A lump or a rash on the genitals or penis
  • Abdominal pain
  • Pain in the eyes
  • Nausea or vomiting
  • Lethargy

People who are unaware they have the infection may experience all of these symptoms for several months. According to the CDC, syphilis can increase the risk of death.

Early symptoms of syphilis include:

  • Fatigue
  • Sore throat
  • Fever
  • Exertion intolerance
  • Low-grade fever
  • Gangrene of fingers and toes
  • Pathogens and vaccines

CDC says, most people may not show any symptoms. But some can experience a rash, headache, weight loss, or a swollen lymph node.

Some infections are treated with antibiotics. But treatment for syphilis is also curative.

However, if left untreated, syphilis can spread throughout the body and produce late complications, such as:

  • Bacterial tumors
  • Liver and kidney damage
  • Pulmonary emboli (blood clots)
  • Brain inflammation
  • Stroke
  • Sickle cell crisis
  • Heart attack

Below are some facts about syphilis.

What causes syphilis?

The CDC says there are a number of factors that cause an increase in syphilis. They include the environment, including global warming, decreasing infectious disease rates, poor sanitary conditions, and stress.

People with low education levels are most likely to be exposed to syphilis and develop the infection. Also, the presence of sexual partners and drugs may increase the risk of the infection.

Syphilis is transmitted through sexual contact or sharing needles with an infected person. People can get syphilis through contact with the blood, semen, saliva, mucus, or vaginal fluid of an infected person.

Syphilis is usually spread through unprotected vaginal, anal, or oral sex with an infected person. Infected people can also infect a new sexual partner if they share syphilis-infected syringes or other objects with the infected person.

According to the CDC, people can also become infected by having sex with an infected person without using a condom.

Syphilis in the United States

The CDC reports that syphilis has affected people in every state and territory in the United States, except for Alaska and Hawaii. The US Department of Health and Human Services estimates there are 927,000 cases of syphilis per year.

People in rural areas, in the South and in other locations in the United States are at higher risk of contracting syphilis. About one in four of syphilis cases in the United States occur in counties with a population less than 50,000 people.

The areas with the highest rates of syphilis have fewer health care providers per capita and higher rates of poverty, lower incomes, and less access to health care.

Education levels in the United States are generally lower than in most countries, with less than 20% of adults with at least a high school diploma. This is why many rural areas are disproportionately affected by syphilis, according to the CDC.

Rural areas also have higher rates of poverty and higher rates of tobacco use. These factors contribute to the higher rates of syphilis in rural areas.

Syphilis has been reported among nearly 20 percent of US men having sex with men, compared to 10 percent of the general population.

Where is syphilis most prevalent?

The CDC says syphilis is most prevalent in the following regions:

  • Alabama
  • Arkansas
  • Florida
  • Georgia
  • Louisiana
  • Mississippi
  • Tennessee
  • Texas
  • Vermont

What are the biggest misconceptions about syphilis?

Some people may think that syphilis is a venereal disease that only affects older people. Syphilis is not a disease that occurs only when a person is sexually active, and it’s not limited to men having sex with men.

The CDC estimates that an estimated 3.3 million people in the United States are living with the disease.

How is it treated?

Treatment of syphilis is similar to that of other sexually transmitted infections, such as chlamydia and gonorrhea.

A doctor will prescribe the antibiotic treatment with the lowest possible dose required to kill the bacteria. This will be followed by penicillin injections in the infected areas to prevent recurrence.

When to see a doctor

People who have any of the listed symptoms of syphilis should see a doctor right away. The infection is easily treatable with antibiotics.

People who are sexually active and have multiple partners, particularly those with more than one sexual partner, may want to talk to their doctor about testing for syphilis.

If treatment is delayed, syphilis can spread to the brain or other parts of the body and cause serious complications, including neurocysticercosis and meningitis.

What is the link to HIV?

While syphilis is not directly transmitted through sex, it can be contracted through other sexual contact. A person can get syphilis and HIV by having sex with another person who is HIV positive, as well as through sex without a condom.

Infected people with both HIV and syphilis may experience higher rates of HIV or other sexually transmitted infections, including gonorrhea.

Syphilis is contagious, and a person can pass syphilis to a partner during unprotected sexual contact.

It is important to practice safe sex and to use a condom during sexual intercourse, and to take all precautionary measures to avoid HIV transmission during sexual intercourse.


Routine screening of partners is recommended for partners of people with syphilis. Also, people who are unsure of their sexual partner’s exposure to syphilis should discuss the infection with their partner.

It is important to be up-to-date with the test for syphilis to prevent syphilis. This requires that a person get tested for syphilis at least once every three to six months.

When to see a doctor

There are several reasons to contact a doctor if a person suspects they have syphilis.

These include:

  • Getting a positive test result for syphilis
  • Staphylococcus aureus bacteria can develop in the bloodstream and lead to a secondary infection, known as a secondary syphilis.

The infection is treatable, but it can lead to an invasive infection in the brain. Treatment may include antibiotics. If syphilis spreads to the brain, it can cause meningitis.

Infection of the brain is rare, but some people experience blurred vision, seizures, or changes to memory and thinking.

Syphilis can spread to the blood, which can lead to an infection known as primary syphilis.


A doctor may first be able to diagnose syphilis based on the symptoms. A doctor may first be able to diagnose syphilis based on the symptoms.

Doctors use tests to confirm a syphilis diagnosis.

They include:

  • penicillin testing
  • renal blood tests
  • routine skin and blood tests
  • spot test
  • assay (protein-based test)

These tests will detect if syphilis bacteria are in a person’s blood, semen, or cervix, and they can give a preliminary indication of whether the infection is present.

A doctor will confirm the diagnosis by sending a sample of the infected tissue to a laboratory for further testing.

A doctor will always advise anyone suspected of having syphilis to see a doctor immediately.

Lactating women

Treatment for syphilis in lactating women is more complicated.

Treatment is still recommended during pregnancy for the benefit of the baby. However, if the mother has a high chance of passing syphilis to the baby, she should consider breastfeeding her baby.


It is essential that a person always protects their sexual partners from syphilis.

At-risk groups

The following groups are at higher risk of syphilis:

  1. Men

These men may have sex without a condom, and some may have unprotected sex with multiple partners.

Risk of syphilis is higher if:

  • one partner is HIV positive
  • the sex has been unprotected

The high-risk groups should consider taking a test every 3 months.

Further Treatment

If syphilis symptoms persist, then the infection needs to be treated immediately. A doctor may prescribe penicillin to treat syphilis.

Before treating syphilis, a doctor may first test for other STIs to ensure that there are no other STIs present in the body.

If a person has HIV, the doctor may advise treatment for HIV.

A person should discuss their options and follow any treatment as directed by their doctor.


The United States Department of Health and Human Services (HHS) recommends that all children should be tested for syphilis at ages 12, 24, and 48 weeks.

Women who have sex with men

It is vital that people who have sex with men should always protect themselves against STIs, including syphilis.

Anyone who has multiple partners or is living with multiple partners should consider visiting a doctor regularly to be tested.

It is a good idea for these people to be tested for syphilis at least once every 3 months.

Sexual assault victims

Men or women who are sexually assaulted may have syphilis, although they may not know it.

A sexual assault can put a person at higher risk of syphilis, as the bacteria are commonly spread during vaginal, anal, or oral sex.

Treatment for Adults

Treatment for syphilis in adults is usually in the form of penicillin.

If it is suspected that the person has syphilis, then doctors will carry out further testing and treatment accordingly.

A doctor will generally recommend antibiotic treatment for a couple of months to kill off all of the active syphilis bacteria.

However, if the infection is limited to the cervix, and does not have symptoms, then the doctor may prescribe treatment for menopause.

If a person has penicillin allergies, then they should talk to a doctor before starting treatment.


Men who have sex with men should consider taking a condom.

Wearing a condom is a simple way to reduce the risk of getting syphilis. It can also protect men who have a pregnant partner.

Be aware of any STI symptoms. Any doctor should be able to tell whether a person has syphilis and if they are at risk.

Anyone who suspects that they have syphilis should see their doctor immediately.


Treatment can often clear syphilis in its early stages. More than 90 percent of people clear syphilis within 6 months of treatment. It is important for anyone who suspects that they have syphilis or another STI to see a doctor.

If syphilis is left untreated, then a person is more likely to develop systemic infections, which are more dangerous and may require hospitalisation.


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