McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is syphilis?

Syphilis is a serious bacterial infection. It is usually passed from one person to another by sexual contact. If it is not treated, syphilis can lead to permanent brain, nerve, and tissue damage.

How does it occur?

The bacteria that cause syphilis enter the body through an opening such as the vagina, mouth, or rectum. They can also enter through a cut or break in the skin.

During the early stages of syphilis, sores form on the body, usually near the genitals. If you touch a sore on an infected person, some of the bacteria will probably rub off onto your body. If the bacteria then get near any moist membrane of your body (such as the vagina, mouth, or rectum) or on any cuts or breaks in your skin, you may get syphilis. Once inside the body, the bacteria spread quickly through the bloodstream.

Sometimes a baby is born with syphilis if the mother has the disease during pregnancy.

What are the symptoms?

The symptoms of syphilis vary according to the stage of the disease. During the first stage a smooth, red, painless sore called a chancre appears. People usually get chancres near the genitals, but they can form anywhere on the body. Women may not know they have a chancre if it is inside the vagina. Chancres on the penis can usually be seen. These sores may appear 10 days to 3 months after contact with an infected person. The sores last 1 to 8 weeks.

If you are infected with syphilis and you do not get treatment, the disease will develop into the second stage. This second stage is called secondary syphilis. It begins 6 to 12 weeks after contact with an infected person and may last for weeks to as long as a year. Symptoms during the second stage of syphilis can include:

• a pinkish or red, bumpy, scaling skin rash that does not itch and may come and go (this rash, which may include spots on the palms of the hands and soles of the feet, is highly infectious)
• swollen lymph glands
• flu symptoms such as fever, body aches, headache, fatigue, and loss of appetite
• hair loss in clumps
• gray or pink patches of fatty tissue in damp areas of the body (also highly infectious)
• wartlike growths in the anal area.

Often the second stage of syphilis is followed by a latent period. During latent syphilis you have no symptoms even though you have not been treated for the disease. This latent period may last a few years or it may last a lifetime.

One in three people who have latent syphilis develop the third stage of syphilis. This third stage is called tertiary syphilis and starts after 10 to 40 years of infection. During this stage, the disease can affect the brain, the aorta (the blood vessel that leads from the heart), and the heart. This can lead to severe heart disease, brain damage, paralysis, and death.

How is it diagnosed?

Your health care provider looks for chancres on the body surface as well as in the vagina, cervix, and anal area. If sores are found, scrapings from the sores are examined under a microscope to look for the bacteria that cause syphilis. Your provider may also test a sample of your blood.

How is it treated?

Syphilis is usually treated with shots or oral doses of penicillin. Your health care provider may prescribe tetracycline or erythromycin if you are allergic to penicillin.

Cases of syphilis are required by law to be reported to the local health department. You must tell the proper authorities of all the people you have had sexual contact with.

How long will the effects last?

The symptoms and effects of syphilis can last from a week to a lifetime. If the infection is not treated but becomes latent after the first or second stage, the infected person has no symptoms but is at risk of developing secondary or tertiary syphilis. If syphilis is treated with antibiotics during an early stage, the symptoms disappear after several weeks and the disease is cured. During the tertiary stage of syphilis, antibiotics can still be used to kill the bacteria causing the infection. However, any damage to the blood vessels, brain, and other organs will remain.

How can I take care of myself?

Follow your health care provider's instructions and take all of your medicine as prescribed. Be sure to tell your provider if you are allergic to penicillin or other medicines.

What can be done to help prevent syphilis?

If you have syphilis, you can help prevent spread of the infection if you:

• Tell people with whom you have had sexual contact about your infection.
• Do not expose other people to your body fluids and open sores. Do not have sexual intercourse or other intimate physical contact with anyone until you have been treated.
• Wash your hands after you use the toilet and before you touch any food, dishes, or utensils.

You can also reduce your risk of getting syphilis from someone else if you:

• Use latex condoms during intercourse.
• Minimize the number of people with whom you have intimate sexual contact.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.