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Syphilis (SIF-uh-luhss) is a sexually transmitted infection (STI) caused by bacteria (germ). It progresses in stages. Syphilis is easy to cure in its early stages. But without treatment, it can hurt your body's organs, leading to severe illness and even death.
Syphilis is spread through direct contact with a syphilis sore or rash during vaginal, anal, or oral sex. The bacteria can enter the body through the penis, anus, vagina, mouth, or through broken skin. An infected pregnant woman can also pass the disease to her unborn child. Syphilis is not spread by contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.
Each stage of syphilis has different symptoms. A person infected with syphilis can pass it to others during the first two stages.
A single sore, called a chancre (SHANG-kuhr), appears in the first, or primary stage. Sometimes, more than one sore appears. The time between infection with syphilis and the start of the chancre can range between 10 to 90 days (21 days average). The chancre is usually firm, round, small, and painless. It appears at the spot where the infection entered the body, such as the vulva, vagina, cervix, tongue, lips, or other parts of the body. In this stage, syphilis can be passed to others through contact with the chancre during vaginal, anal, or oral sex. The chancre lasts 3 to 6 weeks and heals with or without treatment. If the infection is not treated, it moves to the secondary stage.
The secondary stage can start as the chancre is healing or a few weeks after it has healed. It typically starts with a rash on 1 or more areas of the body. Some or all of these symptoms can appear:
In this stage, the infection can be passed to others through contact with open sores or rash during vaginal, anal, or oral sex. Rash and other symptoms will go away with or without treatment. But without treatment, the infection will move to the latent and possibly late stages of disease.
The latent, or hidden, stage starts when symptoms from the first and second stages go away. The latent stage can last for many, many years. During this stage, the infection lives in the body even though there are no signs or symptoms. The infection cannot be passed to others during the latent stage. Sometimes, symptoms from the secondary phase come back. If this happens, the infection can be passed to others until the symptoms go away again. Without treatment, the infection will advance to the late stage in some people.
About 15 percent of people with untreated syphilis will advance to the late stage. This can happen within a few years or as many as 20 years or more after first becoming infected. In the late stage, the disease can hurt your organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can lead to nerve problems, paralysis, blindness, dementia, and other health problems. Some people may die from the disease. You will only reach the late stage if you do not receive treatment earlier. If you have syphilis, get treated as soon as possible to avoid these problems.
A doctor can tell if you have syphilis. The most common ways include:
Penicillin (an antibiotic) is the preferred drug to treat syphilis at all stages. The dose and length of treatment depends on the stage of syphilis and symptoms of the disease. For people who are allergic to penicillin, other drugs might work during the first and second stages. But they cannot be used by pregnant women. In late syphilis, treatment will prevent further harm, but damage already done to body organs cannot be reversed. Treatment does not protect you from getting syphilis again. You can get syphilis again after being cured if you are exposed to it.
Without treatment, syphilis can lead to severe illness and even death. Having syphilis also increases your risk of getting or giving HIV, the disease that causes AIDS. The open sores caused by syphilis make it easier for HIV to spread through sexual contact. If you have syphilis, you are thought to be 2 to 5 times more likely to get HIV if exposed. Untreated syphilis also can cause problems during pregnancy.
Yes. Pregnant women can pass syphilis to their babies during pregnancy and childbirth. It can cause miscarriage, stillbirth, or death soon after birth. An infected baby may be born without signs of disease. However, if not treated right away, the baby may have serious problems within a few weeks. Babies born with syphilis may develop skin sores, rashes, fever, jaundice, anemia, or a swollen liver and spleen. Untreated babies may become developmentally delayed, have seizures, or die.
All pregnant women should be tested for syphilis. Pregnant women with syphilis are treated right away with penicillin. For women who are allergic to penicillin, no other drugs are available for treatment. So, doctors try to help women with this allergy become less sensitive to the penicillin so it can be used. Penicillin will prevent passing syphilis to the baby. But women who are treated during the second half of pregnancy still are at risk of premature labor and problems with the unborn baby.
There are steps you can take to lower your risk of getting syphilis:
Ask your doctor about getting tested for syphilis if:
For more information about syphilis, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:
Content last updated July 08, 2011.
Resources last updated July 28, 2009.