Syphilis Questions and Answers

University of Iowa Hospitals and Clinics
Department of Obstetrics and Gynecology
Peer Review Status: Internally Peer Reviewed
First Published: 1997
Last Revised: January 2003

What are the signs and symptoms of syphilis?
Syphilis is dangerous, but it is easily treated if it is diagnosed early. If left untreated, it can cause blindness, insanity, paralysis, heart disease or death. Symptoms may appear 10-90 days after exposure. Syphilis develops symptoms which are broken down into four stages.

Signs and symptoms in an adult

• Stage One: This is an infectious (contagious) stage of the disease. There are two main symptoms in this stage: Swelling of the lymph glands and the appearance of chancres. Chancres are open, oval shaped sores with hard, raised borders. Chancres are usually seen on the genitals (penis or around the vagina), the mouth or anus, but may appear anywhere. Chancres in women may not be noticed because they may occur inside the vagina. Chancres are not painful and rarely bleed. Syphilis is passed from direct contact (during sex) with the chancres. Chancres will appear 10-28 days after sexual contact and will usually disappear in two to six weeks even if not treated.
• Stage Two: This is also an infectious stage. It begins two weeks to six months after the chancre is gone. A rash appears on the palms of the hands and the soles of the feet. The lymph glands swell, the throat may be sore, and patches appear in the mouth. Flat bumps that look like warts may be seen around the genitals and the mouth. These bumps are very infectious. Other symptoms include hair loss, loss of appetite, constipation, nausea, a low-grade fever and muscle, joint or bone pain. These symptoms may last two to six weeks.
• Stage Three (Latent): This stage (latent stage) may occur two years after the primary stage and could last 50 years. Most people have no symptoms in this stage, but a few may develop painful lesions called "gummas" in bones, skin, nervous tissue and the heart. Syphilis is not spread through sexual contact at this stage, but is present in the blood.
• Stage Four (Tertiary): This is not an infectious stage. One-third of the people with syphilis will develop heart problems, skin rashes, bone and joint pain or other problems such as insanity, slurred speech, senility or paralysis (inability to move an arm or leg). If left untreated syphilis may cause death.

Signs and symptoms in an infant
A pregnant woman with syphilis can infect her unborn child. Syphilis crosses the placenta after 16-18 weeks of gestation. A pregnant woman with syphilis may experience a miscarriage, stillbirth (death of the baby before birth), or give birth to a child with birth defects. If an infant born with syphilis is not treated early, it may develop blindness, brain damage or other problems with growth and development. Infants whose mothers have been treated may still have birth defects if exposed to syphilis before the treatment was begun.

Who is at risk for syphilis?

• Age: Younger men and women (up to age 29) tend to have more sexual partners, which puts them at risk.
• Number of Sexual Partners: Men and women have an increased risk of infection as the number of partners increases.
• Unprotected Sex: Those who have sex and do not use condoms (rubbers) have a greater risk for infection.

How is syphilis diagnosed?
During stage one of syphilis, diagnosis is made based on the presence of chancres. If a chancre is present, fluid from the sore may be used for diagnosis. In the three later stages a blood test is needed to detect syphilis. The blood test will not be positive until five weeks after the chancres first appear.

How is syphilis treated?
Syphilis is treated with penicillin shots. More than one shot may be needed. Other drugs may be used for those allergic to penicillin. Syphilis is curable if treated in time. It is very important to take all the medications the physician prescribes.

How is syphilis prevented?
The use of condoms (rubbers) can prevent the spread of STD's including syphilis. In order to be effective, condoms must be used with every sex partner and every time you have sex. Avoiding multiple sexual partners is also helpful. In the event that syphilis is contracted, early diagnosis and treatment are important so the condition can be treated before advancing to further stages.

See related Patient Textbooks about Obstetrics and Gynecology.

See related Patient Topics Infections, Infectious Diseases, Men's Health, Obstetrics and Gynecology, Sexual Health, Sexually Transmitted Diseases, Syphilis or Women's Health.

See related Provider Textbooks about Obstetrics and Gynecology.

See related Provider Topics Infections, Infectious Diseases, Men's Health, Obstetrics and Gynecology, Sexual Health, Sexually Transmitted Diseases, Syphilis or Women's Health.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

http://www.vh.org/adult/patient/obgyn/syphilis/index.html