Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 29, 2016

Syphilis is a disease caused by a spirochete bacterium that affects thousands of men and women every year. It is most commonly contracted through unprotected sex, though it can be contracted through open sores, cuts and from a mother to her unborn child. The most striking symptoms of this disease are the sores than can be seen on the hands, feet and torso.


Definition & Facts

Syphilis is a sexually transmitted disease (STD) that is spread through sexual activity or through close contact of the open sore of a person who has contracted the disease. Though it was once a common infection, rates of the disease decreased in the mid-20th century due to the widespread use of penicillin. Under 64,000 people contracted syphilis in 2014.

Syphilis is generally detected in just under a month from the time of contraction and can be detected in as little as ten days. Dubbed “the great pretender,” syphilis often has similar symptoms to other diseases.The disease can cause brain damage or damage to heart, liver, or lungs if left untreated. Blood tests are most commonly used to diagnose the disease. If left untreated, the disease can cause problems in the nervous system.

Symptoms & Complaints

Symptoms of syphilis generally appear in two stages: primary and secondary. The primary stage of syphilis is marked by the appearance of a sore where the bacteria first made contact and possible presence of multiple sores. Syphilis can remain undetected because the sore or sores might show up in an area of the body that cannot be seen, like the vagina. Sores will heal within a month to two months.

The secondary stage of the disease is marked by a skin rash on the chest, stomach or back. This rash will spread to the entire body if left untreated and may form infectious lesions which produce pus. Other symptoms include, fever, body aches, sore throat and swollen glands. These symptoms sometimes dissipate and often come and go for up to a year. Sometimes a person with syphilis experiences no symptoms whatsoever. This type of syphilis is called latent syphilis.

If left untreated, the final stage called tertiary syphilis can occur. This is the stage during which incidences of neurosyphilis typically take place, in which the underlying bacteria infect the nervous system. Symptoms of neurosyphilis include dementia, visual impairment, tremor, incontinence, psychosis, and memory loss.


The most common causes of syphilis are through unprotected sex or transfer through an open sore or wound on the body. Since syphilis is a sexually transmitted disease (STD), it is most commonly transferred through unprotected sex. It can travel through the mucous membranes and sexual fluids. This disease can also be transferred through open sores. One of the most common ways to contract syphilis is through kissing someone who has the disease.

The disease can also be transferred from mother to child. If a woman is infected with syphilis and is not treated, she can pass the disease along to her unborn child. This is called congenital syphilis.

Some ways that syphilis cannot be contracted are through contact with inanimate objects. It’s impossible for someone to transfer bacteria from this disease to a toilet seat and then to another person through mucous membranes or open sores. It’s also impossible for the disease to be transmitted through a hot tub or public pool.

Diagnosis & Tests

The three ways to diagnose syphilis are through blood, bodily fluids and spinal fluids. The most common type of syphilis diagnosis is through a blood test. The doctor will draw blood from the patient and test the blood to find signs of antibodies that are present to fight the disease. Even if the disease has been cured, the antibodies might still be present in the blood, so the test cannot be an accurate indicator on someone who previously had syphilis.

Another way of detecting the disease is through fluid from an open sore. If the patient still has the initial syphilis sore, a doctor can scrape fluid to test. The test can also be performed on secondary sores that present themselves on the torso or palms. Finally, a doctor can perform a spinal tap to determine if a patient has syphilis and believes the disease has also led to other complications through the nervous system. This is the most uncomfortable form of diagnosis and will only be performed if other issues arise.

Treatment & Therapy

The most common treatment for syphilis is through a penicillin injection. The injection is created through an antibiotic that can kill the bacteria. Only one injection is needed if the disease is only in the first few stages or has been present in the body for under one year. Further injections can help cure the disease if the disease has been present for longer than one year. Other antibiotic treatments are available for men and women who are allergic to penicillin.

Pregnant women who have developed syphilis can only receive the penicillin treatment. They are advised to have their babies treated with a penicillin injection after birth to ensure the baby does not suffer from the disease also.

Patients who are being treated for this disease should abstain from sexual activity or close contact with others until the disease is cured. Patients should also contact past sexual partners and advise them to be tested for syphilis. Patients are also advised to be screened for HIV and other sexually transmitted diseases as well.

Prevention & Prophylaxis

The best way to prevent this disease is by practicing safe sex. People can avoid unprotected sex by always using a condom or practicing monogamy. People should also be aware that if their sex partners have open sores on the body that might not be covered by a condom, the disease could still be transferred.

Since the disease may also be transferred through open sores or cuts, people should also avoid close contact with anyone who appears to have an open sore or cut. Since syphilis can also be transferred through sharing needles, syphilis can be avoided by abstaining from illegal intravenous drugs.

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