Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria known as Treponema pallidum. In 2016, more than 88,000 cases of syphilisTrusted Source were reported in the United States, according to the Centers for Disease Control and Prevention. The rate of women with syphilis has been declining in the United States, but the rate among men, particularly men who have sex with men, has been rising.
The first sign of syphilis is a small, painless sore. It can appear on the sexual organs, rectum, or inside the mouth. This sore is called a chancre. People often fail to notice it right away.
Syphilis can be challenging to diagnose. Someone can have it without showing any symptoms for years. However, the earlier syphilis is discovered, the better. Syphilis that remains untreated for a long time can cause major damage to important organs, like the heart and brain.
Syphilis is only spread through direct contact with syphilitic chancres. It can’t be transmitted by sharing a toilet with another person, wearing another person’s clothing, or using another person’s eating utensils.
The four stages of syphilis are:
Syphilis is most infectious in the first two stages.
When syphilis is in the hidden, or latent, stage, the disease remains active but often with no symptoms. Tertiary syphilis is the most destructive to health.
The primary stage of syphilis occurs about three to four weeks after a person contracts the bacteria. It begins with a small, round sore called a chancre. A chancre is painless, but it’s highly infectious. This sore may appear wherever the bacteria entered the body, such as on or inside the mouth, genitals, or rectum.
On average, the sore shows up around three weeks after infection, but it can take between 10 and 90 days to appear. The sore remains for anywhere between two to six weeks.
Syphilis is transmitted by direct contact with a sore. This usually occurs during sexual activity, including oral sex.
Skin rashes and a sore throat may develop during the second stage of syphilis. The rash won’t itch and is usually found on the palms and soles, but it may occur anywhere on the body. Some people don’t notice the rash before it goes away.
Other symptoms of secondary syphilis may include:
These symptoms will go away whether or not treatment is received. However, without treatment, a person still has syphilis.
Secondary syphilis is often mistaken for another condition.
The third stage of syphilis is the latent, or hidden, stage. The primary and secondary symptoms disappear, and there won’t be any noticeable symptoms at this stage. However, the bacteria remain in the body. This stage could last for years before progressing to tertiary syphilis.
The last stage of infection is tertiary syphilis. According to the Mayo Clinic, approximately 15 to 30 percent of people who don’t receive treatment for syphilis will enter this stage. Tertiary syphilis can occur years or decades after the initial infection. Tertiary syphilis can be life-threatening. Some other potential outcomes of tertiary syphilis include:
- mental illness
- memory loss
- destruction of soft tissue and bone
- neurological disorders, such as stroke or meningitis
- heart disease
- neurosyphilis, which is an infection of the brain or spinal cord