This article discusses the signs and symptoms of syphilis infection and how it is diagnosed and treated.
First Signs of Syphilis
Symptoms of syphilis are present during the first two stages of infection, known as the primary and secondary stages. Some symptoms can also develop during the final stage, which is known as the tertiary stage, but this happens long after a person first becomes infected.
Primary Syphilis
The primary stage of syphilis occurs between 10 and 90 days after you contract the infection. During the time before the primary stage, known as the incubation period, symptoms are not present.
When the primary stage begins, one or multiple sores, known as chancres, will develop. These sores will appear in the affected area, usually the genitals, and feel firm or are rubbery to the touch. Syphilis sores are typically painless and roughly 0.5–2 centimeters in diameter. In some cases, lymph nodes near the sores will become enlarged.
The primary stage lasts anywhere from four to 10 weeks, during which time a sore will develop and then heal.
Secondary Syphilis
Following the primary stage and after the sores have almost or completely healed, a person will enter the secondary stage of a syphilis infection.
The most notable sign of secondary syphilis is a rash that develops on the palms of the hands and the soles of the feet. The rash will appear flat and red, with areas of raised bumps.
Symptoms that can occur during this stage include:
Fever Fatigue Weight loss Hair loss Swollen lymph nodes Muscle aches and pains Wartlike lesions in the affected areas Neurological involvement, also known as neurosyphilis
Later Stages of Syphilis
The later stages of syphilis include the latent and tertiary stages. The symptoms and duration of these stages can vary significantly.
Swelling and inflammation of the brain and spinal cord Reduced blood flow to the brain Blood clots Tissue death Hearing loss Ringing in the ears (tinnitus) Inflammation of various parts of the eye
Latent Syphilis
The latent stage of syphilis can occur between three and 12 weeks after the secondary stage. During this time, symptoms disappear completely.
In some people, signs of infection can recur during latency. This typically happens within the first two years of the latent period. The latent period can go on for years.
Tertiary Syphilis
The tertiary stage typically occurs roughly 15–30 years after entering the latency stage.
The signs and symptoms of this late-stage syphilis involve other organ systems within the body. Tertiary syphilis is divided into three categories depending on what part of the body is affected and what signs occur. The categories include:
Gummatous: Lesions, known as gummas, begin to develop on the skin and bones. Cardiovascular: Syphilis that affects the heart tends to cause aortic valve enlargement, which is enlargement of a heart valve that controls blood flow into your aorta, the body’s main artery. This can lead to aortic regurgitation, which occurs when the valve doesn’t shut, causing blood to flow back in the wrong direction. Neurological: The neurological problems that can arise during the tertiary stage are similar to those mentioned previously. Symptoms will vary depending on what part of the brain or spinal cord is affected.
When to See a Healthcare Provider
Since syphilis is highly treatable, the best time to see a healthcare provider is before or as soon as you notice any symptoms. This is because proper screening processes for people who are sexually active or at greater risk of contracting syphilis can prevent the disease. Screenings can also catch the first signs early so that treatment can begin quickly.
Dementia Personality changes Severe headaches Psychosis Seizures Weakness or inability to move one side of the body Death
For example, with syphilis, the initial sign is often a painless bump. Many people won’t notice the bump, but a healthcare provider could detect this at a screening and have it tested.
If you do notice any small bumps or other signs of infection, have them checked promptly so you can get get you started on treatment.
Diagnosis
To diagnose syphilis, healthcare providers will check for any visual signs of the infection and collect a health history. They will also have to conduct a blood test or, in some cases, a spinal test.
Men who engage in sexual activities with other menPeople who are HIV (human immunodeficiency virus) positivePeople taking HIV prevention medicationPeople who have syphilis-positive partnersPeople who have multiple sexual partnersPeople who have condomless sex
The tests used to diagnose syphilis include:
Rapid plasma regains (RPRs): This test looks for special proteins in the blood (antibodies) that are created in response to syphilis infection. Venereal disease research laboratory (VDLR): This test also looks for antibodies but can be done using blood or spinal fluid.
If either of these tests comes back positive for syphilis antibodies, more blood tests will be needed to confirm the diagnosis. In some cases, a lab test that specifically looks for syphilis bacteria may be conducted, but they are often used sparingly because they require the use of a specialized lab.
Treatment
Treatment for syphilis is simple and involves taking antibiotics. The sooner you start treatment, the shorter your course of antibiotics will be.
If you have had the infection for less than two years, a penicillin injection can be given once. If you cannot take penicillin, you will take other antibiotics for 10–14 days.
In the event that an infection has gone on for longer than two years, three penicillin injections will be given spread out over the course of three weeks, or oral antibiotics will need to be taken for a period of 28 days.
Summary
There are four stages of syphilis, and symptoms are unique to each stage. Symptoms include rashes, fever, and fatigue. The first sign of syphilis is one or more small, painless bumps in the affected area. While these usually occur in the genital or anal area, they also can develop in the mouth.
The latency stage will show no symptoms and could last for years. Therefore, it’s important to pay attention to the early signs and get prompt treatment in order to avoid any complications. Testing usually involves a simple blood test, and treatment includes a course of antibiotics.
A Word From Verywell
Though syphilis is an unpleasant infection, it is curable. But if left untreated, it can lead to irreparable damage to several different organ systems within the body. As a result, it’s important to pay attention to the early signs to make sure it’s addressed as quickly as possible. Diagnosis and treatment are simple and can protect your health.
