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Health Information Center


  • Cynthia M. Johnson, MA
Publication Type:




Syphilis is a sexually transmitted infection (STI). It can cause brain, nerve, and tissue damage when it is not treated. It can also be deadly.


Syphilis is caused by bacteria. It is spread through contact with a syphilis sore. This may happen during oral, anal, or genital sex with an infected person

Risk Factors

Things that may raise the risk of this problem are:

  • Not using a latex condom during oral, anal, or genital sex
  • Having more than one sex partner
  • Having other STIs


Symptoms will depend on what stage the syphilis is in. There are three main stages as well as a resting phase.


The doctor will ask about symptoms and health history. A physical exam will be done.

Other tests may be:

  • Samples taken from lesions
  • Blood tests to look for signs of infection
  • A lumbar puncture to look for signs of the disease in the fluid that surrounds the brain and spinal cord


Syphilis is treated with antibiotics.

People with syphilis should also avoid sexual contact until treatment is complete and the infection is gone.


The risk of this problem may be lowered by:

  • Not having oral, anal, or genital sex
  • Limiting sex to one partner who is not infected
  • Using latex condoms during sex.

Primary Stage: 7 to 90 Days After Infection

A single sore appears. It will happen in the area where the infection was passed. Common sites are the external genitals, rectum, tongue, inside of the mouth, or lips.

It will start as a raised and painless sore called a chancre. It will break down to form an ulcer. It lasts for 3 to 6 weeks. The ulcer will heal on its own.

Without treatment, the infection may move to the secondary stage. This can happen even if a person no longer sees the ulcers.

Lymph Nodes.

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Secondary Stage: Several Weeks to Months after the Original Sore

This stage features a non-itchy rash. The rash may appear as rough, red, or reddish brown spots on the palms of the hands or soles of the feet. Other rashes may happen on the body and result in:

  • Small blotches, blisters, or scales
  • Moist warts in the groin
  • Slimy white patches in the mouth

The rash may happen with flu-like symptoms, such as sore throat, fever, and muscle aches.

Without treatment, the symptoms will go away within a few weeks. But symptoms may repeat over the next few years.

Latency (Resting) Stage: May Last for Years

The infection is still present but there are no symptoms. It may or may not progress to the third stage.

Tertiary (Third or Late) Stage

This stage may start years after the infection begins. It is rare countries where people have access to medical care. In this stage, the infection damages the:

  • Brain and nerves
  • Eyes
  • Heart and blood vessels
  • Liver
  • Bones and joints

Damage can be harsh enough to cause death. Symptoms are:

  • Small bumps called gummas on the skin, bones, or internal organs
  • Blindness
  • Central nervous system damage, such as weakness, numbness, trouble walking, problems with balance, memory and mental health problems, and loss of bladder control




  • Bibbins-Domingo K, Grossman D, et al. Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2016 Jun 7;315(21):2321-2327.
  • Latent syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/latent-syphilis.
  • Primary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-syphilis.
  • Secondary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/secondary-syphilis.
  • Syphilis-CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm.
  • Tertiary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tertiary-syphilis.


  • Elizabeth Margaret Prusak, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.