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Syphilis: Causes, Symptoms and Treatment

Posted On: December 29, 2019

Syphilis: Causes, Symptoms and Treatment

Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria known as Treponema pallidum

Treponema Palladium has been on quite an adventure since it mysteriously appeared in Europe in the 1400s. In August of 1494 the disease erupted through the city of Naples, infecting the invading French army of King Charles VIII as they celebrated their invasion with debauchery. In its early form of the time it was very unlike the disease we know today.

In the last couple of years, there has been a decline in the rate of women with syphilis in United States, whereas an increase in the infection rate has been reported among men, especially men who have sexual intercourse with men.

Beginning with sores on the genitals, painful and fetid abscesses would spread across the soldier’s bodies. The infection left no respite. As it ran its course, sufferers experienced pain in their bones and muscles, particularly at night, making it almost impossible to sleep. Gradually, the abscesses turned to ulcers. These ulcers would erode into the flesh, ripping out chunks and leaving grotesque craters. As it dragged on, syphilis would destroy the victim’s eyes, noses and lips until finally driving them insane and killing them.

Pleasant, isn’t it?

Thankfully the disease as we know it today is far less gruesome and perfectly curable. For proper maintenance of sexual health it is important to be informed about the symptoms and risks of syphilis and when and how to get tested. Read on for more information.


Primary Syphilis: Say hello to my little friend….

The early symptoms of syphilis are so mild that many people overlook them. In fact it is possible to have syphilis without even knowing you have it. And this is what makes this crafty bacteria so dangerous.

The first stage of syphilis is known as the Primary Stage. This initial stage begins around 2 to 3 weeks after initial contact. The main symptom of this stage is a small, painless sore, usually on the genitals. This is known as a chancre. Most sufferers only have one, though it is possible to have more.

As well as the genitals they can occur on the mouth, lips, buttocks and anus.

Sufferers may also experience swollen glands in the neck, groin or armpits.

These symptoms disappear within 2 to 8 weeks. At this point it’s hard to believe this used to be a quasi-leprous flesh eating infection.

But things get worse.

Enter stage two.

Secondary Syphilis: The Return

Secondary syphilis is much harder to miss than its predecessor. Particularly as it manifests flu like  symptoms such as: headaches, tiredness, high temperature, and joint pain. This stage is much more likely to get you a few days off work.

As well as the aforementioned symptoms, secondary syphilis comes with such delights as:

-a red rash, usually on the palms of the hands or soles of the feet

-small growths (similar to genital warts) around the anus, and the vulva for women.

-white patches in the mouth

-swollen glands

-sometimes patches of hair may fall out

These symptoms will also pass on their own after a few weeks or may come and go over the course of several months.

This is where it gets interesting…

Latent Syphilis: Strong but silent

During the latent stage of syphilis, you are still infected and can still pass on the disease, however no symptoms will show. It is also possible to lapse from latent back to secondary syphilis.

Without treatment this stage can last decades until finally giving way to…

Tertiary Syphilis: We’re all mad here…

Some sufferers may never reach this stage, while for others it can begin as early as 1 year after infection. Statistically one in three cases of untreated latent syphilis develop tertiary syphilis after 20-40 years.

The most famous symptom of this stage is neurosyphilis, caused by the spread of the disease to the nervous system causing symptoms similar to dementia.

This destructive stage can have various other malignant synonyms, including:

  • large sores inside the body or on the skin
  • meningitis
  • Strokes
  • loss of co-ordination
  • numbness
  • vision problems/blindness
  • heart problems

The condition is still treatable in this stage, but many of the symptoms will not be reversible.


Short of total abstinence, the safest way to avoid syphilis (or any STI) is to be in a monogamous relationship with an individual who has been tested for it. This, however, is not a perfect world: vases break, ice creams are dropped, and condoms aren’t 100% effective. If you think you may have contacted syphilis it is best to catch it early with a test.


It is advisable to get tested for syphilis if:

  • You have had unprotected sex
  • You have a sexual partner who has syphilis
  • you have multiple sex partners
  • A partner has multiple sex partners
  • You are a man who has sex with men (MSM)
  • You have HIV/AIDS
  • You have another STI
  • You are a sex worker

Sexually active individuals should try and get tested at least once a year.


You can get tested either by your General Practitioner (GP), at a Genitourinary Medicine (GUM) Clinic, or a specialized sexual health clinic.

Where possible, you should opt for a GUM or sexual health clinic over a GP as they provide free, specialized care and will have easier access to testing equipment. A GP may charge you a prescription fee.


The most common method for testing for syphilis is with a blood test. When your body becomes infected with syphilis it produces antibodies to fight the infection. A blood sample is used to detect these antibodies and diagnose the infection. However this test can show false negatives as the antibodies can take some time to form after infection. Even if you test negative you may be asked to come back for a second test.

Less commonly a swab sample may be taken from any sores/chancres you have. These can be tested under a microscope to spot the T. Palladium bacteria.

Advanced syphilis can spread to the central nervous system and cause life threatening complications. If your diagnosis suggests advanced syphilis you will be given a lumbar puncture. This involves inserting a needle between two vertebrae in your spine and drawing out a sample of your Cerebrospinal Fluid.

As you may well imagine, having a needle in your spine may leave you feeling uncomfortable for a little while afterwards. You may also experience a headache. This is, however, still preferable to meningitis.

What else?

If you are going to get tested for syphilis you should also check for other STI’s. It’s possible to have multiple, concurrent infections and you wouldn’t want the terrible irony of clearing up your syphilis only to later discover you’ve had chlamydia the whole time.

If you do test positive for syphilis, then it is important that you get tested for HIV as syphilis increases your likelihood of contracting it.

Treatment (the reassuring part)

Now for the good news: syphilis is curable. Completely! You don’t have to go mad or blind thanks to the wonders of modern medicine!

Usually syphilis is treated with the antibiotic penicillin. For early stages of syphilis only one injection is necessary to cure it, whereas for the later stages a three week course will be needed.

If you are allergic to penicillin you may be given another drug, such as doxycycline or alternatively put on a course of penicillin desensitization during which you are injected with small doses of penicillin slowly increasing to the desired amount.

During treatment you may need further tests to ensure you are responding properly to the medication. You should avoid any sexual contact until the treatment is complete and notify any sexual partners that they should get tested as well.

Syphilis during pregnancy (Congenital Syphilis)

Syphilis can also be passed from mother to baby. This can occur in the womb or during vaginal birth if the child comes into contact with a sore.

Congenital syphilis can be incredibly harmful and even fatal to a pregnancy (40% of all babies born to mothers with untreated syphilis die as a result of the infection)  so all mothers are given the option to test for syphilis (and other conditions) at around 8-12 weeks into their pregnancy.

Unlike regular syphilis, congenital syphilis can only be treated with penicillin. If a mother is allergic to penicillin she will be put on a desensitization course.

During the pregnancy a syphilis infection presents significant risk to the baby, including:

  • Stillbirth (death occurring after 20 weeks of pregnancy)
  • Miscarriage (death occurring before the 20th week of pregnancy)
  • Premature birth (birth before 37 weeks)
  • Problems with placenta and umbilical cord
  • Low birth weight (less than 5 pounds, 8 ounces)

After birth the baby is still at high risk of complications such as:

  • Neonatal death (death before 28 days of life)
  • Fever
  • Anemia
  • Meningitis
  • Spleen or liver problems (I.e. jaundice)

Congenital syphilis can also present problems later in life, the child’s Central Nervous System could become infected, leading to paralysis or seizures. The child may also experience developmental delay. This is when they do not meet certain developmental milestone at the same time as other children.


While a lot of the symptoms of syphilis can sound scary, there are many ways to minimize your risks. If you are using injected drugs, you will want to refrain from sharing needles and completely run away from sharing sex toys. With protection, such as a condom, it is possible to significantly minimize the risk of contact with the infection. Furthermore, regular testing, particularly after unprotected sex will allow you to halt the disease in its early stages allowing you to avoid the more unpleasant symptoms.

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