Syphilis is infection with the bacteria Treponema pallidum.
Alternative NamesLues; Cupid's disease; Syph
Causes, incidence, and risk factorsSyphilis is a sexually-transmitted infectious disease. The bacteria that cause it spread through broken skin or mucous membranes.
Pregnant mothers infected with the disease can pass it to the baby developing in their womb. This is called congenital syphilis.
Syphilis is widespread in the United States. It mainly affects sexually active adults ages 20 to 29.
Syphilis has several stages.
The symptoms of syphilis depend on the stage of the disease. Many people do not have symptoms.
In general, painless sores and swollen lymph nodes are possible symptoms of primary syphilis. Those with secondary syphilis may also have fever, fatigue, rash, aches and pains, and loss of appetite, among other symptoms. Tertiary syphilis causes heart, brain, and nervous system problems.
For more information, see the article on the specific stage of syphilis.
Signs and testsBlood tests can be done to detect substances produced by the bacteria that cause syphilis. The older test is the VDRL test. Other blood tests may include RPR and FTA-ABS.
TreatmentAntibiotics are an effective treatment for syphilis. The antibiotic of choice is penicillin. The dose and how it's given (into a muscle or into a vein) depend on the stage of syphilis. Doxycycline may be used as an alternative treatment in individuals who are allergic to penicillin.
Several hours after treatment of early stages of syphilis, you may have a reaction called Jarish-Herxheimer reaction. Symptoms of this reaction include:
These symptoms usually disappear within 24 hours.
You must have follow-up blood tests at 3, 6, 12, and 24 months to make sure the infection is gone. You should avoid sexual conduct until two follow-up tests show that the infection has been cured. Syphilis is extremely contagious through sexual contact in the primary and secondary stages.
Syphilis is a reportable infection. That means that doctors must report any cases of syphilis to public health authorities, so that potentially infected sexual partners may be identified and treated.
Expectations (prognosis)With prompt treatment and follow-up care, syphilis can be cured.
Late-stage syphilis can lead to long-term health problems, despite therapy.
ComplicationsComplications of untreated syphilis include:
Notify your health care provider if you develop signs or symptoms of syphilis. Several conditions may have similar symptoms, so you will need to have a complete medical exam.
Also call your health care provider if you have had sexual contact with someone who has syphilis.
PreventionIf you are sexually active, practice safe sex and always use condoms.
All pregnant women, people with HIV, and others at increased risk for having syphilis should be screened for syphilis.
ReferencesHook EW III. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 340.
U.S. Preventive Services Task Force. Screening for Syphilis Infection: Recommendation Statement. Ann Fam Med 2004; 2: 362-365.