Syphilis is a bacterial infection that can cause a temporary and painless sore. The infection continues to develop, but the initial symptoms resolve. The symptoms can return to cause a rash on the palms and soles and body. The rash is very infectious with contact. Testing is done through a blood test.


Syphilis can be treated and cured with antibiotics. It can be prevented by use of condoms or another barrier method. Untreated syphilis can cause birth defects, nerve and brain damage, and death.


The CDC recommends that persons should be routinely tested for syphilis who:

  • are pregnant

  • are sexually active men who have sex with men

  • are living with HIV and are sexually active

  • have signs or symptoms suggestive of syphilis

  • have an oral, anal, or vaginal sex partner who has been recently diagnosed with syphilis

During 2017, there were 101,567 reported new diagnoses of syphilis (all stages). Of syphilis cases, 30,644 were primary and secondary (P&S) syphilis, the earliest and most transmissible stages of syphilis. In 2017, the majority of P&S syphilis cases occurred among gay, bisexual, and other men who have sex with men (MSM). In 2017, MSM accounted for 79.6% of all P&S syphilis cases among males in which sex of sex partner was known and 57.9% of all P&S syphilis cases overall. However, in recent years, the rate of P&S syphilis has been increasing among MSM as well as heterosexual men and women.

In the United States, approximately half of men who have sex with men (MSM) with primary and secondary (P&S) syphilis were also living with HIV. In addition, MSM who are HIV-negative and diagnosed with P&S syphilis are more likely to be infected with HIV in the future. Genital sores caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. Furthermore, syphilis and certain other STDs might be indicators of ongoing behaviors and exposures that place a person at greater risk for acquiring HIV.


Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus, in the rectum, or in or around the mouth. Transmission of syphilis can occur during vaginal, anal, or oral sex. For more information, please visit:

Signs and symptoms of syphilis progress in stages:

  • Primary

    • Firm, round, small, and painless subtle lesions (called chancres) appearing where syphilis entered your body (mainly genital) ~3 weeks after infection.

    • Chancres can heal on their own in a few days up to 6 weeks even without treatment. However, you must still get treatment.

  • Secondary

    • Skin rashes or sores in mouth, vagina, or anus appearing in one or more areas of your body.

    • Rash is not-itchy and looks like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet.

    • Rash can show up when primary sore is healing or several weeks after the sore has healed.

    • Other symptoms include fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and feeling very tired. These symptoms will resolve even without treatment within 2 weeks to 3 months. However, you must still get treatment.

    • This is a highly infectious stage.

  • Tertiary

    • Affects many organs including heart and blood vessels, brain, and nervous system and eventually resulting in death

    • Occurs 10-30 YEARS after infection began

  • Latent

    • This is a period of time when there are no visible signs or symptoms or syphilis.

    • Even without treatment, you can continue to have syphilis in your body for years without signs or symptoms.

  • Neurosyphilis and ocular (eye) syphilis

    • Symptoms of neurosyphilis include severe headache, difficulty coordinating muscle movements, paralysis, numbness, and dementia

    • Symptoms of ocular syphilis include changes in your visit and blindness


If you have more questions, refer to the CDC’s website:




You should get tested for syphilis 3-6 weeks after exposure. There are two types of blood tests available for syphilis:

1) nontreponemal tests

2) treponemal tests.

Both types of tests are needed to confirm a diagnosis of syphilis. Persons with a reactive nontreponemal test should always receive a treponemal test to confirm a syphilis diagnosis. This sequence of testing (nontreponemal, then treponemal test) is considered the “classical” testing algorithm.

The recommended treatment for adults and adolescents with primary, secondary, or early latent syphilis is Benzathine penicillin G 2.4 million units administered intramuscularly in a single dose. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units administered intramuscularly each at weekly intervals. The recommended treatment for neurosyphilis and ocular syphilis is Acqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units intravenously every 4 hours or continuous infusion, for 10-14 days. Treatment will prevent disease progression, but it might not repair damage already done.


Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.



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