SymptomsBy Mayo Clinic staff
CLICK TO ENLARGE
Syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don't always occur in the same order. You may be infected with syphilis and not notice any symptoms for years.
The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them. The chancre usually develops about three weeks after exposure. Many people who have syphilis don't notice the chancre because it's usually painless and it may be hidden within the vagina or rectum. The chancre will heal on its own within six weeks.
Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wart-like sores in the mouth or genital area. Some people also experience muscle aches, fever, sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.
If you aren't treated for syphilis, the disease moves from the secondary to the latent (hidden) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary (third) stage.
Tertiary or late syphilis
About 15 to 30 percent of people infected with syphilis who don't get treatment will develop complications known as tertiary, or late, syphilis. In the late stages, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.
Babies born to women who have syphilis can become infected through the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash on the palms of their hands and the soles of their feet. Later symptoms may include deafness, teeth deformities and saddle nose — where the bridge of the nose collapses.
When to see a doctor
Call your doctor if you or your child experiences any unusual discharge, sore or rash — particularly if it occurs in the groin area.
- Hook EW. Syphilis. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/218862952-3/0/1492/1185.html#4-u1.0-B978-1-4160-2805-5..50345-1--cesec16_14680. Accessed Sept. 16, 2010.
- Syphilis fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm. Accessed Sept. 17, 2010.
- Sexually transmitted diseases surveillance, 2008: Syphilis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/stats08/syphilis.htm. Accessed Sept. 16, 2010.
- Birnbaumer DM, et al. Syphilis. In: Marx JA, et al. Rosen's Emergency Medicine. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05472-0..00096-7--s0015&isbn=978-0-323-05472-0&sid=1054738467&type=bookPage§ionEid=4-u1.0-B978-0-323-05472-0..00096-7--s0040&uniqId=218994117-4#4-u1.0-B978-0-323-05472-0..00096-7--s0040. Accessed Sept. 17, 2010.
- Johnson KE. Overview of TORCH infections. http://www.uptodate.com/home/index.html. Accessed Sept. 27, 2010.
- Marra CM. Neurosyphilis. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2010.