Syphilis Symptoms Stages and Diagnosis

Sexual intercourse is a major vector for developing Syphilis, a bacterial illness. The first symptoms include a painless sore, most often in the mouth, genitalia, or rectum. When a person with Syphilis touches a sore on another person's skin or mucous membranes, they can transfer the disease to that person.

The signs and symptoms of Syphilis that spread through sexual contact might vary widely. While the characteristic indication of primary Syphilis is a single, painless chancre, secondary Syphilis can induce various symptoms.

If Syphilis is confirmed, a quantitative nontreponemal titer test should be performed. These titers should have reduced fourfold within the first six months of treatment for primary or secondary Syphilis and the first 12-24 months for latent or late Syphilis. Cerebrospinal fluid testing must be done regularly to ensure that neurosyphilis treatment works.

Let us know about the symptoms, stages, and diagnosis of Syphilis in detail −

What does Syphilis Appear to be Like?

A smooth sore might appear on the genitalia, mouth, or lips in the first stages of Syphilis. Like a pimple, it might be so little and painless that you ignore it. After about six weeks, this wound will heal on its own.

A rough, red, or brown rash appears in the second stage of Syphilis. While it may start in one spot, it may spread until it affects your entire body, including your palms and the soles of your feet. A rash or sore in the mouth, vagina, or anus is possible.

Symptoms of Syphilis

As syphilis advances, so do the manifestations of the disease. Before any symptoms appear, you are at peak infectiousness. Genital sores are the primary indicator. It's possible that others won't notice them or may write them off as nothing more than a bad case of acne.

In the second stage, a rash develops, and flu-like symptoms, including fatigue, fever, a sore throat, and achy muscles, come in.

After the second stage of Syphilis, no outward symptoms will be present (latent stage). An infection may be present even if no symptoms are present. Only treatment with pharmaceuticals can stem the progression of the disease and restore health to the patient.


If you have Syphilis, you may initially notice a sore in your vagina, mouth, or genital area (called a chancre). While many sexually transmitted infections (STIs) cause excruciating sores, the chancre is often harmless. In addition, its form is often round and small. The chancre will often appear 10 to 90 days after the initial infection.


After the chancre begins to heal or weeks have passed since the initial infection has subsided, the second stage of chancroid infection generally occurs. A broad rash has developed on at least one portion at this phase. Flaky, red skin is one of the signs of this rash. At this point, you may also have flu-like symptoms and hair loss. The disease will enter a latent phase, and the symptoms will disappear without therapy.


Avoiding treatment for Syphilis after the first two stages will allow the infection to enter a latent state, where it will stay dangerous for years. The latent phase may last for years without presenting any signs. If the condition is not addressed, it might progress to the tertiary stage.


If the disease isn't treated in time, the infection might progress and eventually reach the late stage. A person with severe Syphilis may have blindness, aortic aneurysms, paralysis, deafness, dementia, or even death.

Stages of the Syphilis

The early and late phases of infection are when it spreads the greatest. During the latent stage, the illness shows no outward signs but can still spread. The infection is at its worst during the tertiary stage. Continue reading for an in-depth analysis of each step −


Primary-stage infections typically manifest as sores or blisters as the first outward symptom of illness. Typically, symptoms appear three to four weeks following contact with the pathogen. Typically, the principal sources of infection are the mouth, the anal area, and the vaginal region. The sores can stay on the skin for up to six weeks after they first appear and are spread by oral, vaginal, and anal contact.


By the second phase, the rash had reached the patient's palms and soles. Even so, it might surface anywhere. Rashes seldom result in itching; when they do, it's usually followed by a sore throat.


As this stage progresses, it is common for the signs and symptoms experienced in the first two phases to fade. The bacteria has not been eliminated from the host's body. It may take years for the latent phase to give way to the active tertiary phase.


Due to its association with issues in fundamental systems like the heart and brain, this kind of Syphilis is the most dangerous. 15-20% of untreated patients, according to the Mayo Clinic. This syphilis stage can persist for many years, sometimes decades, after the initial infection.


An early diagnosis is essential since Syphilis is treatable, and its more severe phases can be avoided with medication. Two methods for diagnosing Syphilis exist the rapid plasma reagin (RPR) and the venereal diseases research laboratory test (VDRL). In many cases, only the screening test is performed; however, if the result is positive, a second test is necessary to make the definitive diagnosis.

A chancre may be swabbed and examined under a microscope to check for the presence of the bacteria, although this is only done in rare instances. Since Syphilis can be passed on to an unborn child, pregnant women should be checked for the condition.

If you test positive for Syphilis, you must inform your sexual partner (s).

If you come late, your doctor may suggest a lumbar puncture to collect cerebrospinal fluid (CSF) from your spinal column to determine if your sickness has moved to your brain. Until severe brain involvement is detected, no such test is performed.


Without medical intervention, an acute case of Syphilis might turn into a chronic one. If Syphilis is suspected, testing must be done on every individual, and treatment administered if necessary. Penicillin G benzathine injection is the treatment of choice. Those allergic to penicillin should undergo desensitization since it is the best antibiotic for treating penicillin allergies.

The best approach to protect yourself against Syphilis or any other STD is to abstain from sexual activity (STI). But, you may greatly lessen your likelihood of contracting a sexually transmitted infection (STI) by regularly getting tested, limiting your number of partners, and wearing condoms.

Updated on: 06-Mar-2023


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