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Symptoms of Syphilis


Signs, Symptoms and Treatment of Syphilis

Syphilis is a Sexually Transmitted Infection (STI) caused by a bacterium called Treponema pallidum. Infection is divided into four stages (primary, secondary, latent, and tertiary) and signs and symptoms will vary depending on the stage at presentation. It is highly contagious and can be spread via direct contact with syphilis sore or syphilis rash, usually through vaginal, anal, or oral sex. If left untreated, syphilis can spread to other organs around the body and cause potentially life-threatening complications many years after original infection.

Primary syphilis

  • Classically presents with a painless, red ulcer called a chancre which develops at the site of infection (mouth, penis, vagina, rectum)
  • Can develop anywhere between 9-90 days after initial infection
  • Maybe very small and often missed completely, before resolving by itself in 1-6 weeks
  • Sometimes can have more than one ulcer, more commonly in people with co-infection with HIV

Also Read: HIV Rash & Other STD-related Rashes

Secondary syphilis

  • Usually develops 4-6 weeks after primary infection
  • Presents with a symmetrical, pinkish bumpy rash across the trunk, limbs, and palms and soles; the rash can sometimes involve mucous membranes as well
  • Not typically itchy or painful
  • Most contagious stage – rash lesions harbour bacteria that can cause infection if contacted to mucous membranes or broken skin
  • Other symptoms may include fever, malaise, sore throat, weight loss, and headache
  • Symptoms usually resolve in 3-6 weeks, but can recur in up to a quarter of patients

Latent syphilis

  • Period where symptoms have resolved but there is still serological evidence of infection (blood tests)
  • Can last for many years, and may transform into tertiary syphilis if left untreated

Tertiary syphilis

  • This occurs when the bacteria has spread into other organs around the body, most commonly the eyes, nerves, brain, heart, and blood vessels
  • Can develop many years after primary infection (average 5-30 years)
  • Includes potentially severe complications such as syphilitic meningitis, aortitis, dementia and paralysis

Also Read: Next Day Result STD Screening

The best way to prevent syphilis infection is through responsible sexual practices, including having a monogamous sexual partner who you can trust, and proper use of condoms. If you do contract syphilis, it is important to identify and treat the disease early to reduce your risk of late-stage complications and to reduce transmission to others. It is difficult to rely solely on symptoms so if you are worried about potential exposure, it is always best to consult your healthcare provider. If you are in or around Singapore, please visit one of our clinics to get a proper STD & HIV  evaluation and treatment by our specially-trained doctors.

Also Check out our Medical Articles on Syphilis and Men-Who-Have-Sex-With-Men (MSM) and HIV Window Period

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  1. what is the window period for all std?

    • Dr. Julian Ng


      In general, you can do the test at 3 months post-exposure.