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Syphilis (SIF-i-lis) is a sexually transmitted infection (STI) caused by the bacteria (germ) Treponema pallidum. Sexual intercourse, oral sex or any contact between a man’s penis and a woman’s vagina can pass the germ from one person to another.

Who Can Get Syphilis

Anyone who is sexually active has a chance of getting syphilis. Those who have had more than one partner are at greater risk. Syphilis is passed person to person through direct contact with a syphilis sore (chancre). The sore occurs mainly on the external genitals, vagina, anus or in the rectum. The sores can also occur on the lips and in the mouth. Many people are unaware that they have a syphilis sore.

Why Syphilis Is Harmful

If syphilis goes untreated, it can lead to serious health problems such as an increase in a person’s risk for getting human immunodeficiency virus (HIV), the virus that causes AIDS. Pregnant women with syphilis can pass it to babies they are carrying.  It may cause severe problems in the baby.

Signs and Symptoms of Syphilis

Syphilis has three phases:

Primary Syphilis

  • Symptoms usually appear 10 to 90 days after sexual contact with an infected person. Many people miss the signs of primary syphilis.
  • A painless red syphilis sore call a chancre (SHANG-ker) can appear on the genitals at the area where the infection occurred. Lymph nodes enlarge.

Even without treatment syphilis sores will heal after 3 to 6 weeks, but if the infection isn’t treated the disease will progress to the second stage.

Secondary Syphilis

  • Signs of secondary syphilis usually begin weeks to months after the first chancre sore appears. Many people miss the signs of secondary syphilis.
  • Feverheadache, loss of appetite, weight loss, sore throat, muscle aches, joint pain, fatigue, patchy hair loss and enlarged lymph nodes are common symptoms.
  • The rash of secondary syphilis usually develops on the palms of hands and on the bottoms of the feet and also on the trunk, arms and legs. The rash is rough, with red or reddish brown spots.

Late (Tertiary) Syphilis

  • If primary or secondary syphilis is not treated, it can spread through the blood and cause damage to the heart, brain, bones and skin. It can even cause death.
  • Symptoms of late syphilis may include memory loss, problems with mental function, walking, balance, bladder control and vision.

Testing for Syphilis

Blood is drawn from the arm and sent to the lab for testing. If you have a syphilis sore, a small cotton swab will be used to get a specimen from the sore. The specimen is examined by the lab for the syphilis germ.


One or more antibiotic injections are needed to treat syphilis. You may need to receive more than one injection depending on how long you have had the infection. You and your partner(s) must both be treated.

If you live in the Columbus area, your partner(s) can be treated at the Columbus Health Department, 240 Parsons Avenue, Columbus, Ohio 43215. The phone number is (614) 645-7772. If you live outside the Columbus area, call your local health department or primary care doctor for treatment options.

Follow Up Appointments

Blood tests will need to be taken 3 months, 6 months and 12 months after treatment. You and your partner must both be treated and have follow-up appointments to make sure the infection is gone (Picture 1).

Preventing Future Infections

Abstinence (not having sex) is the only 100% effective way to prevent STI’s. If you choose to have sex, here are some things you can do that might help prevent the spread of STI’s:

  • Talk with your partner about prevention of STI's. Know if your partner has been exposed to STI’s and what his or her sexual practices are.You and your partner will need to come back for all follow-ups
  • Limit the number of sexual partners.
  • ALWAYS USE A LATEX CONDOM. Use it correctly. Use it every time you have sex, the whole time you have sex.
  • Be prepared. Have another condom available in case the one you are using breaks.
  • Avoid mind-altering substances such as alcohol and other drugs. You cannot make good decisions if you are drunk or high.
  • Some STI’s make it easier for HIV to enter the skin and mucous membranes. If you have an STI, you will be tested for HIV as well.
  • It is a good idea for sexually active teens to be tested for STI’s at least once a year even if there are no symptoms.

If you have any questions, call the Adolescent Medicine Clinic at (614) 722-2450. For more information, you may also call the National STI Hotline at 1-800-227-8922, 8:00 am to 11:00 pm, Monday through Friday, or you can find out more at

Syphilis (PDF)

HH-I-190 9/09 Copyright 2009, Nationwide Children’s Hospital