Syphilis Symptoms

Quick Glance: Early Warning Signs of Syphilis

Below is a list of some of the common early symptoms of syphilis:

• Painless sore (chancre) on the genitals, anus, rectum, lips, or in the mouth

• Rash on the skin, particularly on the palms and soles

• Swollen lymph nodes

• Fatigue and fever

• Sore throat

• Aches and pains in muscles and joints

• Patchy hair loss

• Flat, wart-like growths near the anus or genitals (condyloma lata)

Symptoms of syphilis depend on the stage of infection. Although early symptoms resolve on their own without treatment, the infection stays in the body and may affect the brain, heart, eyes, and other organs later.

Syphilis Symptoms That Should Not Be Ignored

Some critical Syphilis symptoms that should not be ignored are given in the table below:

Why Do Syphilis Symptoms Occur?

Syphilis is caused by Treponema pallidum (the bacterium responsible for syphilis). It usually enters through tiny breaks in the skin or mucous membranes (the moist tissues inside the mouth, genitals and anus) during direct contact with an infectious sore.

At the beginning, the bacteria multiply in the infected area, causing painless ulcers known as chancres. The bacteria can later spread through the blood and lymphatic system (the network that helps the body fight infection). The immune response may then cause a rash, fever, swollen lymph nodes, tiredness and muscle aches.

Without treatment, the infection can remain in the body for years. In some people, it later affects the brain, nerves, eyes, ears, heart, blood vessels or other tissues.

Syphilis Symptoms That Require Medical Attention

It is recommended to get urgent medical care if you experience the following symptoms of syphilis:

• Sudden loss or marked reduction of vision

• Eye pain, redness or light sensitivity with changing vision

• Sudden hearing loss, severe ringing in the ears or intense vertigo

• A severe headache with confusion, personality changes or unusual drowsiness

• A seizure or loss of consciousness

• Sudden facial weakness, unclear speech or weakness on one side

• New difficulty walking, poor coordination or loss of sensation

• Severe chest or back pain with breathlessness or collapse

Eye, ear and neurological complications can develop during any stage of syphilis and may cause permanent damage if assessment is delayed.

Symptoms of Syphilis Based on Types

Syphilis does not have a classification based on type, but stages. The table below summarises symptoms of syphilis based on its stage:

A primary sore usually heals within three to six weeks, even without treatment. Neurological, eye and ear complications are not limited to tertiary syphilis and can occur during any stage.

Symptoms of Syphilis-Specific Conditions

Here are the symptoms of syphilis-specific conditions:

Congenital syphilis occurs when syphilis is acquired from the mother who is infected with Treponema pallidum during pregnancy. The symptoms can be exhibited right after birth or within the first few months of life.

Symptoms of Syphilis in Men

Syphilis symptoms are generally the same in men and women. In men, the primary sore may appear on or under the foreskin, on the penis or scrotum, around the anus, inside the rectum or in the mouth. A sore under the foreskin or inside the rectum may be difficult to notice.

Secondary symptoms can include a rash, swollen lymph nodes, fever, tiredness, patchy hair loss and wart-like genital or anal growths.

Symptoms of Syphilis in Women

In women, a primary sore may develop on the vulva, inside the vagina, on the cervix, around the anus, inside the rectum or in the mouth. Sores inside the vagina or on the cervix may remain unnoticed because they are often painless.

Other syphilis symptoms, including rash, swollen lymph nodes, fever, tiredness and patchy hair loss, are generally the same as in men. Pregnancy does not cause a separate symptom pattern, and syphilis may remain unnoticed without routine antenatal testing.

Symptoms of Syphilis in Children

Congenital syphilis occurs when the infection is passed to a baby during pregnancy. Some infected babies have no obvious symptoms at birth.

Early syphilis symptoms in children may include:

• A rash, including on the palms and soles

• Persistent nasal discharge called snuffles

• Jaundice

• An enlarged liver or spleen

• Anaemia

• Poor feeding or poor weight gain

• Bone pain, swelling or reduced movement of a limb

• Fever or swollen lymph nodes

Untreated congenital syphilis may later cause hearing loss, vision problems, dental abnormalities, bone changes, seizures or developmental difficulties. Any baby born to a mother who has syphilis or had an untreated infection during pregnancy requires prompt paediatric evaluation.

Can You Have Syphilis Without Symptoms?

Yes, Syphilis may be silent or symptomless for months and even years at the latent stage of infection. Despite the absence of visual indicators, the causative agent, Treponema pallidum, is present in the body and continues to damage organs without treatment.

Very mild symptoms, such as a painless ulcer inside the vagina, rectum, or mouth, may be present in the early stage and not be noticed. Many times, syphilis is detected by chance through routine screening of blood samples during pregnancy, for sexually transmitted infections, blood donations, or prior to some procedures.

When Can Syphilis Symptoms Become Life-Threatening?

Some Syphilis symptoms can become life-threatening if left untreated, and require immediate medical attention. These are listed below:

How are Syphilis Symptoms Diagnosed?

Syphilis cannot usually be diagnosed with a single test. Doctors often conduct multiple tests along with examining symptoms and medical history to rule out other possibilities and reach a confirmed diagnosis.

An overview of different tests and their purpose in diagnosing syphilis is given below: