Syphilis – Causes, Symptoms & Treatment

Syphilis - Causes, Symptoms & Treatment


syphilis respectively. syphilis is a well-known and widespread sexually transmitted disease. In most cases, it occurs chronically. The cure or treatment is favorable since the invention of penicillin with timely diagnosis. Syphilis is notifiable and should be treated promptly by the doctor.

Table of Contents

What is syphilis?

syphilis or syphilis is a venereal disease that is very prevalent in the world. However, since the invention of penicillin, this chronic disease has been largely curable. The main cause of syphilis is a bacterium (Treponema pallidum pallidum), which is usually transmitted during unprotected sexual intercourse from one person to another. Even unborn babies can become infected in this way.

Since the successful treatment of syphilis by penicillin, the venereal disease in Germany and Europe has become rarer. Nevertheless, there is a medical reporting obligation since 2001, even if there is only a suspicion of syphilis. Syphilis occurs increasingly in Germany in large cities. About 3% of the German population are infected with syphilis and have already had it. Statistically speaking, men are more affected by syphilis than women and younger people rather than older people.


The syphilis bacteria spread untreated in the entire body and can also affect other organs. Outside of a host, the syphilis can survive pathogens only briefly. Since up to two or three weeks may pass until the first symptoms appear, can be infected in this time by unprotected intercourse more people. The chance of getting infected with a syphilis sufferer is 30 percent on average.

Symptoms, complaints & sign

Syphilis can manifest itself in many ways and goes through different phases. Depending on the specific stage, different symptoms may occur. In between there are symptom-free latency phases. Characteristic symptoms are marked lymph node swelling and skin lesions. About two to four weeks after infection, small reddened skin nodules form at the entry sites of the bacterium.

At first they are often painless, but later they can cause severe pain. After about a week, they grow to the size of a coin and instead of a colorless, highly infectious liquid. In general, these ulcers, which are referred to as a hard chancre, occur in men on the penis (often on the glans penis) and in women on the vagina and labia.

However, the anus or oral mucous membranes may also be affected. Untreated, they form after about four to six weeks. In the next stage of syphilis there are flu-like symptoms such as fever, headache and body aches and swelling of the lymph nodes.

In addition, there is typically a rash that is initially only noticeable by pink spots, which then develop into copper-colored nodules (papules) and heal by themselves. Often it comes to a standstill after this stage. After three to five years, however, the pathogens have spread throughout the body and affect the internal organs such as the bloodstream, the lungs, liver, stomach, esophagus or even muscles, bones and other body parts.


The course of syphilis can be divided into four stages. In the first three weeks after infection, hard but painless ulcers form at the site of infection (usually penis or vagina). This so-called Ulcus durum (hard chancre) usually does not strike the person concerned.

In the second part of the syphilis disease it comes to massive rashes, redness and mucosal changes. At the latest here, the person concerned should consult a doctor. Often, the symptoms disappear again for a few years, but then break out again particularly strong and dangerous. This is called latent syphilis. In this case, the internal organs, such as the heart, can be particularly damaged. Likewise, neurological disorders and bone changes are possible.

If the syphilis is treated in time, the prognosis for healing nowadays are very favorable. Especially when antibiotics (penicillin) are used, the chances of recovery are good. However, if syphilis is already more advanced and reaches the stage of neurosyphilis, the disease may very likely end in death. But even lasting damage such as lifelong paralysis can make the affected person a nursing case. Only rarely does it come to spontaneous healing.


Miscarriages or premature births are possible. A lues infection increases the risk of infection for HIV, in addition, the two affect each other unfavorably in their course. In the advanced stage of syphilis, the pathogens attack the central nervous system: These so-called neurolues are characterized by chronic spinal cord and brain inflammation, which can lead to mental retardation, depression or dementia.

Motor disorders, pain in the extremities, personality changes and urinary and stool continencies are also typical signs of neurosyphilis. Other complications may include numbness, eye muscle paralysis and dizziness. Nodule formation on the main artery as a long-term consequence can lead to an enlargement of the aorta decades after infection (aortic aneurysm).

If this aneurysm bursts, the person bleeds to death within a short time. Tissue growths can also damage the skin, mucous membranes and bones, an infection of the liver triggers a liver inflammation. During the treatment of syphilis, the complication may be a Jarisch-Herxheimer reaction with high fever, headache and rash.

When should you go to the doctor?

If a person presents with various irregularities and complaints after being exposed unprotectedly to another person, a doctor should be consulted. Swelling of the lymph and skin lesions are considered signs of health impairment. They have to be clarified because the sexually transmitted disease is a highly contagious disease. Pain, redness or discomfort in the mucous membranes, anus or vaginal entrance are considered unusual and should be examined more closely.

If symptoms of flu appear later on, this is also to be understood as a warning signal of the organism. A fever, headache or a general malaise requires a doctor. Dysfunction of the organism, swelling or ulcers are other signs of a disease. In an advanced stage of the disease, mobility or hair loss may be impaired.

Since the syphilis in an unfavorable course of the disease can lead to premature death of the person concerned or the possibility of developing lifelong damage such as paralysis, a doctor should be consulted at the first sign. A general malaise or suspicion of infection should be discussed with a doctor. It is also advisable to have regular check-ups when practicing unprotected sexual activities.

Treatment, therapy & prevention

If suspected syphilis should be consulted immediately a doctor. If the venereal disease is actually present, it is usually treated with the antibiotic penicillin. The medically prescribed dosage should be strictly followed by the patient to exclude permanent damage.

The duration of treatment depends on the severity and advanced stage of syphilis. As a rule, two to three weeks are sufficient for the therapy. Side effects are usually headaches, muscle aches (similar to sore muscles) and fever. A vaccine against syphilis is not yet available. Therefore, for the prevention of protected sexual intercourse, e.g. by condoms, are preferred. Similarly, when donating blood should be paid to syphilis pathogens.


In the vast majority of cases, the drugs – especially antibiotics – continue to be taken even after the symptoms subsided. So the complaints should be permanently completely alleviated. In children, especially the parents are required to ensure a continuous and correct intake. When it comes to aftercare, it is always important to involve the partner as well – even if no infection is detected in her or her.

During this time even protected sexual intercourse should be taboo – this excludes a smear infection. Syphilis is usually not spontaneously cured. With long existence even malignant degeneration is not excluded. Regular long-term follow-up checks seem inevitable because of the high risk of relapse.

After a syphilis therapy, antibodies in the blood are determined again at certain times. In this way, a re-germination of the infection should be prevented. If the sexually transmitted disease was previously advanced, that is, before treatment, the six-month review of both serum and cerebrospinal fluid values ​​is compulsory for a total period of three years. Other measures are usually not necessary, the life expectancy of the person affected is not reduced – always very fast diagnosis and timely treatment provided accordingly.

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You can do that yourself

For the notifiable disease, cooperation with a doctor is mandatory. In the context of self-help, a cautious approach should be maintained especially in the case of sexual contact with another person. The sex partner must be informed about the presence of the disease. In addition, sufficient protective measures should be taken during sexual contact.

Since in many cases the disease is only noticed at an advanced stage, previous sexual partners should be informed about the diagnosis. You also have to undergo medical tests and, in turn, contact former sex partners. Unprotected intercourse should be avoided at all costs.

Since the disease usually shows a chronic disease course, the immune system is supported. A healthy lifestyle is recommended over a vitamin-rich food and the avoidance of pollutants. The consumption of nicotine, drugs, non-prescribed drugs or alcohol can significantly affect the further development. In contrast, a weight in the normal range, sufficient exercise, restful sleep and a mental strength are helpful. Stressors of everyday life should be kept to a minimum.

Dealing with the disease is particularly difficult if the unborn child has also been infected. Nevertheless, calm is to be preserved and a sovereign approach is necessary. Precautions should be taken to prevent further transmission.

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Christina Cherry
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