Syphilis is an infection that is caused by a microscopic organism called Treponema pallidum . The disease can go through three active stages and a latent (inactive) stage.
In the initial or primary stage of syphilis, a painless ulcer (the chancre) appears in a sexually-exposed area, such as the penis, mouth, or anal region. Sometimes, multiple ulcers may be present. The chancre develops any time from 10 to 90 days after infection, with an average time of 21 days following infection until the first symptoms develop. Painless, swollen glands (lymph nodes) are often present in the region of the chancre, such as in the groin of patients with penile lesions. The ulcer can go away on its own after 3 to 6 weeks, only for the disease to recur months later as secondary syphilis if the primary stage is not treated.
Secondary syphilis is a systemic stage of the disease, meaning that it can involve various organ systems of the body. In this stage, therefore, patients can initially experience many different symptoms, but most commonly they develop a skin rash that does not itch. Sometimes the skin rash of secondary syphilis is very faint and hard to recognize; it may not even be noticed in all cases. In addition, secondary syphilis can involve virtually any part of the body, causing, for example, swollen glands (lymph nodes) in the groin, neck, and arm pits, arthritis, kidney problems, and liver abnormalities. Without treatment, this stage of the disease may persist or resolve (go away).
Depending on the stage of disease, the treatment options for syphilis vary as summarized in the table below.
Stage of Infection