Syphilis is a vertically or sexually transmitted infection caused by Treponema pallidum subspecies pallidum.
In the primary stage of acquired syphilis, there is an appearance of a painless ulcer (chancre). Then in the secondary stage, there are skin rashes and sores on mucous membranes.
In the latent stage, it is asymptomatic and not communicable. It is in the tertiary or late stage that it is symptomatic but not communicable; it usually appears 10-20 years after 1st infection.


  • Syphilis is a vertically or sexually transmitted infection (STI) caused by Treponema pallidum subspecies pallidum
    • Infection is spread through direct contact with the lesion or through blood transfer, eg blood transfusion, injection drug use
  • Most infections occur in low-income countries while lower rates of occurrence are seen in middle- and high-income countries  
    • Incidence has increased in the past decade in western Europe and North America among men who have sex with men (MSM)  
  • A 10-15 year period of resurgence of syphilis is observed and is attributed to either unsuccessful efforts at sustaining infection control or changing risk behaviors and host immunity to infection
  • A person w/ primary syphilis has a 60% risk of infecting her sex partner & 70-100% risk of passing the infection to the fetus
    • Syphilis is sexually infectious during the early, primary and secondary stages of the disease; congenital transmission can happen years after being in the latent stage  
    • Sexual transmission is rare following 2-3 years of untreated infection and management focuses on development of complications such as neurosyphilis and gummatous and cardiovascular infections
  • Initial lesions appear at the site of inoculation after an incubation period of 21 days and can be found at any place where direct contact with the infected lesion occurred

Risk Factors

  • Possible risk factors:
    • Sexual contact with a known case of syphilis
    • Sex worker
    • Homeless or with history of intravenous (IV) drug use
    • Diagnosed with other sexually transmitted infections (STIs) or human immunodeficiency virus (HIV)
    • With multiple sexual partners
    • Use of protection barrier during intercourse
    • With a sexual partner with any of the above characteristics
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