Syphilis is a dangerous bacterial disease caused by the bacterium Treponema pallidum. It is one of the four most common venereal diseases. Since the beginning of the 21st century, a steady increase in the number of syphilis cases has been observed. In Poland, nearly 2000 new cases were reported in 2018.

Number of syphilis cases in Poland in the years 2008-2017 according to the National Institute of Hygiene

Despite the efforts made to combat venereal diseases, syphilis remains a significant problem among people who are sexually active. Treponema pallidum are extremely sensitive to dryness and disinfectants, therefore syphilis does not spread through contact with inanimate material, e.g. contact with a toilet seat. In addition to the possibility of transmitting infection through sexual intercourse, infection can be effected through blood transfusion or during pregnancy – from mother to child. Congenital syphilis is a growing problem nowadays. If the mother’s disease is not diagnosed, the disease can cause premature birth, low birth weight, deformation of organs and even the death of the foetus. Therefore, if miscarriages are recurrent, it is advisable to consider getting tested for infections in intimate areas.

Syphilis follows a three-phase course:

  • Primary syphilis is the initial phase of infection. Its specific symptom is a lesion in the mucous membrane at the site penetrated by the spirochaetes. The so called chancre is the first spot where the bacteria multiply, which in the next stages of infection spread through the body through the blood and the lymphatic system. This lesion appears 10 to 90 days after the infection. Initially, it takes the form of an unsuspicious nodule, which over time transforms into a painless ulcer with protruding edges. After 1-2 weeks, enlarged lymph nodes can be observed in the area where the ulcer appears. This lesion disappears spontaneously after about 2 months, which the patients often mistakenly consider to be recovery.
  • Secondary syphilis manifests itself by the spirochaetes spreading throughout the body. It starts with flu-like symptoms such as sore throat, headache, muscle pain, fever and enlarged lymph nodes. One of the most typical symptoms is a rash on the skin and mucous membranes, which can take various forms: macular, papular or pustular. During this period, cracks may appear on the mucous membranes of the mouth. These symptoms, like in the primary syphilis, disappear spontaneously within a few weeks. After this time, the disease becomes chronic or clinically inactive.
  • Tertiary syphilis is the last stage of the disease and occurs in every third untreated person. Late syphilis can lead to the destruction of any organ. This stage is characterised by the formation of gummas, i.e. granulomatous lesions, which may affect the skin, mucous membranes of the oral cavity and upper respiratory tract, liver and even bones. The consequences of late syphilis are diseases of specific systems, such as neurosyphilis, and cardiovascular syphilis. It is worth noting that neurosyphilis may also occur in the early stages of the disease, as the spirochaetes may infect the central nervous system during the early stages of syphilis.

Primary ulcer in primary syphilis increases the risk of HIV infection!


The good news is that syphilis is highly curable. Penicillin is the antibiotic of choice. Tetracycline or doxycycline can be used alternatively in people with an allergy to penicillin. The decision on treatment is made by the doctor, therefore each laboratory test result should be consulted with a specialist as soon as possible. Due to the insidious effects of syphilis and the possible occurrence of a latent form for years, after noticing any symptom of syphilis or after a risky sexual situation, it is absolutely necessary to get examined so that targeted treatment can start as early as possible.

In the case of a positive test result for an infection of the intimate areas, the partner and the persons with whom you have had sexual intercourse during the last two months should be informed immediately. Partners should also be tested for the infection. Sexual restraint should be maintained during and up to one week after the end of treatment.