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Syphilis is an STI caused by Treponema pallidum bacteria. It is spread through direct contact with the sores or lesions that are part of the infection. When present between early infancy and puberty, syphilis may be a sign of sexual abuse.

A pregnant woman with syphilis can spread the disease to her fetus through the placenta or during birth. It can result in stillbirth, a premature birth, and various birth defects.

After infection, it takes about 3 weeks for the first signs of syphilis to appear.

Signs and Symptoms

The first signs of infection, primary syphilis, begin with painless sores (chancres) on the skin or the lining of the genitals. The sores will be visible when they’re present on the penis or a woman’s outer genitals, but they can also be hidden from view in a woman’s vagina or cervix or under a male’s foreskin.

After a month or two without treatment, other signs and symptoms (secondary syphilis) will develop, including

  • A skin rash that can occur anywhere on the body, but is usually present on the palms of the hands and soles of the feet
  • Sores in the mouth and on the genitals or anus
  • Swollen lymph glands
  • Mild fever
  • Sore throat
  • Headache
  • Fatigue
  • Joint aches

These symptoms may come and go over a period of 1 to 2 years. If the infection is still untreated, the organisms may spread throughout the body over time, damaging many organs and causing chronic conditions ranging from heart disorders to neurologic problems and even death in some cases (late syphilis).

A newborn who acquires a syphilis infection from his mother often appears completely well. About half the time, however, he may have signs and symptoms such as a yellow-mucous nasal discharge (snuffles), rashes, skin ulcers, fluid retention, bone infection, fever, swollen spleen and liver, low red blood cell count (anemia), and jaundice (yellowing of the skin). These findings may be present at birth or develop within the initial months of life.

When To Call Your Pediatrician

If your teenager complains of having a sore in the genital area or other symptoms associated with syphilis, he should see his pediatrician.

How Is The Diagnosis Made?

The pediatrician will evaluate your child’s signs and symptoms and conduct blood tests that can identify the presence of syphilis. Secretions from sores can be examined under the microscope for the syphilis bacteria to provide further evidence of the infection.

Your child and his sexual partner(s) should be tested for syphilis as well as other STIs such as gonorrhea and chlamydial, hepatitis B, and HIV infections. If necessary, his partner(s) should be treated.

All pregnant women should receive a blood test for syphilis early in their pregnancies. Treatment of an infected pregnant woman will also treat the developing baby.


Most often, syphilis is treated with penicillin given by a shot. This treatment has been proven effective in teenagers and adults as well as in pregnant women and newborns.

What Is The Prognosis?

The treatment of syphilis with penicillin can resolve the infection. Patients should have blood tests to confirm that the infectious bacteria have been eliminated.


Teenagers should be instructed on how to practice safe sex to avoid STIs.

Last Updated
Immunizations & Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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