By | June 10, 2022

Syphilis or Lues is a well-known and widespread sexually transmitted disease. It usually occurs chronically. Since the invention of penicillin, the cure or treatment has been favorable if diagnosed in good time. Syphilis is notifiable and should be treated immediately by a doctor.

What is syphilis?

Syphilis or Lues is a sexually transmitted disease that is very widespread 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 from one person to another during unprotected sexual intercourse. Even unborn babies can be infected in this way. For what is csd, please visit

Since the successful treatment of syphilis with penicillin, the sexually transmitted disease has become rarer in Germany and Europe. Nevertheless, since 2001 there has been an obligation to report to a doctor, even if there is only a suspicion of syphilis. In Germany, syphilis is increasingly common in large cities. About 3% of the German population are infected with syphilis and have already had it. Statistically, men are more likely to be affected by syphilis than women and younger people more than older people.


The cause of syphilis is bacterial infection with Treponema pallidum pallidum. This bacterium can only affect humans. It is transmitted during sexual intercourse through the mucous membranes and small cracks or injuries in the skin. In pregnant women, the unborn child can also become infected with syphilis in this case.

If left untreated, the syphilis bacteria spread throughout the body and can also infect other organs. Outside of a host, the syphilis pathogen can only survive for a short time. Since it can take up to two or three weeks for the first symptoms to appear, other people can be infected through unprotected sexual intercourse during this time. The chance of becoming infected with a syphilis patient is on average 30 percent.

Symptoms, Ailments & Signs

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

These are often painless at first, but can later cause severe pain. After about a week, they grow to the size of a coin and secrete a colorless, highly infectious fluid. Typically, these sores, called hard chancres, appear on the penis (often the glans) in men and the vagina and labia in women.

However, the anus or the oral mucosa can also be affected. If left untreated, they regress 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 skin rash, which is initially only noticeable as pink spots, which then develop into copper-colored nodules (papules) and heal by themselves. It often comes to a standstill after this stage. After three to five years, however, the pathogens have spread throughout the body and infect the internal organs such as the bloodstream, lungs, liver, stomach, esophagus or muscles, bones and other parts of the body.


The course of syphilis can be divided into four stages. Hard but painless sores form at the site of infection (usually the penis or vagina) for the first three weeks after infection. This so-called Ulcus durum (hard chancre) is usually not noticed by the affected person.

In the second part of the syphilis disease, there are massive rashes, reddening of the skin and changes in the mucous membranes. At this point at the latest, the person concerned should see a doctor. The symptoms often disappear again for a few years, but then break out again in a particularly severe and dangerous manner. This is also called latent syphilis. The internal organs, such as the heart, can then be particularly damaged. Neurological disorders and bone changes are also possible.

If syphilis is treated in time, the prognosis for healing is very favorable nowadays. Especially when antibiotics (penicillin) are used, the chances of recovery are good. However, if the syphilis is already more advanced and has reached the stage of a neurosyphilis, there is a high probability that the disease can be fatal. But permanent damage, such as lifelong paralysis, can also lead to the need for long-term care. Spontaneous healing is rare.


If treated early, syphilis usually heals without consequences; if left untreated, the disease can cause serious complications and even death. The disease is highly contagious, especially in the early stages, and can be spread further through unprotected sexual intercourse. During pregnancy, the pathogen can pass to the child and lead to congenital syphilis.

Miscarriages or premature births are also possible. Lues infection increases the risk of HIV infection, and the two diseases also influence each other unfavorably as they progress. In the advanced stage of syphilis, the pathogens attack the central nervous system: This so-called neurosyphilis is characterized by chronic spinal cord and encephalitis, which can lead to mental impairment, depression or dementia.

Motor disorders, pain in the extremities, personality changes and urinary and fecal continence are also typical signs of neurosyphilis. Other complications can include deafness, paralysis of the eye muscles and dizziness. A knot formation in the main artery as a late consequence can lead to an enlargement of the aorta (aortic aneurysm) decades after infection.

If this aneurysm bursts, the affected person bleeds to death within a short time. Tissue proliferation can also damage the skin, mucous membranes and bones, and an attack on the liver triggers liver inflammation. A Jarisch-Herxheimer reaction with high fever, headache and skin rashes can develop as a complication during the treatment of syphilis.

When should you go to the doctor?

If the person concerned develops various irregularities and symptoms after unprotected sexual contact with another person, a doctor should be consulted. Swelling of the lymph and skin changes are considered signs of health impairment. They must be clarified, since the sexually transmitted disease is a highly contagious disease. Pain, redness or discomfort in the area of ​​the mucous membranes, the anus or the vaginal entrance are considered unusual and should be examined more closely.

If flu-like symptoms occur later on, this is also to be understood as a warning signal from the organism. A doctor is required if you have a fever, headache or general malaise. Functional disorders of the organism, swelling or ulcers are further signs of an existing disease. In an advanced stage of the disease, mobility restrictions or hair loss can occur.

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

Treatment, therapy & prevention

If syphilis is suspected, a doctor should be consulted immediately. If the sexually transmitted disease is actually present, it is usually treated with the antibiotic penicillin. The dosage prescribed by the doctor should be strictly adhered to by the patient in order to rule out permanent damage.

The duration of treatment depends on the severity and advanced stage of the syphilis. As a rule, two to three weeks are sufficient for the therapy. Side effects are mostly headaches, muscle pain (similar to sore muscles ) and fever. There is no vaccination against syphilis yet. Protected sexual intercourse, eg using condoms, should therefore be preferred as a preventive measure. Likewise, when donating blood, attention should be paid to syphilis pathogens.


In the majority of cases, the medication – especially antibiotics – must be taken even after the symptoms have subsided. In this way, the symptoms should be permanently and completely alleviated. In the case of children, it is above all the parents who are required to ensure that they are taken correctly and continuously. When it comes to aftercare, it is fundamentally important to also involve your partner – even if he or she has not yet been infected.

During this time, even protected sexual intercourse should be taboo – this way, a smear infection can be ruled out. Syphilis usually does not heal spontaneously. If it persists for a long time, even malignant degeneration cannot be ruled out. Regular long-term follow-up checks appear unavoidable due to the high risk of recurrence.

After syphilis therapy, antibodies in the blood are determined again at certain intervals. This is to prevent the infection from germinating again. If the sexually transmitted disease was already at an advanced stage, i.e. before the treatment, the six-month review of both the serum and the liquor values ​​is obligatory – this over a period of three years in total. Further measures are usually not necessary, whereby the life expectancy of the affected person is not reduced – always assuming a very quick diagnosis and corresponding timely treatment.

You can do that yourself

In the case of a notifiable illness, cooperation with a doctor is absolutely necessary. In the context of self-help, careful handling should be maintained, especially in the case of sexual contact with another person. The sexual partner must be informed of the presence of the disease. In addition, adequate protective measures must be taken in the event of sexual contact.

Since in many cases the disease is only noticed at an advanced stage, previous sex partners should be informed about the diagnosis. They themselves must also submit to medical tests and in turn contact former sex partners. Unprotected sex avoid it at all costs.

Since the disease usually shows a chronic course of the disease, the immune system must be supported. A healthy lifestyle is recommended by eating a diet rich in vitamins and avoiding harmful substances. The use of nicotine, drugs, over-the-counter medicines or alcohol can have a significant impact on further development. On the other hand, a weight in the normal range, sufficient exercise, restful sleep and mental strength are helpful. Everyday stressors should be reduced to a minimum.

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