Syphilis in Man: Causes And Risk Factors, Prevention, Treatment

Syphilis (or syphilis) is a disease caused by a bacterium Treponema pallidum ), which causes a chronic progressive infection with potential permanent damage to all organs . Man contracts this pathology mainly through unprotected sexual intercourse , both genital and oral, with a previously infected person . The appearance of the first symptoms of syphilis in male subjects occurs three to four weeks after infection , with the development of ulcers

Syphilis in Man

or round wounds at the injection site of the pathogen (i.e. in areas that have come into contact with the other person’s infected areas). Such lesions are typically associated with swollen regional lymph nodes .

Primary syphilitic lesions are often localized in the genital area, particularly on the penis , prepuce (skin portion that covers the glans ) or anus and, if left untreated, tend to progress towards the secondary stage of the disease Secondary syphilis
presents about six weeks after the disappearance of the primary lesion (called syphiloma ) with a macular rash on the limbs and trunk, sometimes accompanied by fever , joint pain , tiredness and hair loss .
In the latent period, the man does not show any symptoms, but can still transmit the disease. If healing does not occur, syphilis can evolve into the third stage (tertiary syphilis), which can occur even thirty years after the first infection.
The diagnosis of syphilis in humans is based on clinical and anamnestic data, on the microscopic identification of T. pallidum and on the results of serological investigations. Treatment involves antibiotic therapy, while prevention must be implemented by practicing safe and protected sex to reduce the risk of infection.

Note. Syphilis is one of the most important sexually transmitted diseases . The infection can affect both genders, but men are more frequently affected by the problem.

Causes And Risk Factors

Syphilis is caused by Treponema pallidum , a spirochete (coil-shaped bacterium) that spreads easily throughout the body.
This infectious agent is able to penetrate through intact mucous membranes (genital, rectal and oropharyngeal) or damaged skin , so it can be easily transmitted through oral contact and unprotected vaginal and anal intercourse.

In the absence of adequate treatment, syphilis evolves within weeks or months: this microorganism migrates through the skin capillaries , and then spreads to the lymph nodes, where it multiplies until it reaches levels sufficient to cause clinical disease. Typically, incubation times for syphilis range from 2 to 12 weeks.

In people with the disease, Treponema pallidum is found in all body fluids, such as semen and vaginal secretions . Furthermore, the bacterium is found in skin, genital and mucous membrane lesions, including that of the mouth, which occur in the course of syphilis.

Without prompt diagnosis and treatment, a progressive evolution of the disease is possible, which can lead to serious permanent damage to multiple organs and systems, such as the skin, heart , brain and skeleton .


How Can Man Contract Syphilis?

Man usually contracts the disease through unprotected sexual intercourse , both genital (vaginal or anal), and oral, with a person suffering from syphilis.

Other possible modes of transmission are petting (i.e. simple contact between the genitals) without protection and the exchange of contaminated sexual instruments (e.g. sex toys).
However, the infection can also be contracted non-sexually, through direct contact with wounds or skin and mucous ulcers , which form in the areas where the disease mainly occurs (genital, anus, mouth, throat or skin surface damaged). In some cases, some of these manifestations are painless or go unnoticed, so the man may not be aware that he is suffering from syphilis, thus risking infecting his partner.
Occasionally, the disease can be transmitted through theblood transfusions (now very rare method of contagion).

In the case of the congenital form , the transplacental passage of the bacterium from the infected mother to the child (maternal-fetal transmission) is also possible .
Syphilis does not confer immunity against subsequent reinfection; this means that the patient recovered from the disease can contract the infection over and over again during his life.


The natural course of untreated syphilis follows four evolutionary stages:

  • Primary syphilis;
  • Secondary syphilis;
  • Latent syphilis;
  • Tertiary syphilis.

In any case, the disease is complex and, if not properly treated, can lead to various complications, such as heart disease and neurological disorders , up to death.

Primary Syphilis In Man

The initial stage of the infection occurs about 3-4 weeks after the infection, with the appearance of a localized, rosacea, circular papular lesion with sharp edges ( syphiloma ) at the injection site of the Treponema pallidum .

Ulcer on the penis (syphiloma) caused by syphilis. See More Photos Syphilis

In men, the most frequent localization of syphiloma is the scrotal skin , the balano-preputial sulcus , the opening of the urethra on the penis and the region around the anus ; less often, this lesion can occur on the skin of the hands or inside the oral cavity , therefore on the lips, gums , pharynx or tongue. Syphiloma generally does not cause pain, but is typically associated with an increase in the volume of regional lymph nodes , which are not, however, painful to palpation.

Within a short time, the surface of the syphiloma tends to ulcerate, exposing a bright red background, from which a serous exudate containing the treponemas comes out.
The symptoms of the first stage of syphilis in humans generally persist for a period ranging from 2 to 6 weeks. Without treatment, syphilis evolves into the secondary stage.

Secondary Syphilis In Man

Secondary syphilis begins 3 to 6 weeks after syphiloma onset. This phase is characterized by a macular eruption spread over one or more areas of the body surface , associated with swelling of the lymph glands . This manifestation is transient or recurrent and can have a highly variable appearance: for example, roundish cracks can appear on the palms of the hands and on the soles of the feet, or groups of pink speckles spread on the trunk and limbs, which resemble the measles rash . _

Secondary syphilis in womenSecondary syphilis in a woman with a history of unprotected sex. Involvement of the sole of the foot

In this stage, moreover, the man with syphilis manifests flu-like systemic disorders , due to the proliferation and diffusion by blood and lymphatic of Treponema pallidum . In particular, the following may appear: fever, asthenia , headache , muscle pain and general malaise.
Syphilis in humans can also lead to sore throat , lack of appetite , weight loss , vision disturbances, hearing and balance alterations, bone pain , hair lossin strands and the appearance of thickened, gray or pink skin patches ( warts ).
In humans, a rarer form of syphilitic manifestation is intense balanoposthitis ( inflammation of the glans penis and foreskin), apparently caused by other infectious agents.

Latency Period

At the end of the secondary stage, a long latency period begins, which can last for months or even years. This phase is due to the immune control of the disease: the man with syphilis does not show any symptoms, however the infection persists.

Tertiary Syphilis In Man

After many years (generally after about 10-25 years from the moment of infection), syphilis progresses to the tertiary stage.

In this stage, the disease is characterized by the formation of painless lumps ( gums ) of the skin or brain, bones and joints , and by severe damage to the internal organs of the body (including the liver , kidneys , lungs and heart).
Once syphilis enters stage three, the individual may experience personality changes, gradual blindness, dementia , inability to control muscle movements, and progressive paralysis. In severe cases, syphilis leads to the death of the patient.
The evolution of syphilis can be accelerated by acoexisting HIV infection ; in these cases, ocular involvement, meningitis and other nervous complications are more frequent and serious.


The diagnosis of syphilis in humans can be formulated with the evaluation of the signs and the set of symptoms reported by the patient during an accurate medical examination, and through the observation under the microscope of the material taken from the lesions (which allows to recognize the treponemas ). In support of these investigations, the execution of blood tests
is also indicated to detect the possible presence of antibodies against the bacterium already in the early stages of the infection, bearing in mind that these appear in a period ranging from 2 to 5 weeks. These analyzes are essentially divided into:

  • Non-specific tests for Treponema – including the Venereal Disease Research Laboratory ( VDRL ) – aimed at identifying a lipoid antigen deriving from the bacterium or its interaction with the host; these investigations may offer an advantage in disease control.
  • Treponemal tests , such as the Passive Agglutination of Treponema Particles (TP-PA) test or Fluorescence for Treponema Antibody Absorption (FTA-ABS) test; these tests make it possible to establish the degree of activity of the infection, and then define the most appropriate therapeutic protocol for the case.

If the man is found to be infected, all sexual partners from the previous 3 months (in case of confirmed primary syphilis) or the previous year (in case of confirmed secondary syphilis) should be evaluated and treated.


Treatment of syphilis in humans involves the administration of parenteral penicillin .

In patients allergic to this active ingredient , other drugs, such as doxycycline and tetracycline, can be used .
To establish the correct dosage and duration of antibiotic therapy , the doctor will be based on the stage of the disease defined during the diagnostic procedure. Prompt treatment allows lesions to heal and prevent secondary or tertiary syphilis, but any permanent organ damage tends to persist.
During drug treatment, to avoid infecting your partner, abstinence from any type of sexual intercourse is mandatory, until complete healing of the lesions caused by syphilis. In fact, it should always be remembered that wounds and skin ulcers can transmit the infection even during oral sex or any other skin contact with infected areas.


As regards the prevention of syphilis, a good measure is the correct use of the condom, which must be used from the beginning to the end of sexual intercourse (whether vaginal , anal or oral) and also to protect any objects used during intimate contact.
Furthermore, it is possible to avoid exposing oneself to the risk of contagion by abstaining from sexual practices with potentially infected people, and by reducing the number of partners.

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