Reviewed by Segun Adeoye, MD, Board Certified, American Board of Family Medicine. Reviewed October 21, 2026.
Syphilis is a sexually transmitted infection that is easy to miss and easy to treat once it is found. It often starts as a single painless sore, then a rash. A simple blood test finds it, and a penicillin shot usually cures it. Go to the ER right away if you have vision changes, hearing loss, ringing in the ears, confusion or new weakness, because syphilis can affect the eyes, ears and brain at any stage.
The stages of syphilis
Primary. A single, painless sore (a chancre) where the infection entered, often the genitals, anus or mouth. It shows up about three weeks after exposure and heals on its own in a few weeks. The infection does not go away when the sore does.
Secondary. Weeks to months later, a rash, often on the palms of the hands or the soles of the feet. Fever, swollen glands, sore throat, patchy hair loss, headaches and tiredness are common. These also fade on their own while the infection continues.
Latent. No symptoms at all, sometimes for years. The infection is still there.
Tertiary. Years later, without treatment, syphilis can damage the heart, brain, nerves and other organs. This stage can be life-threatening.
Brain, eye and ear problems can happen at any stage
The CDC says syphilis can spread to the nervous system, eyes or ears at any stage, including early on. Go to an emergency room right away if you have, or might have, syphilis and you notice:
- Blurry vision, vision loss, eye pain or redness
- Hearing loss, ringing in the ears, or dizziness
- Confusion, a severe headache, a stiff neck, or new weakness or numbness
- Chest pain or shortness of breath
Vision and hearing loss from syphilis can become permanent if treatment is delayed.
Syphilis in pregnancy
Syphilis can pass to a baby during pregnancy and cause miscarriage, stillbirth or serious lifelong health problems. In 2024 nearly 4,000 babies in the United States were born with syphilis. Every pregnant woman should be tested. If you are pregnant and have a sore or rash, get checked right away.
Who should get tested
- Anyone with a sore or rash that could be syphilis
- Anyone with a new partner or more than one partner
- Anyone whose partner has been diagnosed with an STD
- Anyone who is pregnant
How it is tested and treated
A blood test diagnoses syphilis. Treatment is usually a penicillin injection. Early syphilis is usually cured with a single shot. Later stages need more doses. If you are allergic to penicillin, other antibiotics such as doxycycline or ceftriaxone may be used. Pregnant women and people whose syphilis affects the brain or nerves have no safe alternative, so they go through penicillin desensitization, a supervised process that lets them take penicillin safely. Avoid sex until you and your partners have finished treatment and your provider says it is safe.
Protecting yourself
Syphilis spreads through contact with a sore during sex. Condoms lower the risk but do not remove it, because sores can be in places a condom does not cover. Regular testing and talking openly with partners are the best protection.
What happens when you come to Life Savers ER
A board-certified emergency physician examines you and runs the syphilis blood test on site, with results in just under two hours. We do not give the penicillin shot here. The long-acting penicillin used for syphilis is only available at designated centers, so if your test is positive, we refer you to a city STI clinic for treatment. For eye, ear or nerve symptoms, we evaluate you urgently and arrange specialist care. Your visit is confidential.
We are open 24 hours a day, every day, and there is no wait. For routine testing without symptoms, see our STD testing page: https://lifesaverser.com/std-testing/
Where to find us
Life Savers ER is open 24 hours a day, 7 days a week, including holidays, at four locations:
- Willowbrook: 17685 TX-249, Houston, TX 77064
- Heights: 3820 N Shepherd Dr Ste A, Houston, TX 77018
- Summerwood: 12665 W Lake Houston Pkwy, Houston, TX 77044
- Sugar Land: 222 Hwy 6, Sugar Land, TX 77478
Common questions
Can syphilis be cured?
Yes. Penicillin cures syphilis. Treatment cannot undo damage already done, which is why early testing matters.
Does the sore going away mean I am fine?
No. The sore heals on its own, but the infection keeps going until it is treated.
Can I get syphilis again?
Yes. Having had syphilis does not protect you. You can be infected again.
Sources
CDC, “Neurosyphilis, Ocular Syphilis, and Otosyphilis”: https://www.cdc.gov/syphilis/hcp/neurosyphilis-ocular-syphilis-otosyphilis/
CDC, “CDC Releases 2024 National STI Data”: https://www.cdc.gov/nchhstp/director-letters/release-2024-sti-data.html
