Can syphilis affect the tongue?

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Can syphilis affect the tongue?



Written by Dr. Andrea Pintoon August 17th, 2021

Syphilis is an STI that can cause symptoms in many different parts of the human body, but did you know that syphilis can affect the tongue? This disease can cause different manifestations in the oral cavity, although they can often be overlooked or misdiagnosed.

Let’s talk about how syphilis can affect the tongue, the symptoms of oral syphilis, and how the condition can be treated.

Can syphilis affect the tongue?

Yes, syphilis can affect the tongue. 

The fact that syphilis can affect so many parts of the human body is why this condition is also referred to as “the great imitator”, since it can be confused with other diseases. This includes the tongue, nose, eyes, nervous system, and skin, among other body structures and organs.

Syphilis, which is caused by the bacteria Treponema pallidum, is a sexually transmitted infection (STI) that can affect practically any part of your body.  According to the Mayo Clinic, syphilis can be transmitted during vaginal, anal, and oral sex, and it can also be passed from mother to child during pregnancy or delivery.

Syphilis is just one of several STIs that can affect the oral cavity, which also include gonorrhea, chlamydia, andfungal infections.

Oral syphilis can develop as a result of giving unprotected oral sex to a partner with genital or anal syphilis.

Symptoms of oral syphilis

The symptoms of syphilis in part of the body will largely depend on which stage of the disease the patient is in. Syphilis can be divided into four classic stages:

  • Primary syphilis
  • Secondary syphilis
  • Latent syphilis
  • Tertiary syphilis

According to a study published by The Brazilian Journal of Infectious Diseases, oral manifestations of syphilis are more commonly seen in the secondary stage of the disease, although they can also appear during the primary stage. The study mentions that some of the symptoms of oral syphilis can include:

  • Multiple, painless oral ulcers
  • Irregularly shaped lesions with whitish edges
  • Swollen gums
  • Swollen lymph nodes around the jaw and neck


Additionally, a study published by the journal Case Reports in Emergency Medicine reports the case of a patient with oral syphilis whose tongue was affected; in this case, the patient had painless tongue ulcers that were additionally covered by a grayish membrane. The oral lesions caused by syphilis can affect different parts of the oral cavity, including:

  • Lips
  • Tongue
  • Jugal mucosa (inside the cheeks)
  • Oropharynx (throat)
  • Tonsils

Because there are a wide range of health conditions that can cause similar lesions inside the mouth, it’s not uncommon for oral syphilis to be diagnosed incorrectly at first, or completely looked over. According to a study published by the journal Topics in Antiviral Medicine, manifestations of oral syphilis can be mistaken for oral herpes, thrush, or a condition called oral leukoplakia.

Syphilis on the tongue or mouth can also cause secondary symptoms. According to a study published by the journal Medicina Oral, Patología Oral, y Cirugía Bucal, secondary findings associated with oral syphilis can include:

  • Headache
  • Tearing
  • Increased nasal secretion
  • Sore throat


Can oral syphilis be treated?

For most of human history, syphilis was untreatable and often led to serious consequences and even death.

Throughout the centuries, syphilis caused millions of cases around the world that couldn’t be treated properly — and although physicians tried to come up with many different remedies, they were ineffective and sometimes even dangerous.

That all changed once syphilis was discovered. Many cases of syphilis can actually be treated with a single shot of penicillin; however, it’s important to diagnose the disease as early as possible to prevent complications and poor health outcomes. Patients who are allergic to penicillin can still receive effective treatment with other types of antibiotics.

Keep in mind that according to the CDC, penicillin can cure the infection but it can’t always reverse the damage that has already been done by the disease.

In addition to practicing safe sex, it’s vital to get regular medical checkups and STD testing if you’re sexually active — especially if you have or have had multiple partners in the past. And since many STIs can remain completely asymptomatic for many years, getting tested can help ensure that they’re caught early so you can receive the treatment that you need.

Thankfully, modern antibiotics and detection tests have made it possible to diagnose and treat most cases of syphilis during the early stages of the disease. If you ever experience any of these symptoms and suspect that you could have syphilis, you should try to seek medical assistance as quickly as possible.

After examining you, your physician will probably order a series of tests for different STIs. Once your results are back, a diagnosis will be made and your provider will be able to determine which treatment is right for you.

It’s important to abstain from sex until the STI has been treated, and to inform any partners that may have caught the condition from you. Fortunately, syphilis treatment has a high success rate, and most cases are completely cleared very quickly.


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