IT IS commonly acknowledged that patients treated for early acquired infectious syphilis can be reinfected on subsequent exposure to an infectious case. So well known is this that the phenomenon of reexposure with resultant reinfection has been picturesquely and facetiously called pingpong syphilis.
Immunity in untreated syphilis develops rather slowly, with time measured in weeks rather than days. Thus, it may be three months or so before any clinically detectable immunity occurs. As long as the patient remains untreated, the immunity status to superinfection continues. Once the patient is treated, however, immunity to reinfection is relative and depends upon the degree of immunity achieved prior to treatment and the interval of time between treatment and reexposure. With time, there is a slow decline in the immunity level of any treated patient.
The cure of early infectious syphilis with penicillin is so rapid that in 24 hours one cannot detect Treponema
Fiumara NJ. Acquired Syphilis in a Patient With Congenital Syphilis. JAMA. 1965;193(1):70–71. doi:10.1001/jama.1965.03090010076029
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