Gumma: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Gumma?
An infectious disease doctor, a doctor who treats infections such as syphilis, usually leads care for a gumma. A dermatologist, a skin doctor, may help if the growth is on the skin. Other specialists may join in if the liver, heart, or brain is affected. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is gumma?
A gumma is a soft, tumor-like growth of the tissues. Doctors call this kind of growth a granuloma. It occurs in people with syphilis. Syphilis is a sexually transmitted infection (STI). Without treatment, it can cause serious health problems. The infection develops in stages: primary, secondary, latent, and tertiary. A gumma appears during late-stage tertiary syphilis.
Most people with untreated syphilis do not develop tertiary syphilis.
Symptoms
A gumma most often contains a mass of dead and swollen fiber-like tissue. It is most often seen in the liver. It can also occur in the:
- Bone.
- Brain.
- Heart.
- Skin.
- Testicles.
- Eyes.
Tertiary syphilis can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. In tertiary syphilis, the disease damages your internal organs and can result in death.
Without treatment, syphilis can also spread to the brain and nervous system, the eye, or the ear. Signs can include:
- Severe headache.
- Trouble focusing, confusion, or memory problems.
- Eye pain or redness.
- Hearing loss.
- Ringing, buzzing, roaring, or hissing in the ears.
Causes and who gets it
A gumma is caused by the bacteria that cause syphilis. Similar-looking sores sometimes occur with tuberculosis.
You can get syphilis from vaginal, anal, or oral sex without a condom with a partner who has syphilis. Having syphilis once does not protect you from getting it again.
How doctors diagnose it
A provider can usually diagnose tertiary syphilis with the help of several tests. Most of the time, providers use a blood test. A likely diagnosis, called a presumptive diagnosis, needs two kinds of blood tests.
Treatment
A gumma is caused by syphilis, so treatment targets the infection. The right antibiotics can cure syphilis. Penicillin G, given by injection, is the preferred drug at every stage. Tertiary syphilis needs a longer course of treatment.
Treatment might not undo any damage the infection has already caused. Follow-up testing is necessary to make sure treatment worked.
Some people have a reaction called the Jarisch-Herxheimer reaction. It can bring headache, muscle aches, and fever in the first 24 hours after treatment starts. It is a reaction to treatment and not an allergic reaction to penicillin. Your provider can tell you how to manage it.
When to see a doctor
If you are sexually active, talk openly with your health care provider. Ask whether you should be tested for syphilis or other STIs. See a provider if you have a severe headache, eye pain or redness, hearing loss, ringing in the ears, or new memory or thinking problems. These can be signs that syphilis has spread to the brain, eye, or ear.
Call 911 or go to the emergency room if you have chest pain or fainting. Go too if you have sudden weakness, trouble speaking, sudden vision loss, or sudden confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can order or review blood tests, talk through the results, and refer you to an infectious disease doctor. They can also help coordinate care and follow-up testing.
Common questions
Can a gumma be cured?
Yes. The syphilis that causes a gumma can be cured with the right antibiotics. Treatment might not undo damage the infection has already caused, so follow-up testing is important.
Does everyone with syphilis get a gumma?
No. Most people with untreated syphilis do not develop tertiary syphilis, the late stage when a gumma appears.
Where does a gumma occur in the body?
A gumma is most often seen in the liver. It can also occur in the bone, brain, heart, skin, testicles, and eyes.
What stage of syphilis causes a gumma?
A gumma appears during late-stage tertiary syphilis. It is a soft, tumor-like growth called a granuloma that occurs in people with syphilis.
Sources
- MedlinePlus - Gumma
- Centers for Disease Control and Prevention - About Syphilis
- Centers for Disease Control and Prevention - Syphilis STI Treatment Guidelines
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
