Syphilis untreated most often progresses from primary through secondary and latent stages to tertiary stage syphilis which involves life-threatening complications.
Signs and Symptoms of Infection
The incubation period for syphilis ranges from 10-90 days (average 21 days) following exposure to the bacterium. The first sign of infection is a sore that appears on the skin or mucous membranes at the site where the bacterium entered the body.
Without treatment, infection progresses through a number of stages as described below.
Primary syphilis
- Appearance of a single firm, small, round, painless sore (chancre) or multiple sores at site of entry.
- Chancre lasts 3-6 weeks and heals without treatment.
- Infection progresses to secondary stage without treatment.
Secondary syphilis
- Development of a rough non-itchy rash (typically red or reddish brown spots) .
- Rash may appear as chancre is healing or may take several weeks to present.
- Rash characteristically forms on palms of hand and bottoms of feet (may occur on other parts of the body).
- Rash may vary in appearance on other body parts.
- Rash may be faint in appearance and go unrecognized.
Additional non-specific symptoms may also be experienced:
- fever
- swollen lymph glands
- sore throat
- patchy hair loss
- head aches
- weight loss
- muscle aches
- fatigue
Symptoms of secondary treatment are self-limited, but without treatment infection will progress to latent and tertiary stages. The secondary stage of syphilis is often unrecognized because:
- characteristic rash is not seen,
- rash may mimic that seen in other infections and be diagnosed as such,
- non-specific symptoms are diagnosed as flu or other self-limited illness.
Latent syphilis
- Hidden stage of infection following disappearance of secondary symptoms.
- Asymptomatic.
- May progress to tertiary syphilis within one year or may take many years .
Tertiary syphilis
Tertiary syphilis results in damage to internal organs including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.
Symptoms may include:
- difficulty coodinating muscle movements
- paralysis
- numbness
- gradual blindness
- dementia
- death
Congenital syphilis
T. pallidum may be passed from an infected mother to her unborn child during pregnancy. Congenital syphilis may result in stillbirth or death shortly after birth. Although infected infants may be born without obvious signs of infection, serious problems may develop within a few weeks. Immediate treatment is required to prevent developmental delay, seizures and/or death.
Syphilis is relatively easy to treat during the primary and secondary stages.
Syphilis is a sexually transmitted infection that has increased in prevalence in the past decade: treatment is required for sexual partner(s) and preventive measures are extremely important to prevent spread to sexual partner(s).
Read more about syphilis and other sexually transmitted infections:
Syphilis Diagnosis: Treponema pallidum Testing
Syphilis Infection: Sexually Transmitted Spirochete
Spread of Syphilis: Historical Perspective
Sources:
Primary and Secondary Syphilis --- United States, 2003—2004
Frequently Asked Questions About Syphilis
