Last Updated on June 4, 2020 by Nancy Carteron, MD, FACR
STD Symptoms – Syphilis
Often, syphilis has no symptoms or has such mild symptoms that a person doesn’t notice them.
There are also several stages of syphilis which may overlap. The stages may be separated by latent stages, or times when no symptoms are present. Symptoms vary with each stage and the syphilis symptoms do not always occur in the same order.
The primary stage of syphilis is usually marked by the appearance of a painless sore or open, wet ulcer, known as a chancre (pronounced ‘shanker’), within 10 to 90 days after contact with the bacteria and at the site of infection.
It usually appears as a single, painless sore, that is raised or elevated. On average, chancres appear about 2 to 3 weeks after infection, but may take up to 90 days. Without treatment, they generally last 2 to 6 weeks. Swollen glands may also occur during the primary phase.
Chancres may be found: outside the genitals, including the penis, scrotum and vagina; inside the vagina or rectum; or at or around the anus. The chancre will go away with or without treatment.
Without treatment, the person will still have syphilis and can transmit it to others.
Less commonly, in men and women, sores may appear in the mouth, and on the lips, tonsils, fingers or buttocks.
The sores of first stage syphilis are very infectious and may take 2 to 6 weeks to heal. By this time, the bacteria will have spread to other parts of the body and it will then be known as second stage syphilis.
The secondary stage of syphilis can develop 3 to 6 weeks after the sores appear. Symptoms can last from 2 to 6 weeks and they may come and go for up to 2 years.
Symptoms can include:
- A general sense of ill health
- Bumps or patches inside the mouth, anus or vagina
- Condylomata lata or syphilitic ‘warts’ – moist, raised or elevated skin lesions, may be found in the anus or genital area
- Hair loss
- Loss of appetite
- Mild fever
- Mucous patches – flat, round, grayish-white sores, can appear on the mouth, throat, and cervix
- Muscle pains
- Patchy loss of hair on the head and other parts of the body
- Rashes on other parts of the body, including the neck, head torso, belly, and genitals
- Rough, reddish-brown rash that appears on the palms of the hands or the soles of the feet, which normally does not itch
- Sore throat
- Swollen glands
- Weight loss
Symptoms of secondary syphilis will clear up with or without treatment, but the disease will still be present if untreated. It will then enter into a latent stage which has no signs or symptoms.
If the infection remains untreated the second stage usually occurs some weeks after any sores have appeared and healed.
Syphilis is still infectious at this stage and can be passed on to someone else.
Latent syphilis is defined as the time where there are no signs or symptoms of the disease. It develops from 2 to 30+ years after infection.
Because there are no signs or symptoms, the only way to test for infection during the latent period is by blood test.
Late Stage (Tertiary)
Symptoms of late stage or tertiary syphilis can occur 2 to 30+ years after infection.
Complications during this stage can include:
- Chronic nervous system disorders, such as blindness, insanity and paralysis
- Gummas (small bumps or tumors that can develop on the skin, bones, liver or any other organ)
- Problems with heart and blood vessels
1 out of 3 people who have syphilis that is not treated suffer serious damage to the nervous system, heart, brain, or other organs, and death may result. This can occur 1 to 20 years after the start of the infection.
Early signs generally appear from 3 to 8 weeks after a baby is born. Even though these symptoms develop soon after birth, most cases go unnoticed until late congenital symptoms appear in childhood or adolescence.
Late congenital syphilis has similar symptoms to tertiary syphilis in adults, though heart complications rarely occur in cases of congenital syphilis.
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