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The first symptom of primary syphilis is an ulcer called a chancre
("shan-ker"). The chancre can appear within 10 days to three months
after exposure, but it generally appears within two to six weeks. Because the
chancre may be painless and may occur inside the body, it may go unnoticed. It
usually is found on the part of the body exposed to the partner's ulcer, such
as the penis, the vulva, or the vagina. A chancre also can develop on the
cervix, tongue, lips, or other parts of the body. The chancre disappears within
a few weeks whether or not a person is treated. If not treated during the
primary stage, about one-third of people will progress to chronic stages.
is often marked by a skin rash that is characterized
by brown sores about the size of a penny. The rash appears anywhere from three
to six weeks after the chancre appears. While the rash may cover the whole body
or appear only in a few areas, the palms of the hands and soles of the feet are
almost always involved. Because active bacteria are present in these sores, any
physical contact - sexual or nonsexual - with the broken skin of an infected
person may spread the infection at this stage. The rash usually heals within
several weeks or months. Other symptoms also may occur, such as mild fever,
fatigue, headache, sore throat, as well as patchy hair loss, and swollen lymph
glands throughout the body. These symptoms may be very mild and, like the
chancre of primary syphilis, will disappear without treatment. The signs of
secondary syphilis may come and go over the next one to two years. If
untreated, syphilis may lapse into a latent stage during which the disease is
no longer contagious and no symptoms are present. Many people who are not
treated will suffer no further consequences of the disease. Approximately
one-third of those who have secondary syphilis, however, go on to develop the
complications of late, or tertiary, syphilis, in which the bacteria damage the
heart, eyes, brain, nervous system, bones, joints, or almost any other part of
the body. This stage can last for years, or even for decades.
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Late syphilis, the final stage, can result in mental illness, blindness,
other neurologic problems, heart disease, and death.
Neurosyphilis: Syphilis bacteria frequently invade the nervous system
during the early stages of infection, and approximately 3 to 7 percent of
persons with untreated syphilis develop neurosyphilis. Some persons with
neurosyphilis never develop any symptoms. Others may have headache, stiff neck,
and fever that result from an inflammation of the lining of the brain. Some
patients develop seizures. Patients whose blood vessels are affected may
develop symptoms of stroke with resulting numbness, weakness, or visual
complaints. In some instances, the time from infection to developing
neurosyphilis may be up to 20 years. Neurosyphilis may be more difficult to
treat and its course may be different in people with HIV infection.
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