The primary stage:

• Usually marked by the appearance of a single sore
  (called chancre, pronounced shanker),
• Multiple sores are common.
• The chancre appears at the spot where syphilis entered the body and is usually firm, round, small, and painless.
• The chancre lasts three to six weeks and will heal without treatment.
• Without medical attention the infection progresses to the secondary stage.
• The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days).
• During the primary stage an infected person can infect others.

The secondary stage:

• Typically begins with a skin rash and mucous membrane lesions (sores in the mouth, nose, eyes, vagina, penis, anus, etc.).
• The rash may appear as rough, red, or reddish brown spots both on the hands and bottoms of the feet. The rash does not cause itching.
• Rashes of a different appearance can occur on other parts of the body.
• Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed.
• 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.

Other symptoms of secondary stage syphilis include:

• fever
• swollen lymph glands
• sore throat
• patchy hair loss
• headaches
• weight loss
• muscle aches
• fatigue

Latent syphilis:

Latent syphilis causes no symptoms. The infection can only be detected with a blood test. If not treated, latent syphilis continues for life. Although many people with latent syphilis never have serious problems, some progress to the final stage, called late (tertiary) syphilis.

The late (tertiary) stage:

Occurs when an infected person does not receive medical treatment. During late stage syphilis the primary and secondary stage signs and symptoms are gone even though the infection remains in the body.

Tertiary syphilis will begin to damage the organs, including:

• brain
• nerves
• blood vessels
• bones
• eyes
• heart
• liver
• joints

Once the damage begins it may eventually lead to death.

Signs and symptoms of late stage tertiary syphilis include:

• difficulty coordinating muscle movements
• paralysis
• numbness
• gradual blindness
• dementia

Late stage syphilis can be cured but the damage done to the body is permanent.

Syphilis can invade the nervous system at any stage of infection, and causes a wide range of symptoms, including headache, altered behavior, difficulty coordinating muscle movements, paralysis, sensory deficits, and dementia. This invasion of the nervous system is called “neurosyphilis.”

If syphilis is left untreated, some people will develop neurosyphilis. During the early stages of infection, syphilis bacteria invade the nervous system. Neurosyphilis might be more difficult to treat and treatment might be different for people with HIV infection.

Some people never develop symptoms, however others experience the following symptoms:

• Seizures
• Headache, stiff neck, and fever brought on from an inflammation of the lining of the brain.
• Symptoms of stroke with resulting numbness, weakness, or vision problems.

The time from infection to developing neurosyphilis might be as long as 20 years.