What are the symptoms of syphilis?

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Symptoms of Syphilis: A Comprehensive Overview

Primary Syphilis Symptoms: Painless Chancre and Lymphadenopathy

Primary syphilis typically begins with a solitary, painless chancre at the site of infection. This ulcer is firm and indurated, often accompanied by regional lymph node swelling . The chancre usually appears about three weeks after exposure and heals spontaneously within a few weeks, even without treatment.

Secondary Syphilis Symptoms: Rash, Fever, and Systemic Manifestations

Secondary syphilis occurs several weeks to months after the primary infection and is characterized by a wide array of symptoms. The most common manifestations include a polymorphic rash, which often involves the palms and soles, and generalized lymphadenopathy . Other frequent symptoms are fever, malaise, sore throat, headache, muscle aches, and mucocutaneous lesions such as condyloma lata . Less common symptoms include pruritus, visual disturbances, and loss of scalp hair.

Latent Syphilis: Asymptomatic Phase

Latent syphilis is divided into early and late stages, during which the infection is asymptomatic and detectable only through serologic testing . This phase can last for years, and although there are no clinical symptoms, the disease can still be transmitted during the early latent stage.

Tertiary Syphilis: Severe and Destructive Symptoms

Tertiary syphilis can develop years after the initial infection and is marked by severe complications. This stage includes gummatous lesions, cardiovascular syphilis, and neurosyphilis, which can affect any organ system . Symptoms of neurosyphilis may include ocular and auditory abnormalities, headache, paraesthesia, vertigo, facial paresis, motor weakness, and unexplained pain in the legs .

Neurosyphilis: Central Nervous System Involvement

Neurosyphilis can occur at any stage of syphilis and presents with a variety of neurological symptoms. These may include meningitis, cranial nerve abnormalities, cerebrovascular accidents, and other central nervous system issues . In HIV-infected individuals, neurosyphilis is more common and may present with more severe symptoms .

Oral Manifestations of Syphilis

Oral manifestations are particularly challenging for diagnosis and can include subacute erosive or ulcerative lesions, mucous patches on the tongue, nodular lesions, and leukokeratotic lesions. These symptoms are often seen in secondary syphilis and can be isolated, making diagnosis difficult.

Conclusion

Syphilis presents with a wide range of symptoms that vary depending on the stage of the disease. Primary syphilis is marked by a painless chancre and lymphadenopathy, while secondary syphilis includes systemic symptoms such as rash, fever, and mucocutaneous lesions. Latent syphilis is asymptomatic, and tertiary syphilis can lead to severe complications affecting multiple organ systems. Neurosyphilis can occur at any stage and presents with various neurological symptoms. Understanding these symptoms is crucial for timely diagnosis and treatment.