Primary syphilis represents the invasion stage, which begins at the infecting contact and it is not remarked sometimes. Sometimes it can be noticed from the anamnesis a contact with an ill person with 1 - 8 weeks before. The typical lesion is represented by the chancre at the entrance, the most frequently the penis, the labia, or the uterine cervix.



It will take an average of 21 days for the spirochete to develop, depending on different factors. The chancre starts to erode slightly and quickly develops into a painless surface wound. Inflammation of regional ganglions will be noticed though it will be isolated, mobile, and also painless.

Secondary syphilis is the period where the infection starts to spread, appearing after 7-10 weeks from first exposure and 2-3 weeks after the primary infection, wherein the microbes migrate from the ganglions in great numbers. There will be a resulting second incubation until skin ulcerations come out within 45 days from appearance of first signs and 60-70 days from first contact with infection.

The infection will sometimes cause fever. Any part of the body tissue can be affected and injured. In general, the lesions will develop in the teguments and mucous membranes. The lesions will appear like rashes caused by a viral disease, however lesions will be pustule-like elements.

Recurrent syphilis occurs after insufficient or incorrect treatment. In this case, secondary syphilis can emerge again (in 3 to 9 months after treatment). Relapses can be only serologic, without any clinical manifestations. If clinical manifestations still occur, they can be skin and mucous membranes lesions, neurological symptoms, sore eyes, bones affections or visceral ones.

In latent syphilis, infection has been diagnosed in the blood but present no clinical manifestations. It is the period between secondary resumption and progress towards the tertiary stage.

During this stage, the serologic reaction is positive, the LCR exam is negative; the radiological and clinical exam and the ECG highlight possible cardiovascular lesions.

Tertiary syphilis is the third stage of the infection that can take place years after latency. During the late latency stage, lesions can appear as a result of an allergic reaction to the Treponema Palladium, which will affect tissues of the skin and the mucous membranes. There could appear tubercle formations and nodules that could develop into wounds. The mucous membranes can develop tubercles and lesions as well.

A pregnant woman can infect the fetus while inside the uterus. Thus the baby is born with congenital syphilis. The father cannot transmit it to the fetus if the mother is healthy.

When the child is born or during the first two years of its life, blister like symptoms are produced which sometimes turn into wounds. This is the precocious congenital syphilis.

Late congenital syphilis occurs after the age of two and the lesions are associated to the third stage of disease.