Table 1.

Common clinical manifestations of syphilis

Stage of syphilisClinical manifestationsIncubation period
PrimaryChancre, regional lymphadenopathy3 wk (3–90 days)
SecondaryRash, fever, malaise, lymphadenopathy, mucus lesions, condyloma lata, alopecia, meningitis, headaches2–12 wk (2 wk–6 mos)
LatentAsymptomaticEarly, <1 yr; late, >1 yr
Tertiary
 Cardiovascular syphilisAortic aneurysm, aortic regurgitation, coronary artery ostial stenosis10–30 yr
 Neurosyphilis
  AsymptomaticNone
  Acute syphilitic meningitisHeadache, meningeal irritation, confusion<2 yr
  MeningovascularCranial nerve palsies
  General paresisProdrome: headache, vertigo, personality disturbances, followed by acute vascular event with focal findings5–7 yr
  Tabes dorsalisInsidious onset of dementia associated with delusional state, fatigue, intention tremors, loss of facial-muscle tone10–20 yr
Lightning pains, dysuria, ataxia, Argyll Robertson pupil, areflexia, loss of proprioception15–20 yr
  GummaMonocytic infiltrates with tissue destruction of any organ1–46 yr (most cases 15 yr)
Congenital
 EarlyFulminant disseminated infection, mucocutaneous lesions, osteochondritis, anemia, hepatosplenomegaly, neurosyphilisOnset <2 yr
 LateInterstitial keratitis, lymphadenopathy, hepatosplenomegaly, bone involvement, condylomata, anemia, Hutchinsonian teeth, eight-nerve deafness, recurrent arthropathy, neurosyphilisPersistence >2 yr after birth