In many cases, syphilis symptoms begin with a single, small, painless sore occurring 10 to 90 days after infection. However, symptoms vary, not only from stage to stage, but also among individuals. As the disease progresses to the later stages, signs and symptoms may not be apparent at all, but can include a rash on the palms and bottoms of the feet, fever, and mental illness.
The four stages of syphilis include:
- Primary syphilis
- Secondary syphilis
- Latent syphilis
- Tertiary syphilis.
Symptoms of syphilis vary within each of these stages, as well as within each individual. Syphilis is sometimes called "the great imitator" because it has so many possible symptoms and they are similar to those of many other diseases. Furthermore, many people infected with the disease do not have any syphilis symptoms for years, yet remain at risk for late complications if they are not treated.
Primary Symptoms of Syphilis
The first symptom of primary syphilis is often a single, small, round, painless sore, called a chancre (shan-ker). This chancre appears about 10 to 90 days after infection, most commonly around 3 weeks after a person has become infected with the syphilis bacteria (Treponema pallidum). The sore can appear on the vulva, vagina, cervix, tongue, lips, or other parts of the body, including inside the body. Usually, there is only one chancre, but sometimes there are many. Nearby lymph glands are often swollen (lymph glands, or nodes, are small bean-shaped organs of your immune system containing cells that help fight off germs that are found throughout the body).
Because chancres are usually painless and because a chancre can occur inside your body, you might not notice it. The chancre disappears in about 3 to 6 weeks whether or not you are treated. Thus, you can go through primary syphilis without syphilis symptoms or with only brief symptoms that you overlook.
If primary syphilis is not treated, however, the infection moves to the secondary stage. In this stage, syphilis can be passed to others through contact with an open sore during vaginal, anal, or oral sex.