There are several words that we use to qualify a diagnosis of syphilis. I’ll get into detail here. When there were still no antibiotics developed, there were literally thousands of manifestations of syphilis, but we don’t see them anymore because it’s relatively easy to treat syphilis even with old-fashioned penicillin.

Latent syphilis:

Latent means that there are no symptoms, that you have got it but without knowing.

More than half of the infections of syphilis I see, there are no symptoms, the person just tests positive.

We usually divide latent syphilis into two groups…..

  1. Early latent syphilis

This means that in the last year, the patient tested negative for syphilis and now tests have become positive. Antibiotic treatment is short and easy.

Late latent syphilis

And this is the opposite – that we don’t know when the patient was infected because we don’t have syphilis test results for the last year. It may have been more than a year, and then requires a longer antibiotic course as a precaution. But of course, maybe they got infected very recently, but since we can’t prove it, we have to be cautious.

All the other patients will have symptoms, then. We classify this by how long they have been infected, according to their symptoms, let me explain…

Primary syphilis:

The patient has a single sore (ulcer). It represents the first point of entry into the body and is found in the part of the body exposed during sex (in the mouth in oral sex, on the genitals, etc.). It does not usually hurt, sometimes there is a “local” reaction with swollen lymphatic glands (which do not hurt either) and the bacteria has not spread beyond this local area. Primary syphilis requires treatment, because if not, it goes on to the next phase. It is relatively easy to treat.

Secondary syphilis:

Eventually the syphilis will pass from the originally infected area and produce a general infection throughout the body. If there are symptoms of this wide-spread extension, we call it secondary syphilis.

There can be many symptoms from having the infection all around the body – fever, unwellness, rashes on the skin or hands/feet, alopecia (hair loss), multiple swollen glands.

But it is not particularly difficult to treat either, with regular standard antibiotics there is usually a complete cure.

In general, the other manifestations of syphilis are not common at all. There are phases when syphilis has penetrated the brain (neurosyphilis) and also when there is permanent damage to the organs (tertiary syphilis) but we rarely see these scenarios, since there are plenty of antibiotics in our arsenal to combat this bacteria.

If you have doubts about this subject and your own situation, please write to me here.