The Stages of Syphilis
Untreated syphilis infection can lead to chronic disease with protean manifestations.15
| Stage | Signs and Symptoms | Chronology |
| Primary | Chancre: a firm, nontender ulceration, usually in the genital area, that may be associated with regional lymphadenopathy15 | Chancres generally develop within 3 weeks of exposure and, without treatment, last from 2 to 6 weeks15 |
| Secondary | Blood-borne dissemination leads to many clinical manifestations, including headache, muscle and joint pain, fatigue, fever, rash (often on the palms and soles), lymphadenopathy, condylomata lata (raised, nontender plaques), hair loss, osteitis, arthritis, hepatitis, gastritis, nephropathy, uveitis, meningitis15 | Can start 4 to 8 weeks after a chancre develops; signs and symptoms resolve in weeks to months (even without treatment)11,14 |
| Latent (early) | None; disease is detected by serologic tests.7 Signs and symptoms of secondary syphilis may recur during this stage.7 | Defined in the United States as the first year after the resolution of primary or secondary lesions (or as a newly reactive serologic test in an asymptomatic person who has had a negative test within the past year)12 |
| Latent (late) | None1 | May last a lifetime; ends with development of tertiary syphilis, which develops in approximately one third of those who remain untreated 11,14 |
| Tertiary | ||
Neurosyphilis |
Asymptomatic, or can cause meningitis, meningovascular disease (leading to ischemic injury), or involvement of brain parenchyma, leading to general paresis or tabes dorsalis1 | Follows latent infection1 |
Cardiovascular |
Aortic aneurysm, aortic regurgitation, chest wall mass, hoarseness1 | |
Gummatous |
Focally destructive inflammatory lesions in almost any tissue or organ1 |
Relevant links 
See the full prescribing information for BICILLIN® L-A.
Information for patients about BICILLIN® L-A.
Get a copy of the CDC sexually transmitted diseases guidelines, 2006.
Note: BICILLIN® L-A and BICILLIN® C-R have different indications.2,3 Learn about BICILLIN® C-R (penicillin G benzathine and penicillin G procaine injectable suspension).
