TABLE 1.

Common clinical manifestations of syphilis

Stage of syphilis	Clinical manifestations	Incubation period
Primary	Chancre, regional lymphadenopathy	3 wk (3–90 days)
Secondary	Rash, fever, malaise, lymphadenopathy, mucus lesions, condyloma lata, alopecia, meningitis, headaches	2–12 wk (2 wk–6 mos)
Latent	Asymptomatic	Early, <1 yr; late, >1 yr
Tertiary
Cardiovascular syphilis	Aortic aneurysm, aortic regurgitation, coronary artery ostial stenosis	10–30 yr
Neurosyphilis
Asymptomatic	None
Acute syphilitic meningitis	Headache, meningeal irritation, confusion	<2 yr
Meningovascular	Cranial nerve palsies
General paresis	Prodrome: headache, vertigo, personality disturbances, followed by acute vascular event with focal findings	5–7 yr
Tabes dorsalis	Insidious onset of dementia associated with delusional state, fatigue, intention tremors, loss of facial-muscle tone	10–20 yr
	Lightning pains, dysuria, ataxia, Argyll Robertson pupil, areflexia, loss of proprioception	15–20 yr
Gumma	Monocytic infiltrates with tissue destruction of any organ	1–46 yr (most cases 15 yr)
Congenital
Early	Fulminant disseminated infection, mucocutaneous lesions, osteochondritis, anemia, hepatosplenomegaly, neurosyphilis	Onset <2 yr
Late	Interstitial keratitis, lymphadenopathy, hepatosplenomegaly, bone involvement, condylomata, anemia, Hutchinsonian teeth, eight-nerve deafness, recurrent arthropathy, neurosyphilis	Persistence >2 yr after birth