What is the typical titer for third-stage syphilis?

Written by Zhu Zhu

Dermatology

Updated on May 21, 2025

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The titers of tertiary syphilis are generally lower than those of primary and secondary syphilis. Syphilis is divided into three stages. During the primary and secondary stages, the reactivity of the Treponema pallidum is higher, thus the titers are also higher. However, the titers for tertiary syphilis often appear lower or even negative. The level of syphilis titers is not significantly related to the duration of the illness. Interestingly, tertiary syphilis generally occurs when the disease has already progressed for more than two years, which results in lower titers.

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Written by Huang Ling Juan

Dermatology

1min 4sec

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How to determine if you have syphilis

To determine if one has syphilis, initial assessments should integrate clinical symptoms, including the presence of a chancre and syphilis rash. Subsequently, it is advised to visit an accredited hospital to undergo serological testing for syphilis, which involves the detection of both specific and non-specific antibodies of syphilis. A comprehensive evaluation of these findings can assist in diagnosing whether one is infected with syphilis. Once syphilis is confirmed, it is crucial to commence systematic and standardized treatment promptly. Generally, if both the syphilis-specific antibody test and the non-heated treponemal pallidum particle agglutination test are positive, these indicate an active syphilis infection. Treatment should be sought at a reputable medical facility, promptly utilizing penicillin for standardized treatment. If there is an allergy to penicillin, tetracycline antibiotics can be considered as an alternative.

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Written by Luo Hong

Dermatology Department

58sec

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How long after the disappearance of a chancre does secondary syphilis occur?

Secondary syphilis generally occurs three to four weeks after the disappearance of the primary chancre, which means it often occurs 9 to 12 weeks after the infection by the Treponema pallidum. Of course, it is rare yet possible for it to appear simultaneously with the primary chancre. The main reason secondary syphilis develops is either due to untreated primary syphilis or incomplete treatment. The Treponema pallidum enters the bloodstream from the lymphatic system, causing bacteremia and spreading throughout the body, leading to systemic damage including skin and mucosal lesions, known as secondary syphilis. Common signs of secondary syphilis include erythema on the palms and soles, which is a characteristic manifestation. Another sign includes flat, moist warts around the anus and genital areas, similar to condyloma acuminatum, but these warts are flatter and less protruding.

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Written by Luo Hong

Dermatology Department

55sec

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Gonorrhea and syphilis symptoms

Gonorrhea infection, if in males, generally presents with significant urethral irritation including symptoms such as urethral discharge, frequent urination, urgent urination, and pain during urination. However, in females with gonorrhea, it may cause increased vaginal discharge and an unusual odor, but many women with gonorrhea do not exhibit any symptoms. As for syphilis, if it is primary syphilis, ulcers may appear on the genitals, lips, or other body parts, known as chancres. In typical secondary syphilis, pinkish-red rashes may appear on the palms of the hands and soles of the feet, usually without itching, although rashes may also occur on the trunk and might not be itchy. Additionally, many cases of syphilis remain latent and show no clear symptoms.

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Written by Zhu Zhu

Dermatology

1min 18sec

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Early symptoms of syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum, with the disease course within two years referred to as early syphilis. Not all infected individuals display symptoms; asymptomatic syphilis is also known as latent syphilis. Symptomatic early syphilis primarily manifests as either primary or secondary syphilis. The main symptom of primary syphilis is a chancre, typically occurring as a clear-bordered ulcer in the genital area. It is flesh-colored and neither painful nor itchy. Several weeks after the chancre heals, secondary syphilis can develop, characterized by a rash that may resemble other skin conditions. Common manifestations include macules, papular macules, copper-red papules on hands and feet, flat condyloma, and syphilitic alopecia. Individuals who suspect they may have been exposed to syphilis should visit a hospital for a blood test to detect syphilis antibodies. Antibodies can usually be detected four weeks after infection, and a negative result three months later can rule out syphilis.

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Written by Li Chang Yue

General Surgery

1min 1sec

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Is there a high possibility of syphilis with enlarged inguinal lymph nodes?

Enlarged inguinal lymph nodes generally suggest the possibility of syphilis, but such enlargement caused by syphilis commonly appears in the secondary or tertiary stages of the disease. In the early primary stage of syphilis, it is rare to see swollen inguinal lymph nodes; the symptoms are mostly seen on the external genitals, including soft and hard chancres. As syphilis progresses, it may gradually lead to swelling of the inguinal lymph nodes, including other superficial lymph nodes. However, enlargement of the inguinal lymph nodes alone cannot conclusively determine that the cause is syphilis. Other conditions such as bacterial lymphadenitis, lymph node tuberculosis, or lymphoma could also cause swollen inguinal lymph nodes. Therefore, to diagnose whether it is caused by syphilis, it is crucial to consider the results of syphilis serological tests and specific pathological puncture findings.