Is third-stage syphilis contagious?

Written by Zhu Zhu
Dermatology
Updated on January 27, 2025
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Third-stage syphilis is infectious, but its contagiousness is relatively weak compared to first-stage and second-stage syphilis. The titers detected in third-stage syphilis are usually lower, so its infectiousness is comparatively minor. However, third-stage syphilis still has the capability to infect others. Therefore, patients with third-stage syphilis must actively seek treatment and refrain from having sexual relations with others, while also enhancing their own immunity.

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Written by Zhu Zhu
Dermatology
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Can tertiary syphilis be transmitted?

Third-stage syphilis is contagious, but its infectivity is weaker compared to first-stage and second-stage syphilis. However, the damage caused by third-stage syphilis is very severe, often causing damage to tissues and organ functions. It can potentially cause disabilities, deformities, or even life-threatening conditions. Therefore, the characteristic of third-stage syphilis is its weak infectivity but strong damaging effects. Thus, it is crucial to take third-stage syphilis seriously and seek regular and timely treatment.

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Written by Li Chang Yue
General Surgery
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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.

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Written by Luo Hong
Dermatology Department
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Syphilis IgM negative represents what?

Syphilis IgM negative, which is primarily screened using the ELISA method. Generally, a negative IgM can temporarily rule out syphilis. If still uncertain, further confirmatory syphilis tests can be conducted, such as TPPA (Treponema Pallidum Particle Agglutination) or TPHA (Treponema Pallidum Hemagglutination). Usually, syphilis can be temporarily dismissed if IgM is negative. However, if symptoms of a primary chancre are present, such as genital ulcers, an early Syphilis IgM might be negative. In such cases where symptoms are clear but IgM is negative, it is typically advised to retest after one month. If the result turns positive, a confirmatory test should be performed to diagnose and treat syphilis.

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Written by Zhu Zhu
Dermatology
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What are the symptoms of tertiary syphilis?

Tertiary syphilis belongs to the latest stage of syphilis. If a patient develops tertiary syphilis, their symptoms are generally very severe, mainly involving the skin, cardiovascular system, musculoskeletal system, and even the nervous system. In particular, when the nervous system is involved, symptoms such as drowsiness and confusion may occur. Cardiovascular involvement can lead to related cardiovascular symptoms, and if the musculoskeletal system is affected, symptoms generally appear in the bones.

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Written by Zhu Zhu
Dermatology
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When is the third stage of syphilis?

Tertiary syphilis is a relatively late stage of syphilis, often occurring two to three years after the initial detection of the disease. For patients with a longer course of the disease, it generally appears five to ten years later. Once tertiary syphilis is diagnosed, it is often accompanied by damage to various organ functions, such as the cardiovascular system, bones, skin, and nervous system. Therefore, it is crucial to detect and treat syphilis early and to follow standard treatment protocols with a doctor. Otherwise, once it progresses to tertiary syphilis, it becomes very difficult to cure.