Is syphilis without symptoms serious or not serious?

Written by Luo Hong
Dermatology Department
Updated on May 07, 2025
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Syphilis without symptoms is generally called latent syphilis. Whether asymptomatic syphilis is severe or not cannot be generalized. Some people react late, and some just have latent syphilis, which is seropositive without other symptoms. Of course, there might also be cases where people have relatively high degrees of TRUST or particularly high low degrees of RPR in latent syphilis. In such cases, symptoms might not be mild, and this type is highly contagious, which might lead to abnormalities in the cerebrospinal fluid. If there are abnormalities in the cerebrospinal fluid, these symptoms might not be mild early on and are actually quite serious. Early-stage neurological issues might include memory decline, which is not easily detectable.

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Written by Zhu Zhu
Dermatology
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Can third-stage syphilis be completely cured?

Whether tertiary syphilis can be completely cured depends on the specific conditions of different patients. If tertiary syphilis has not caused serious complications, then timely and standard syphilis treatment at this stage can potentially lead to a cure. However, if it has been a long time and the condition has been neglected, it might cause severe damage to tissue and organ functions and can be life-threatening. At this point, it cannot be completely cured; even using anti-inflammatory drugs to treat syphilis cannot reverse the complications and greatly affects the quality of life.

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Written by Zhu Zhu
Dermatology
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Is tertiary syphilis highly contagious?

The infectivity of tertiary syphilis is not very high, although it still possesses relatively weak contagiousness. Syphilis in its primary and secondary stages often shows high titers in tests and has stronger infectivity, while tertiary syphilis has reduced infectivity. However, tertiary syphilis can easily lead to various complications, including damage to tissues and organs, making it more harmful than the primary and secondary stages. Therefore, it is crucial to treat tertiary syphilis promptly.

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Written by Cui Lin Jing
Dermatology
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What are the symptoms of tertiary syphilis?

Tertiary syphilis mainly occurs two to three years, or even five to ten years or longer, after infection. The primary skin manifestations are gummas, which often occur on the extensor side of the lower legs, and can present as ulcerations, erosions, nodules, and hyperplasia. It may also involve bones, joints, the heart, and blood vessels. The main manifestations include aortitis, aortic valve insufficiency, and aortic aneurysms. When the nervous system is involved, it can present as spinal tuberculosis and general paralysis, which are symptoms of paralytic dementia. The diagnosis of tertiary syphilis requires serological tests and cerebrospinal fluid analysis. The treatment involves primarily penicillin and benzathine penicillin, with erythromycin or tetracycline as alternatives for patients allergic to penicillin, and requires a longer course of treatment.

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Written by He Jing
Obstetrics and Gynecology
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Is fungal vaginitis related to syphilis?

Yeast vaginitis and syphilis are unrelated. Yeast vaginitis is caused by a disruption in the vaginal environment leading to an infection with Candida albicans, resulting in increased vaginal discharge. This is accompanied by itching of the vulva and the discharge may appear like cottage cheese or have a curd-like texture. However, syphilis is caused by the infection of the bacterium Treponema pallidum. It is a sexually transmitted disease characterized primarily by painless ulcers on the genitals. The treatment methods for the two are also different. Yeast vaginitis can be treated by external washing with baking soda and inserting clotrimazole vaginal suppositories, typically resolving within about a week. Treatment for syphilis, on the other hand, generally involves intravenous injections of penicillin. (Medication use should be supervised by a professional doctor.)

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Written by Qu Jing
Dermatology
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What are the symptoms of syphilis?

Syphilis is divided into acquired syphilis and congenital syphilis, which is transmitted via the fetus. Acquired syphilis, based on the duration of the disease and using two years as a boundary, is further divided into early-stage syphilis and late-stage syphilis. Early-stage syphilis, particularly primary syphilis, mainly presents symptoms such as a chancre and scleradenitis, generally without systemic symptoms. Secondary syphilis occurs when primary syphilis is untreated or not completely treated, allowing the virus to enter the bloodstream from the lymphatic system and spread throughout the body. This causes damages to the skin, mucous membranes, and systemically, known as secondary syphilis. It can manifest as various forms of syphilitic rash, some resembling papular rashes, others similar to dermatitis, eczema, flat lichen, urticaria, psoriasis, pustular disease, and others. Some secondary syphilitic rashes are similar to flat genital warts, and sometimes syphilis can lead to alopecia. Syphilis can also affect mucous membranes, appearing in the mouth, tongue, pharynx, larynx, and genital mucous membranes, characterized by one or more areas of distinct erythema, vesicles, erosion, covered with a grayish-white membrane, generally painless. Some syphilis cases might affect bones, causing damage to bones and joints. Latent syphilis presents no obvious symptoms, and late-stage syphilis might involve the cardiovascular and nervous systems.