Primary Syphilis:
- Painless, indurated chancre (ulcer) at the infection site (e.g., genital, oral, or anal).
- Regional lymphadenopathy (swollen lymph nodes).
- Rationale: The chancre is a hallmark of primary syphilis, often unnoticed due to its painlessness.
- Secondary Syphilis:
- Constitutional symptoms: fever, malaise, headache, myalgias (muscle pain).
- Skin rash (often on palms and soles), mucocutaneous lesions (e.g., condyloma lata).
- Hepatitis, nephropathy, ocular changes (e.g., anterior uveitis), periostitis (bone inflammation).
- Rationale: Secondary syphilis is systemic, affecting multiple organs.
- Tertiary Syphilis:
- Neurosyphilis: Demyelination of posterior columns, dorsal roots, and ganglia, leading to:
- Ataxia, foot drop, paresthesia, bladder disturbances, impotence, areflexia.
- Loss of positional, deep-pain, and temperature sensations.
- Cardiovascular syphilis: Aortic aneurysm, aortic regurgitation.
- Gummas (soft, non-cancerous growths) in skin, bones, or liver.
- Rationale: Tertiary syphilis is severe, often causing irreversible damage.
- Latent Syphilis:
- No symptoms, but serologic evidence of infection.
- Rationale: Latent syphilis is asymptomatic but can progress to tertiary syphilis if untreated.
- Oral Manifestations:
- Mucous patch: Painless, silver-gray erosion with a red periphery.
- T. pallidum DNA detected in oral swabs even without visible lesions (transmission risk unclear).
- Rationale: Oral lesions can be a source of transmission, though not always visible.
Would you like more details on any specific stage or symptom?