Version July 2025
| Stage | Clinical manifestations |
| Primary syphilis | Single painless ulcer (chancre) at site of inoculation, regional adenopathy |
| Secondary syphilis | Rash (disseminated and/or involving the palms and soles), fever, malaise, mucocutaneous lesions, hepatitis, arthritis, glomerulonephritis, condyloma lata, pharyngitis, alopecia |
| Latent syphilis* | Asymptomatic |
| Early latent (<1 year after initial infection) | |
| Late latent (>1 year after initial infection) | |
| Tertiary (late) syphilis | |
| Gummatous disease | Granulomatous disease of the skin and subcutaneous tissues, bones, or viscera |
| Cardiovascular disease | Aortic aneurysm, aortic insufficiency |
| Central nervous system disease (neurosyphilis) | Tabes dorsalis, Argyll-Robertson pupils, paresis, seizures, subtle psychiatric manifestations, dementia. May be asymptomatic. |
| Neurosyphilis (can occur at any time during the course of infection) | |
| Early | Asymptomatic meningitis, symptomatic meningitis, or, less commonly, meningovascular disease (ie, meningitis and stroke). Vision or hearing loss with or without concomitant meningitis may also be present, and ocular/otologic syphilis is treated as neurosyphilis. |
| Late | Most common forms involve the brain and spinal cord (dementia [general paresis] and tabes dorsalis). |
