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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Symptoms of tertiary syphilis

Tertiary syphilis is the most severe stage of syphilis. The most common skin and mucosal damage in tertiary syphilis appears on the scalp, scapula, back, and the extensor sides of the limbs, where nodular syphilitic rashes can be observed, and gummatous swellings can also be seen on the lower legs. Apart from damaging the skin and mucous membranes, tertiary syphilis can also harm the cardiovascular and nervous systems. If the cardiovascular system is affected, it can cause problems in the aortic arch, leading to aortic valve insufficiency and syphilitic heart disease. If the nervous system is involved, it can cause neurosyphilis, manifesting as syphilitic meningitis, cerebrovascular syphilis, meningeal gumma, paralytic dementia, and more. In summary, once afflicted with tertiary syphilis, patients can exhibit a variety of clinical symptoms such as increased intracranial pressure, headaches, sensory abnormalities, ataxia, paralytic dementia, and localized brain compression, among other symptoms.

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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 Zhu Zhu
Dermatology
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Does third-stage syphilis rash itch?

People with tertiary syphilis generally do not experience itching. Tertiary syphilis represents the later stages of the disease manifestation. Typically, the symptoms on the skin are neither painful nor itchy, which is the case for most individuals. However, some patients may feel differently from the majority, experiencing anomalies, or they might develop secondary conditions such as eczema or allergies, among others, possibly leading to mild itching and so on.

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Written by Ye Xi Yong
Infectious Diseases
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What are the symptoms of AIDS and syphilis?

AIDS and syphilis infections are both long-term processes. For example, a patient with primary syphilis mainly presents with a hard chancre. This can occur at locations such as the corona of the glans penis, the urinary meatus of the foreskin, the labia, the cervix, and also can be seen on the tongue, lips, breasts, and other places. At these locations, a hard chancre appears, which is painless and itchless, and presents as a round or oval, well-demarcated ulcer. The symptoms of AIDS are primarily seen in the early stages of the disease, and include fever, vomiting, fatigue, itchy skin, nodules, joint pain, and other symptoms of decreased immune function.

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Written by Zhu Zhu
Dermatology
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How long does tertiary syphilis appear?

Tertiary syphilis often appears two to three years after contracting syphilis. Syphilis is staged based on the time of onset, and is typically divided into primary, secondary, and tertiary stages. Tertiary syphilis is the latest and most severe stage among these, often affecting the heart, nervous system, skin, and other areas. Due to the risk of severe complications, early and timely treatment is recommended to prevent the occurrence of tertiary syphilis.