Clinical Stages of Syphilis

Last Updated: June 2026

Syphilis is associated with different clinical stages, although approximately 50% of people infected have no symptoms. The required treatment will vary depending on the progression and stage of the syphilis infection.

If there is any doubt about the length of infection, treat as late latent syphilis.

This chart provides an overview of the syphilis disease stages.

These stages are often not distinct, and most patients do not develop all or most of these signs or symptoms.

Infectious?	Disease Stage (often not distinct)	Symptoms and Signs
Yes – Infectious	Primary syphilis	Genital, anal or oral ulcer
	Secondary syphilis	Generalised febrile illness Rash Alopecia Oral, anal or genital lesions Neurological: visual changes, hearing changes, cranial nerve palsies Whilst most often part of secondary syphilis, neurosyphilis can occur at any stage
	Early latent syphilis (infected <2yrs)	Positive syphilis serology but clinical symptoms or signs no evidence of past treatment negative test or a 4-fold increase in RPR within past 2 years
Non-Infectious (by sexual contact*)	Late latent syphilis (infected >2yrs)	Positive syphilis serology but no clinical symptoms or signs no evidence of past treatment negative test more than 2 years ago (or never been tested before)
Non-Infectious (by sexual contact*)	Tertiary syphilis	Destructive skin, cardiovascular or neurological disease
*Syphilis infection can pass from pregnant person to baby during the pregnancy within ANY stage of the syphilis infection.