During both the primary and secondary phases of syphilis, a person is very infectious to partners. As can be imagined, both phases of the infection are often missed, either because the initial lesion is not noticed or because the symptoms are thought to have another cause, since they are so vague. In addition, since both of these phases are transient, people may think the problem has gone away when the symptoms resolve, but this is not the case. People with infection persisting beyond this point can live for many years, often decades, without experiencing further symptoms. Infection may be detected only through routine blood testing, and it is then called latent syphilis. People are still potentially infectious during this time, especially soon after resolution of the secondary syphilis stage.

The syphilis-causing bacterium can cause destruction of internal organs, a stage known as tertiary syphilis or late syphilis. This stage is rarely seen today, since the discovery of antibiotics has made syphilis so treatable, but virtually any organ system—such as the bones, liver, skin, and heart—can be damaged. If infection progresses to the brain, it is called neurosyphilis. In these stages the infection can be life threatening.

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