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Which body systems can be damaged by tertiary syphilis?

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Scanning electron micrograph of Treponema pallidum, the spirochete bacterium that is the causative agent of syphilis. — syphilis Scanning electron micrograph of *Treponema pallidum*, the spirochete bacterium that is the causative agent of syphilis.

Tertiary syphilis, the final stage of the disease, can cause widespread damage throughout the body as spirochetes affect various organ systems. The primary body systems impacted include:1

Cardiovascular System: The infection frequently targets the aorta, destroying elastic tissue and leading to aneurysms or degeneration of the aortic valves. This can result in aortic insufficiency, heart failure, and impaired coronary circulation.12
Nervous System: Known as neurosyphilis, this involvement can be crippling or fatal. It includes conditions such as paresis, caused by brain tissue destruction, and tabes dorsalis, which results from the degeneration of the spinal cord.1
Skeletal System: Tertiary syphilis is commonly marked by the development of gummas—ulcerated lesions that can affect the bones, as well as the skin, mucous membranes, and organs such as the liver and brain.13

While antibiotic treatment with penicillin can kill the bacteria and halt the disease's progression, it cannot reverse the permanent damage already inflicted on these systems.24