Visceral syphilis is not limited to the tertiary stage. Lesions of the viscere may occur during the secondary period of syphilis, but visceral syphilis occurs chiefly in the tertiary period.
Clinical evidence of visceral syphilis occurs more frequently in disease of the liver or heart and blood-vessels than of any other organs of the body. Fever of a septic remittent or intermittent type is not an infrequent event. It is not unusual to find chills, fever and sweat resembling malarial fever. Indeed, the fever of visceral syphilis is frequently mistaken for malaria, tuberculosis, typhoid fever or rheumatism. The fever will frequently recur at intervals over years of time. Gummas are usually the source of such fevers and the fact that a gumma may spontaneously heal and disappear, and, especially if the patient is put to rest, is not usually recognized. While the condition may be obscure in these febrile conditions,
BILLINGS F. VISCERAL SYPHILIS. JAMA. 1911;LVII(21):1653-1656. doi:10.1001/jama.1911.04260110153001