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The lesions associated with primary and secondary syphilis are self-limiting, even without treatment, and resolve with few or no residua. Ocular and otologic syphilis has been associated with permanent vision and hearing loss. Tertiary and congenital syphilis may be highly destructive and permanently disabling and may lead to death. Many experts now believe that while infection is almost never completely eradicated in the absence of treatment, most infections remain latent without sequelae, and only a small number of latent infections progress to further disease.