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With the disappearance of second stage symptoms and without treatment, the bacterium begins to damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.

The late or tertiary stage begins many years later in about one third of untreated persons. Symptoms may include lack of muscle coordination, paralysis, inability to feel pain, dementia or other personality changes, impotency, shooting pains, tumors or other lesions on various body organs, damage to the joints, and sores on the soles of the feet or toes. Death may result.