Latent Syphilis

Aka: Latent Syphilis

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II. Pathophysiology

  1. Asymptomatic stage in which Secondary Syphilis findings have resolved
  2. Noninfectious without lesions (Primary SyphilisChancre or Secondary SyphilisCondyloma Lata)
    1. However, vertical transmission to the fetus (Congenital Syphilis) in pregnancy still occurs

III. Signs

  1. No clinical signs of Syphilis (CSF Normal)
  2. Recurrence of Secondary Syphilis findings may occur in up to 25% of patients (in first 4 years)

IV. Types

  1. Early Latency (First year after infection)
    1. Symptoms present in 25% of early Latent Syphilis and this group will transmit Syphilis sexually
  2. Late Latency (Latent infection >1 year, typically 3-20 years)
    1. No symptoms of primary or Secondary Syphilis
    2. Typically only infectious in pregnancy and transfusion

V. Labs

  1. See Syphilis Testing
  2. Only Syphilis Serology is positive during Latent Syphilis

VI. Management

  1. See Syphilis

VII. Course

  1. Progression to Tertiary Syphilis in one third of untreated patients

VIII. References

  1. Green, Cohen, Billington (2016) Crit Dec Emerg Med 30(11): 4-10
  2. Kirk, McHugh and Parnell (2023) Crit Dec Emerg Med 37(8): 23-9
  3. Mattel (2012) Am Fam Physician 86(5): 433-40 [PubMed]
  4. Ricco (2020) Am Fam Physician 102(2): 91-8 [PubMed]

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Related Topics in Sexually Transmitted Disease

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