II. Epidemiology
- Untreated Latent Syphilis progresses to Tertiary Syphilis in one third of patients
- Occurs years to decades afer initial untreated Syphilis infection
III. Pathophysiology
- Low-level Syphilis infection with strong immune response
IV. Types
- Late benign Syphilis (50% of Tertiary Syphilis cases)
-
Cardiovascular Syphilis
- Typically involves Great Vessels (especially ascending aortitis)
-
Thoracic Aortic Aneurysm (including ascending aortic aneurysm)
- Proximal involvement may result in aortic valve insufficiency or Coronary Artery Disease
-
Neurosyphilis (Occurs in 10% of untreated Syphilis)
- Treponemal penetration of the blood brain barrier
- Tabes Dorsalis (Peripheral Neuropathy)
- Intracranial gummata (appear as CNS Mass)
- Meningitis
- Dementia
V. Labs
- See Syphilis Testing
VI. Management
- See Syphilis
- See Neurosyphilis
VII. Complications
- Thoracic Aortic Aneurysm (from ascending aortitis)
- Neurosyphilis complications
VIII. References
- Kirk, McHugh and Parnell (2023) Crit Dec Emerg Med 37(8): 23-9
- Mattel (2012) Am Fam Physician 86(5): 433-40 [PubMed]
- Ricco (2020) Am Fam Physician 102(2): 91-8 [PubMed]