II. Epidemiology

  1. Untreated Latent Syphilis progresses to Tertiary Syphilis in one third of patients
  2. Occurs years to decades afer initial untreated Syphilis infection

III. Pathophysiology

  1. Low-level Syphilis infection with strong immune response

IV. Types

  1. Late benign Syphilis (50% of Tertiary Syphilis cases)
    1. Presents with gumma, Granulomas and Psoriasis-like Plaques
    2. May form 1 to 10 years after initial infection
    3. Destructive Granulomatous lesions (fungating masses) affect any area
    4. Responds rapidly to treatment
  2. Cardiovascular Syphilis
    1. Typically involves Great Vessels (especially ascending aortitis)
    2. Thoracic Aortic Aneurysm (including ascending aortic aneurysm)
      1. Proximal involvement may result in aortic valve insufficiency or Coronary Artery Disease
  3. Neurosyphilis (Occurs in 10% of untreated Syphilis)
    1. Treponemal penetration of the blood brain barrier
    2. Tabes Dorsalis (Peripheral Neuropathy)
    3. Intracranial gummata (appear as CNS Mass)
    4. Meningitis
    5. Dementia

V. Labs

VI. Management

VII. Complications

  1. Thoracic Aortic Aneurysm (from ascending aortitis)
  2. Neurosyphilis complications

VIII. References

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Related Studies

Ontology: Syphilis, tertiary (C0153188)

Concepts Disease or Syndrome (T047)
MSH C536774
ICD9 097.0
ICD10 A52 , A52.9, A52.3
SnomedCT 186905004, 187358009, 276200006, 72083004
English Late syphilis unspecified, Late syphilis, unspecified, [X]Late syphilis, unspecified, late syphilis (diagnosis), late syphilis, Tertiary Treponema pallidum infection, Late syphilis NOS, Syphilis (late), Syphilis, tertiary, late tertiary syphilis, tertiary syphilis, syphilis tertiary, Late syphilis unspecified (disorder), [X]Late syphilis, unspecified (disorder), Late syphilis, Late tertiary syphilis, Tertiary syphilis, Late syphilis (disorder), late; syphilitic, syphilis; late, syphilis; tertiary, tertiary; syphilitic, Late syphilis, NOS
Italian Sifilide terziaria, Sifilide tardiva non specificata, Infezione terziaria da Treponema pallidum
Dutch gevorderde syfilis, niet-gespecificeerd, tertiaire Treponema pallidum-infectie, laat; syfilis, syfilis; laat, syfilis; tertiair, tertiair; syfilis, Late syfilis, niet gespecificeerd, derde stadium van syfilis, Late syfilis
French Infection tertiaire à Treponema pallidum, Syphilis tardive, non précisée, Syphilis tertiaire
German Spaetsyphilis, unspezifisch, tertiaere Treponema pallidum-Infektion, Spaetsyphilis, nicht naeher bezeichnet, Spaetsyphilis, tertiaere Syphilis
Portuguese Sífilis tardia NE, Infecção terciária por Treponema pallidum, Sífilis terciária
Spanish Sífilis tardía no especificada, Infección terciaria por Treponema pallidum, sífilis tardía no especificada (trastorno), [X]sífilis tardía, no especificada (trastorno), [X]sífilis tardía, no especificada, sífilis tardía no especificada, sífilis tardía (trastorno), sífilis tardía, Sífilis terciaria
Japanese 晩期梅毒、詳細不明, 第3期梅毒, 第3期梅毒トレポネーマ感染症, バンキバイドクショウサイフメイ, ダイ3キバイドクトレポネーマカンセンショウ, ダイ3キバイドク
Czech Terciální infekce Treponema pallidum, Pozdní syfilis, blíže neurčená, Terciální syfilis
Korean 만기 매독, 상세불명의 만기 매독
Hungarian tertier syphilis, késői syphilis, nem meghatározott, Treponema pallidum tertier fertőzés

Ontology: Syphilitic gumma (C0221385)

Concepts Disease or Syndrome (T047)
ICD10 A52.3
SnomedCT 154385000, 64102008
English Syphilitic gumma, Syphiloma, Gumma (syphilitic), syphilitic gumma, syphilitic gumma (diagnosis), syphilis gummatous, Syphilitic gumma (disorder), gumma; syphilitic, syphilis; gumma, syphiloma, Syphilitic gumma, NOS
Dutch syfilitisch gumma, gumma; syfilis, syfilis; gumma
French Gomme syphilitique
German syphilitische Gumma
Italian Gomma sifilitica
Portuguese Goma sifilítica
Spanish Goma sifilítica, goma sifilítico (trastorno), goma sifilítico, sifiloma, sifílide gomatosa nodular
Japanese 梅毒性ゴム腫, バイドクセイゴムシュ
Czech Syfilitické guma
Hungarian Syphilises gumma