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Syphilis - tertiary
Alternative namesLate syphilis; Tertiary syphilis
DefinitionTertiary syphilis is a late phase of the sexually transmitted disease syphilis , caused by the spirochete Treponema pallidum .
Causes, incidence, and risk factors
Tertiary syphilis can follow the initial infection, primary syphilis , by 3 to 15 years. Secondary syphilis is the stage that precedes tertiary syphilis if primary syphilis is not treated.
Lesions in the central nervous system produce neurological disease called neurosyphilis which can include tabes dorsalis , general paresis , and optic atrophy. Lesions of the heart, heart valves and aorta can lead to aneurysms , valvular heart disease , and aortitis.
SymptomsSymptoms of tertiary syphilis depend on which organ systems have been affected. They vary widely and are difficult to diagnose. In individuals with tertiary syphilis the primary and secondary stages of syphilis usually have been long forgotten. Medical findings of aortic aneurysms and neurological problems require astute diagnostic ability to link them to syphilis. Some of the symptomatic problems are listed below.
Signs and tests
TreatmentThe treatment of syphilis is determined by the length of time the person has been infected. Primary, secondary, and latent syphilis of less than one year duration is treated as follows:
To treat syphilis during pregnancy:
Penicillin is recommended as the only real drug of choice. Tetracycline cannot be used because of toxicity to the fetus, and erythromycin may fail to prevent congenital syphilis in the fetus. Penicillin-allergic individuals should be desensitized and then treated with penicillin.
These symptoms usually disappear within 24 hours.
Individuals with primary or secondary syphilis should abstain from sex until they have been treated. Syphilis is extremely contagious in the primary and secondary stages.
Expectations (prognosis)Late syphilis may be permanently disabling and may lead to death.
Calling your health care providerUntreated syphilis can result in serious health problems. It is imperative that you inform your physician of the possibility of having had syphilis previously, even if it was many years ago.
People who have multiple or unknown sex partners or partners who are involved in any high-risk sexual practices are at risk for acquiring sexually transmitted diseases (STDs). Individuals who recognize that they are at risk have taken the first step toward prevention.
Total abstinence is the only way to completely avoid the possibility of infection with a sexually transmitted disease. Monogamous sex with a healthy partner is lower risk, and protected sex using condoms also dramatically reduces risk. Condoms act as a barrier to the transmission of infectious organisms (pathogens) and should be used in any and all situations that could be considered risky.
Update Date: 8/4/2002Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT