Syphilis - tertiary Health Article

Definition

Tertiary syphilis is a late phase of the sexually transmitted disease syphilis, caused by the spirochete Treponema pallidum.

Alternative Names

Late syphilis; Tertiary syphilis

Causes, incidence, and risk factors

Syphilis is a sexually transmitted, infectious disease caused by the spirochete Treponema pallidum.

Syphilis has three main stages:

• Primary syphilis
• Secondary syphilis
• Tertiary syphilis

This article focuses on tertiary syphilis. Tertiary syphilis can follow the initial infection (primary syphilis) by 3 to 15 years.

In tertiary syphilis, the infection-causing organisms have continued to grow for years. Pockets of damage, or lesions, affects various tissues such as the bones, skin, nervous tissue, heart, and arteries. These areas are called gummas, and are very destructive.

Tertiary syphilis is less frequently seen today than in the past because of early detection and adequate treatment.

Symptoms

Symptoms 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.

• Cardiovascular syphilis which affects the aorta and causes aneurysms or valve disease
• Central nervous system disorders (neurosyphilis)
• Infiltrative tumors of skin, bones, or liver (gumma)

Signs and tests

VDRL or RPR blood tests are used as screening tests. If they are positive, one of the following is needed to confirm the diagnosis of syphilis:

• FTA-ABS (fluorescent treponemal antibody test)
• MHA-TP

Spinal fluid examination in neurosyphilis shows signs of meningitis.