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Latent Syphilis

Untreated secondary syphilis resolves spontaneously, leading to latent syphilis, an asymptomatic phase characterized only by a positive treponemal serology. Based on the likelihood of mucocutaneous relapse and therefore of "infectiousness," patients are classified as having early latent syphilis during the first year after infection, when 90% of relapses occur, and late latent syphilis beyond this time. Although patients with late latent syphilis can no longer transmit the disease by sexual contact, transplacental or blood transmission is still possible.


Late (Tertiary) Syphilis

Late syphilis is a progressive inflammatory disease that may develop in 25% to 40% of patients with untreated syphilis, usually occurring 5 to 30 years after the initial infection. This stage can be divided into late neurosyphilis, cardiovascular syphilis, and gummatous syphilis, depending on the organ system involved.


Gummatous (Late Benign) Syphilis

Gummatous syphilis is an indolent late manifestation of untreated syphilis and in the post-antibiotic era tends to occur most commonly in HIV-infected patients. Granulomatous-like lesions (gummas) can form in any organ but tend to develop in the skeletal system, skin, and mucocutaneous tissues. Clinical manifestations result from local tissue destruction. Gummatous hepatitis may be symptomatic and lead to eventual cirrhosis. Other causes of granulomatous disease must be distinguished from syphilis. Gummas generally heal rapidly with penicillin therapy.


Men's Health