Other Types Of Syphilis

Other types of Syplilis include:

Tertiary syphilis usually appears within 3-10 years of infection. The typical lesion is a gumma (local lesion with soft tumor-like formations, histiocytes), one can also experience bone pain, which is described as a deep boring pain characteristically worse at night. Gummas may be identified on the skin, in the mouth, and in the upper respiratory tract. They appear most commonly on the leg just below the knee. Gummas may be multiple or diffuse but usually are solitary lesions that range from less than 1 cm to several centimetres in diameter. There can also appear symptoms representative for the area affected, e.g. brain involvement (headache, dizziness, mood disturbance, neck stiffness, blurred vision) and spinal cord involvement (bulbar symptoms, weakness and wasting of shoulder girdle and arm muscles, incontinence, impotence). Some people may experience, 20 years after infection, behavioral changes and other signs of dementia, which is indicative of neurosyphilis.

Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with secondary or tertiary syphilis. The infection inside the uterus mostly occurs during the fifth month. According to the CDC, 40 % of the births to syphilitic mothers are stillborn, 40-70 % of the survivors will be infected, and 12 % of these will die prematurely. The manifestations of untreated congenital syphilis can be divided into those that are expressed prior to age 2 years (early) or after age 2 years (late). The early manifestations include abnormal x-rays (61%), hepatomegaly (enlarged liver) (51%), splenomegaly (enlarged spleen) (49%), petechiae (tiny localized hemorrhages from the small blood vessels just beneath the surface of the skin) (41%), other skin rashes (35%), anemia (34%), lymphadenopathy (swelling of the lymph nodes) (32%), jaundice (30%), pseudoparalysis (28%), and snuffles (obstructed nasal respiration) (23%). Late manifestations are rare and, if encountered, usually involve complications including interstitial keratitis (inflammation of the cornea), cranial nerve VIII deafness, corneal opacities, and/or recurrent arthropathy (joint disease). Dental abnormalities may be evident, such as centrally notched and widely spaced, peg-shaped, upper central incisors (Hutchinson teeth) and sixth-year molars with multiple poorly developed cusps (mulberry molars). Death from congenital syphilis is usually through pulmonary haemorrhage. Affected children are highly infectious until about 2 years old.

Neurosyphilis appears when the infection spreads to the neurological system and it may occur during any stage of syphilis. It may be symptomatic or asymptomatic. The symptomatic neurosyphilis can manifest as syphilitic meningitis (an infection of the lining of the brain), meningovascular syphilis, or parenchymatous neurosyphilis (the parenchyma is the tissue of an organ). Syphilitic meningitis develops within several years of initial infection and the symptoms are the symptoms of meningitis, including headache, nausea and vomiting, and photophobia, but are typically afebrile. Meningovascular syphilis usually manifests 5-10 years after infection and is the result of endarteritis (inflammation of the inner lining of an artery), which affects small blood vessels of the meninges (the three membranes pia mater, arachnoid mater, and dura mater that surround the brain and spinal cord), brain, and spinal cord. Parenchymatous neurosyphilis results from direct parenchymal CNS (Central Nervous System) invasion by T pallidum and is usually a late development (15-20 years after primary infection). Symptoms of parenchymatous reurosyphilis include ataxia (loss of coordination), incontinence (the inability to control urination), paresthesias (abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus), and loss of position, vibratory, pain, and temperature sensations. Paresis and dementia, with changes in personality and intellect, may develop.