Pediatric emergency medicine trisk 2415 2415
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Stage
Symptoms
Time frame
Primary
Chancre: nontender, firm red lesion,
often with associated nontender
regional adenopathy. As often
found in the cervix or vagina,
may not be noted by many
women
Due to disseminated spirochetemia.
Fever, influenza-like illness,
generalized adenopathy, and
dermal finding predominate in
adults but are less prominent in
young children. These include
condylomata lata and lesions on
palms and soles (contact
precautions should be used).
Reactive serologic tests without
symptoms
10–90 days after
exposure
Secondary
Latent
2–10 wks after primary
disease
Early latent: <1 yr
Late latent: >1 yr
Tertiary
Gummas: indolent localized dermal 3–10 yrs after secondary
nodules caused by the host
disease
inflammatory reaction; in
contrast to secondary syphilis,
few spirochetes are found
Neurosyphilis Paralytic dementia, meningitis,
≥5 yrs after primary
seizures, gummas of the spinal
disease
cord, optic atrophy, or tabes
dorsalis (myelopathy of the
posterior columns of the spinal
cord, resulting in loss of
proprioception and vibration
sensation)
Cardiovascular Arteritis of the aorta and pulmonary 10–40 yrs after primary
vessels that can result in valvular
disease
regurgitation or myocardial
insufficiency
