What are the symptoms of tertiary syphilis, and what are the manifestations of tertiary syphilis? Below are the characteristics and symptoms of tertiary syphilis. The symptoms of primary syphilis are relatively mild and can easily be confused with other diseases, but this is not the case with tertiary syphilis, as its symptoms are distinctive. By remembering this, we can determine whether we have developed tertiary syphilis based on the symptoms.
Characteristics of tertiary syphilis:
1. Late onset (2-15 years after infection), prolonged course, lasting 10-20-30 years if untreated, or even a lifetime;
2. Complex symptoms, potentially affecting any tissue or organ, including skin, mucous membranes, bones, joints, and internal organs, with a tendency to involve the nervous system, easily confused with other diseases, making diagnosis difficult;
3. Few Treponema pallidum in the body and skin lesions, weak infectivity, but strong tissue destruction, often causing tissue defects, organ damage, leading to disability, or even life-threatening conditions;
4. Anti-syphilis treatment is effective but cannot repair already damaged tissues or organs.
5. Unstable syphilis serological reactions, with a negative rate exceeding 30%, often changes in cerebrospinal fluid.
The three major symptoms of tertiary syphilis:
1. Gumma: Commonly seen in tertiary syphilis, accounting for about 61% of cases. It is a deep, hard nodule under the skin, initially the size of a pea, gradually growing to the size of a broad bean or plum, or larger, hard, movable upon touch, varying in number. Starting with normal skin color, as the nodule enlarges, the color gradually changes to light red, dark red, or even purplish red. The nodule tends to necrotize, soften, ulcerate, and discharge gum-like secretions, forming specific round, oval, or horseshoe-shaped ulcers with clear boundaries, raised edges like embankments, surrounded by brownish red or dark red infiltrates, hard to touch. Often, one end heals while the other continues to spread like a snake.
2. Nodular syphilid: Mostly occurs 3-4 years after infection, commonly found on the head, shoulders, back, and extensor surfaces of the limbs. It appears as a group of infiltrative nodules about 0.3-1.0 cm in diameter, copper-red in color, with smooth surfaces or thin scales, hard in texture, asymptomatic. The evolution of the nodules may have two outcomes, one being the flattening and absorption of the nodules, leaving small atrophic patches with long-lasting deep brown pigmentation. The other outcome is central necrosis, forming small abscesses, ulcerating to form nodular ulcerative syphilid, leaving superficial scars after healing. The scars are surrounded by pigmentation, the atrophic areas are smooth and thin, and new lesions may appear at the edges. This is characteristic of this condition. Old and new rashes alternate, new ones continue to emerge, and the condition can persist for years.
3. Syphilitic cardiovascular disease: Caused by Treponema pallidum invading the cardiovascular system in the late stage (tertiary), including syphilitic aortitis, syphilitic aortic valve insufficiency, syphilitic aortic aneurysm, coronary ostial stenosis, and myocardial gumma.
Tertiary syphilis generally occurs 2 years after the onset but may last as long as 3-5 years. It is most common between the ages of 40-50. Tertiary syphilis causes severe damage to the skin, manifesting as syphilides, and many patients develop gummas. If cardiovascular disease is also present, it indicates that syphilis has invaded the cardiovascular system, signifying a very serious condition.
