Late syphilis

Tertiary manifestation of syphilis, which is very rare, may be 'benign' with development of gummas (granulomatous lesions) in almost any organ, or more serious with cardiovascular or central nervous system involvement. Benign gummatous disease is rare but cardiovascular disease and neurosyphilis occasionally occur. Careful management and follow-up of patients with early or latent disease is essential to prevent late sequelae.

Late syphilis should be excluded in any patient with aortic incompetence or dilatation of the ascending arch of the aorta. Syphilis should be excluded as the cause of dementia, personality change, multifocal neurological disorders, nerve deafness, pupillary abnormalities, retinal disease or uveitis.

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