Syphilis: Understanding Latent Stages and the Importance of Screening
Syphilis (Treponema pallidum) progresses through stages:
- Primary: chancre (painless ulcer) at inoculation site; heals spontaneously.
- Secondary: rash (palms/soles), condyloma lata, fever, lymphadenopathy; resolves.
- Latent: Seropositive, no symptoms. Early latent (<1 year) infectious; late latent (>1 year) low infectivity but can transmit vertically.
- Tertiary: Gummas, cardiovascular, neurosyphilis (years-decades later).
Latent syphilis is detectable only by serology (RPR/VDRL + confirmatory FTA-ABS/TP-PA). Screening is essential in pregnancy, HIV, PrEP users, high-risk groups. Penicillin G cures all stages; dosing varies. Jarisch-Herxheimer reaction may occur.
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