Quaternary syphilis (syphylis end stage)

General or Other | Emergency Medicine | Quaternary syphilis (syphylis end stage) (Disease)


Quaternary syphilisis an advanced form of syphilis. Quaternary syphilis is syphilis in late stages that has involved the heart or brain (neurosyphilis). Neurosyphilis is a progressive and advanced brain infection (encephalitis).

This may trigger dementia, personality changes, unsteady gait, visual problems, stroke symptoms and seizures.

Causes and Risk factors

Syphilis is caused by bacteria called Treponema pallidum. The bacteria can enter the body if you have close contact with an infected sore, normally during vaginal, anal or oral sex or by sharing sex toys. Syphilis is almost always passed through sexual contact. It also can be passed from an infected mother to her baby during pregnancy.

It may also be possible to catch syphilis if one is an injecting drug user and shares a needle with somebody who is infected.

Diagnosis and Treatment

Argyll Robertson pupil test and a lumbar puncture to evaluate the cerebrospinal fluid are performed for diagnosis.

Late infections need IV penicillin for at least 10 days. If the patient is allergic, ceftriaxone can be used. Other kinds of late disease may be treated with once-weekly intramuscular penicillin G for three weeks. If allergic, doxycycline or tetracycline may be used, for a longer duration. These treatments can stop further progression, but not fully reverse the disease. ...

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