DRG Category: 868

Mean LOS: 5.4 days

Description MEDICAL: Other Infectious and Parasitic Diseases Diagnoses with CC

classification section:



Syphilis is a chronic, infectious, systemic, sexually transmitted vascular infection characterized by five stages: incubation, primary, secondary, latency, and late. The incubation stage begins with the penetration of the infecting organism, the spirochete Treponema pallidum, into the skin or mucosa of the body. Within 10 to 90 days after the initial infection, the primary stage begins with the appearance of a firm, painless lesion called a chancre at the site of entry. In women, the chancre often forms in the vagina or on the cervix and therefore goes unnoticed. If it is left untreated, the chancre heals spontaneously in 1 to 5 weeks. As this primary stage resolves, systemic symptoms appear, signaling the start of the secondary stage. Secondary stage symptoms include malaise, headache, nausea, fever, loss of appetite, sore throat, stomatitis, alopecia, condylomata lata (reddish-brown lesions that ulcerate and have a foul discharge), local or generalized rash, and silver-gray eroded patches on the mucous membranes. These symptoms subside in 1 week to 6 months, and the infected person enters a latent stage, which may last from 1 to 40 years. During latency, periodic symptoms of secondary syphilis may recur.

Approximately one-third of untreated syphilis patients eventually progress to the late or tertiary stage of syphilis; the complications are often disabling and life threatening. In this stage, destructive lesions called gummas develop in either the skin, bone, viscera, central nervous system, or cardiovascular system. Three subtypes of late syphilis are late benign syphilis, cardiovascular syphilis, and neurosyphilis. Late benign syphilis can result in destruction of the bones and body organs, which leads to death. Cardiovascular syphilis develops in approximately 10% of untreated patients and can cause aortitis, aortic regurgitation, aortic valve insufficiency, and aneurysm. Neurosyphilis develops in approximately 8% of untreated patients and can cause meningitis and paresis.