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Syphilis LatencyLatency The secondary stage subsides and the patient enters a latent period. The diagnosis can then only be established with a positive serologic test for syphilis during the latent period. Relapses of secondary syphilis can occur up to 4 years after contact. This period when relapses are possible is called the early latent period. Relapses are very unlikely after this time and this period is called the late latent stage. Seventy-five percent of relapses occur within the first year and are a consequence of an immune dysfunction in cellular immunity such as occurs in the last trimester of pregnancy. Late syphilis The term late syphilis refers to the clinically apparent or inapparent tertiary disease that develops in up to one third of untreated patients. Most of these lesions involve the vaso vasorum of the aorta or the arteries of the CNS, or both; the rest consist principally of gummas, a unique granulomatous lesion with a coagulated or amorphous center and small vessel endarteritis. The skin, liver, bones, and spleen are the most common sites for development of gummas. |