Syphilis natural history, complications and prognosis: Difference between revisions

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==Complications==
==Complications==
Complications that can develop as a result of syphilis are:


===Ocular===
*[[Interstitial keratitis]]<ref name="pmid16282150">{{cite journal| author=Kiss S, Damico FM, Young LH| title=Ocular manifestations and treatment of syphilis. | journal=Semin Ophthalmol | year= 2005 | volume= 20 | issue= 3 | pages= 161-7 | pmid=16282150 | doi=10.1080/08820530500232092 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16282150  }} </ref><ref name="pmid16651059">{{cite journal| author=Balba GP, Kumar PN, James AN, Malani A, Palestine AG, Welch JN et al.| title=Ocular syphilis in HIV-positive patients receiving highly active antiretroviral therapy. | journal=Am J Med | year= 2006 | volume= 119 | issue= 5 | pages= 448.e21-5 | pmid=16651059 | doi=10.1016/j.amjmed.2005.11.016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16651059  }} </ref><ref name="pmid17707328">{{cite journal| author=Westeneng AC, Rothova A, de Boer JH, de Groot-Mijnes JD| title=Infectious uveitis in immunocompromised patients and the diagnostic value of polymerase chain reaction and Goldmann-Witmer coefficient in aqueous analysis. | journal=Am J Ophthalmol | year= 2007 | volume= 144 | issue= 5 | pages= 781-5 | pmid=17707328 | doi=10.1016/j.ajo.2007.06.034 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17707328  }} </ref>
*Anterior, intermediate, and posterior [[uveitis] <ref name="pmid7072806">{{cite journal| author=Schlaegel TF, Kao SF| title=A review (1970-1980) of 28 presumptive cases of syphilitic uveitis. | journal=Am J Ophthalmol | year= 1982 | volume= 93 | issue= 4 | pages= 412-4 | pmid=7072806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7072806  }} </ref>
*[[Episcleritis]] <ref name="pmid1590633">{{cite journal| author=Deschenes J, Seamone CD, Baines MG| title=Acquired ocular syphilis: diagnosis and treatment. | journal=Ann Ophthalmol | year= 1992 | volume= 24 | issue= 4 | pages= 134-8 | pmid=1590633 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1590633  }} </ref>
*[[Scleritis]]
*[[Iritis]]<ref name=ocular>Moore, Joseph Earle. "Syphilitic iritis: a study of 249 patients." American Journal of Ophthalmology 14.2 (1931): 110-126.</ref>
*[[Iridocyclitis]]
*[[Vitritis]]
*[[Chorioretinitis]]
*[[Retinitis]]
*Retinal [[vasculitis]]
*[[Optic neuropathy]]
*[[optic neuritis]]
===Auditory===
*[[Sensorineural deafness]]<ref name="pmid1487268">{{cite journal| author=Morrison AW| title=On syphilis and the ear--an otologist's view. | journal=Genitourin Med | year= 1992 | volume= 68 | issue= 6 | pages= 420-2 | pmid=1487268 | doi= | pmc=1194985 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1487268  }} </ref>
===Neurological ===
*[[Meningitis]]<ref name="pmid24365430">{{cite journal| author=Berger JR, Dean D| title=Neurosyphilis. | journal=Handb Clin Neurol | year= 2014 | volume= 121 | issue=  | pages= 1461-72 | pmid=24365430 | doi=10.1016/B978-0-7020-4088-7.00098-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24365430  }} </ref>
*Meningiovascular syphilis<ref name="pmid3890813">{{cite journal| author=Simon RP| title=Neurosyphilis. | journal=Arch Neurol | year= 1985 | volume= 42 | issue= 6 | pages= 606-13 | pmid=3890813 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3890813  }} </ref><ref name="pmid3056164">{{cite journal| author=Lukehart SA, Hook EW, Baker-Zander SA, Collier AC, Critchlow CW, Handsfield HH| title=Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment. | journal=Ann Intern Med | year= 1988 | volume= 109 | issue= 11 | pages= 855-62 | pmid=3056164 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056164  }} </ref>
*[[Argyll-Robertson pupil]]<ref name="pmid19093312">{{cite journal| author=Loewenfeld IE| title=The Argyll Robertson pupil 1869-1969. A critical survey of the literature. | journal=Surv Ophthalmol | year= 1969 | volume= 14 | issue= 3 | pages= 199-299 | pmid=19093312 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19093312  }} </ref>
*[[Stroke]]<ref name="pmid7340118">{{cite journal| author=Hotson JR| title=Modern neurosyphilis: a partially treated chronic meningitis. | journal=West J Med | year= 1981 | volume= 135 | issue= 3 | pages= 191-200 | pmid=7340118 | doi= | pmc=1273113 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7340118  }} </ref>
*Cranial nerve neuropathies <ref name=syphilisCNS>Musher, Daniel M., Richard J. Hamill, and Robert E. Baughn. "Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment." Annals of Internal Medicine 113.11 (1990): 872-881.</ref>
*Parenchymal syphilis<ref name=neurosyphilis>Katz, Debra A., Joseph R. Berger, and Robert C. Duncan. "Neurosyphilis: a comparative study of the effects of infection with human immunodeficiency virus." Archives of neurology 50.3 (1993): 243-249.</ref>
:*[[General paresis of the insane|Generalized paresis of the insane]] 
:*[[Tabes dorsalis]]
===Cardiovascular ===
*[[Syphilitic aortitis]]<ref>{{cite journal | author=Sapira JD | title="Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations" | journal=South Med J. | date=1981 Apr | volume=74 | issue=4 | pages=459-67 }}</ref>
*[[Aortic aneurysm]]<ref name="pmid11870245">{{cite journal| author=Pugh PJ, Grech ED| title=Images in clinical medicine. Syphilitic aortitis. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 9 | pages= 676 | pmid=11870245 | doi=10.1056/NEJMicm010343 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11870245  }} </ref>
*[[Aneurysm]] of [[sinus of Valsalva]]
*[[Aortic regurgitation]]
*Coronary artery [[ostial stenosis]]<ref name="pmid16179782">{{cite journal| author=Kennedy JL, Barnard JJ, Prahlow JA| title=Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction and death. | journal=Cardiology | year= 2006 | volume= 105 | issue= 1 | pages= 25-9 | pmid=16179782 | doi=10.1159/000088337 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16179782  }} </ref><ref name="pmid9518283">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 10-1998. A 46-year-old man with chest pain and coronary ostial stenosis. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 13 | pages= 897-903 | pmid=9518283 | doi=10.1056/NEJM199803263381308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9518283  }} </ref><ref name=syphilisCVS>Burch, George E., and Travis Winsor. "Syphilitic coronary stenosis, with myocardial infarction." American Heart Journal 24.6 (1942): 740-751.</ref>
*[[Heart failure]]
===Renal===
*Transient [[albuminuria]]
*[[Nephrotic syndrome]] <ref name="pmid8439646">{{cite journal| author=Hunte W, al-Ghraoui F, Cohen RJ| title=Secondary syphilis and the nephrotic syndrome. | journal=J Am Soc Nephrol | year= 1993 | volume= 3 | issue= 7 | pages= 1351-5 | pmid=8439646 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8439646  }} </ref>
*Acute [[nephritis]]
*[[Acute renal failure]]
*[[Membranous glomerulonephritis]]
*Diffuse endocapillary glomerulonephritis
===Musculoskeletal ===
*[[Synovitis]]
*[[Charcot joints]]<ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456  }} </ref>
*[[Arthritis]]
*[[Osteitis]]<ref name="pmid8502778">{{cite journal| author=Reginato AJ| title=Syphilitic arthritis and osteitis. | journal=Rheum Dis Clin North Am | year= 1993 | volume= 19 | issue= 2 | pages= 379-98 | pmid=8502778 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8502778  }} </ref>
*[[Periostitis]]<ref name="pmid2921046">{{cite journal| author=Mindel A, Tovey SJ, Timmins DJ, Williams P| title=Primary and secondary syphilis, 20 years' experience. 2. Clinical features. | journal=Genitourin Med | year= 1989 | volume= 65 | issue= 1 | pages= 1-3 | pmid=2921046 | doi= | pmc=1196177 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2921046  }} </ref>
===Dermatological ===
*Syphilidis(macular, maculopapular scaly lesions)<ref name="pmid17560432">{{cite journal| author=Wöhrl S, Geusau A| title=Clinical update: syphilis in adults. | journal=Lancet | year= 2007 | volume= 369 | issue= 9577 | pages= 1912-4 | pmid=17560432 | doi=10.1016/S0140-6736(07)60895-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560432  }} </ref>
*[[Pustular]] syphilis
*[[Condyloma lata]]<ref name="pmid7455863">{{cite journal| author=Chapel TA| title=The signs and symptoms of secondary syphilis. | journal=Sex Transm Dis | year= 1980 | volume= 7 | issue= 4 | pages= 161-4 | pmid=7455863 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7455863  }} </ref>
*[[lues maligna]]<ref>http://medical-dictionary.thefreedictionary.com/Lues+maligna</ref> <ref name="pmid19035775">{{cite journal| author=Pleimes M, Hartschuh W, Kutzner H, Enk AH, Hartmann M| title=Malignant syphilis with ocular involvement and organism-depleted lesions. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 1 | pages= 83-5 | pmid=19035775 | doi=10.1086/594127 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19035775  }} </ref><ref name="pmid5761808">{{cite journal| author=Fisher DA, Chang LW, Tuffanelli DL| title=Lues maligna. Presentation of a cas and a review of the literature. | journal=Arch Dermatol | year= 1969 | volume= 99 | issue= 1 | pages= 70-3 | pmid=5761808 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5761808  }} </ref><ref name=syphilisCNS>Musher, Daniel M., Richard J. Hamill, and Robert E. Baughn. "Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment." Annals of Internal Medicine 113.11 (1990): 872-881.</ref>
*[[Alopecia]]<ref name="pmid7455863">{{cite journal| author=Chapel TA| title=The signs and symptoms of secondary syphilis. | journal=Sex Transm Dis | year= 1980 | volume= 7 | issue= 4 | pages= 161-4 | pmid=7455863 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7455863  }} </ref>
===Gastrintestinal===
*[[Hepatitis]]<ref name="pmid1401840,">{{cite journal| author=Young MF, Sanowski RA, Manne RA| title=Syphilitic hepatitis. | journal=J Clin Gastroenterol | year= 1992 | volume= 15 | issue= 2 | pages= 174-6 | pmid=1401840, | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1401840  }} </ref>
*[[Hepatosplenomegaly]]<ref name="pmid17560432">{{cite journal| author=Wöhrl S, Geusau A| title=Clinical update: syphilis in adults. | journal=Lancet | year= 2007 | volume= 369 | issue= 9577 | pages= 1912-4 | pmid=17560432 | doi=10.1016/S0140-6736(07)60895-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560432  }} </ref><ref name="pmid426583">{{cite journal| author=Campisi D, Whitcomb C| title=Liver disease in early syphilis. | journal=Arch Intern Med | year= 1979 | volume= 139 | issue= 3 | pages= 365-6 | pmid=426583 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=426583  }} </ref>
*Non specific gastritis <ref name="pmid8113584">{{cite journal| author=Greenstein DB, Wilcox CM, Schwartz DA| title=Gastric syphilis. Report of seven cases and review of the literature. | journal=J Clin Gastroenterol | year= 1994 | volume= 18 | issue= 1 | pages= 4-9 | pmid=8113584 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8113584  }} </ref>
*Gastric ulcers<ref name="pmid1733388">{{cite journal| author=Winters HA, Notar-Francesco V, Bromberg K, Rawstrom SA, Vetrano J, Prego V et al.| title=Gastric syphilis: five recent cases and a review of the literature. | journal=Ann Intern Med | year= 1992 | volume= 116 | issue= 4 | pages= 314-9 | pmid=1733388 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1733388  }} </ref>
===Gummatous lesions===
*CNS<ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456  }} </ref><ref name="pmid17560432">{{cite journal| author=Wöhrl S, Geusau A| title=Clinical update: syphilis in adults. | journal=Lancet | year= 2007 | volume= 369 | issue= 9577 | pages= 1912-4 | pmid=17560432 | doi=10.1016/S0140-6736(07)60895-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560432  }} </ref><ref name="pmid27088540">{{cite journal| author=Zhang L, Zhou Y, Chen J, Yan W, Kong Q, Chen P et al.| title=A case of a cerebral syphilitic gumma developed in a few months mimicking a brain tumor in a human immunodeficiency virus-negative patient. | journal=Br J Neurosurg | year= 2016 | volume=  | issue=  | pages= 1-3 | pmid=27088540 | doi=10.3109/02688697.2016.1173190 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27088540  }} </ref>
*Bone
*skin


==Prognosis==
==Prognosis==

Revision as of 16:25, 22 September 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Natural history

Complications

Complications that can develop as a result of syphilis are:

Ocular

Auditory

Neurological

Cardiovascular

Renal

Musculoskeletal

Dermatological

Gastrintestinal

Gummatous lesions

Prognosis

References

  1. ↑ Kiss S, Damico FM, Young LH (2005). "Ocular manifestations and treatment of syphilis". Semin Ophthalmol. 20 (3): 161–7. doi:10.1080/08820530500232092. PMID 16282150.
  2. ↑ Balba GP, Kumar PN, James AN, Malani A, Palestine AG, Welch JN; et al. (2006). "Ocular syphilis in HIV-positive patients receiving highly active antiretroviral therapy". Am J Med. 119 (5): 448.e21–5. doi:10.1016/j.amjmed.2005.11.016. PMID 16651059.
  3. ↑ Westeneng AC, Rothova A, de Boer JH, de Groot-Mijnes JD (2007). "Infectious uveitis in immunocompromised patients and the diagnostic value of polymerase chain reaction and Goldmann-Witmer coefficient in aqueous analysis". Am J Ophthalmol. 144 (5): 781–5. doi:10.1016/j.ajo.2007.06.034. PMID 17707328.
  4. ↑ Schlaegel TF, Kao SF (1982). "A review (1970-1980) of 28 presumptive cases of syphilitic uveitis". Am J Ophthalmol. 93 (4): 412–4. PMID 7072806.
  5. ↑ Deschenes J, Seamone CD, Baines MG (1992). "Acquired ocular syphilis: diagnosis and treatment". Ann Ophthalmol. 24 (4): 134–8. PMID 1590633.
  6. ↑ Moore, Joseph Earle. "Syphilitic iritis: a study of 249 patients." American Journal of Ophthalmology 14.2 (1931): 110-126.
  7. ↑ Morrison AW (1992). "On syphilis and the ear--an otologist's view". Genitourin Med. 68 (6): 420–2. PMC 1194985. PMID 1487268.
  8. ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
  9. ↑ Simon RP (1985). "Neurosyphilis". Arch Neurol. 42 (6): 606–13. PMID 3890813.
  10. ↑ Lukehart SA, Hook EW, Baker-Zander SA, Collier AC, Critchlow CW, Handsfield HH (1988). "Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment". Ann Intern Med. 109 (11): 855–62. PMID 3056164.
  11. ↑ Loewenfeld IE (1969). "The Argyll Robertson pupil 1869-1969. A critical survey of the literature". Surv Ophthalmol. 14 (3): 199–299. PMID 19093312.
  12. ↑ Hotson JR (1981). "Modern neurosyphilis: a partially treated chronic meningitis". West J Med. 135 (3): 191–200. PMC 1273113. PMID 7340118.
  13. ↑ 13.0 13.1 Musher, Daniel M., Richard J. Hamill, and Robert E. Baughn. "Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment." Annals of Internal Medicine 113.11 (1990): 872-881.
  14. ↑ Katz, Debra A., Joseph R. Berger, and Robert C. Duncan. "Neurosyphilis: a comparative study of the effects of infection with human immunodeficiency virus." Archives of neurology 50.3 (1993): 243-249.
  15. ↑ Sapira JD (1981 Apr). ""Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations"". South Med J. 74 (4): 459–67. Check date values in: |date= (help)
  16. ↑ Pugh PJ, Grech ED (2002). "Images in clinical medicine. Syphilitic aortitis". N Engl J Med. 346 (9): 676. doi:10.1056/NEJMicm010343. PMID 11870245.
  17. ↑ Kennedy JL, Barnard JJ, Prahlow JA (2006). "Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction and death". Cardiology. 105 (1): 25–9. doi:10.1159/000088337. PMID 16179782.
  18. ↑ "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 10-1998. A 46-year-old man with chest pain and coronary ostial stenosis". N Engl J Med. 338 (13): 897–903. 1998. doi:10.1056/NEJM199803263381308. PMID 9518283.
  19. ↑ Burch, George E., and Travis Winsor. "Syphilitic coronary stenosis, with myocardial infarction." American Heart Journal 24.6 (1942): 740-751.
  20. ↑ Hunte W, al-Ghraoui F, Cohen RJ (1993). "Secondary syphilis and the nephrotic syndrome". J Am Soc Nephrol. 3 (7): 1351–5. PMID 8439646.
  21. ↑ 21.0 21.1 Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.
  22. ↑ Reginato AJ (1993). "Syphilitic arthritis and osteitis". Rheum Dis Clin North Am. 19 (2): 379–98. PMID 8502778.
  23. ↑ Mindel A, Tovey SJ, Timmins DJ, Williams P (1989). "Primary and secondary syphilis, 20 years' experience. 2. Clinical features". Genitourin Med. 65 (1): 1–3. PMC 1196177. PMID 2921046.
  24. ↑ 24.0 24.1 24.2 Wöhrl S, Geusau A (2007). "Clinical update: syphilis in adults". Lancet. 369 (9577): 1912–4. doi:10.1016/S0140-6736(07)60895-2. PMID 17560432.
  25. ↑ 25.0 25.1 Chapel TA (1980). "The signs and symptoms of secondary syphilis". Sex Transm Dis. 7 (4): 161–4. PMID 7455863.
  26. ↑ http://medical-dictionary.thefreedictionary.com/Lues+maligna
  27. ↑ Pleimes M, Hartschuh W, Kutzner H, Enk AH, Hartmann M (2009). "Malignant syphilis with ocular involvement and organism-depleted lesions". Clin Infect Dis. 48 (1): 83–5. doi:10.1086/594127. PMID 19035775.
  28. ↑ Fisher DA, Chang LW, Tuffanelli DL (1969). "Lues maligna. Presentation of a cas and a review of the literature". Arch Dermatol. 99 (1): 70–3. PMID 5761808.
  29. ↑ Young MF, Sanowski RA, Manne RA (1992). "Syphilitic hepatitis". J Clin Gastroenterol. 15 (2): 174–6. PMID 1401840, Check |pmid= value (help).
  30. ↑ Campisi D, Whitcomb C (1979). "Liver disease in early syphilis". Arch Intern Med. 139 (3): 365–6. PMID 426583.
  31. ↑ Greenstein DB, Wilcox CM, Schwartz DA (1994). "Gastric syphilis. Report of seven cases and review of the literature". J Clin Gastroenterol. 18 (1): 4–9. PMID 8113584.
  32. ↑ Winters HA, Notar-Francesco V, Bromberg K, Rawstrom SA, Vetrano J, Prego V; et al. (1992). "Gastric syphilis: five recent cases and a review of the literature". Ann Intern Med. 116 (4): 314–9. PMID 1733388.
  33. ↑ Zhang L, Zhou Y, Chen J, Yan W, Kong Q, Chen P; et al. (2016). "A case of a cerebral syphilitic gumma developed in a few months mimicking a brain tumor in a human immunodeficiency virus-negative patient". Br J Neurosurg: 1–3. doi:10.3109/02688697.2016.1173190. PMID 27088540.

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