*4.2.3 Syphilis*

Special considerations for Syphilis must be taken considering the different clinical stages at presentation. Primary syphilis classically presents as a single painless ulcer or chancre at the site of infection but can also present with multiple, atypical, or painful lesions. Secondary syphilis manifestations can include skin rash, mucocutaneous lesions, and lymphadenopathy. Tertiary syphilis can present with cardiac involvement, gummatous lesions, tabes dorsalis, and general paresis. Latent infections are those lacking clinical manifestations and are detected by serologic testing; if this was acquired within the preceding year it is referred to as early latent syphilis; all other cases of latent syphilis are classified as late latent syphilis or latent syphilis of unknown duration [2–16].
