Tertiary syphilis: Cardiovascular Syphilis
Warning
Asymptomatic: diagnosed on clinical, radiological and echocardiographic changes.
Symptomatic: usually from aortic valve disease, aneurysmal changes of the aorta or coronary ostial occlusion.
Requires assessment by Cardiologist before treatment. Discuss with senior doctor before referring.
Treatment
Treatment as for late latent syphilis plus Prednisolone 40-60mg orally once daily for three days, starting anti-treponemal treatment 24 hours after commencing Prednisolone.
Partner notification and follow-up as for late latent syphilis but will also need long term follow up with cardiology. Cardiovascular lesions may progress despite adequate treatment for syphilis.