BACTERIAL INFECTIONS (SYPHILIS)

Question 1

CONCEPT

Answer 1

VENERAL DISEASE

Question 2

CAUSE

Answer 2

• TREPONEMA PALLIDUM (ANAEROBIC SPIROCHETE)
• PRIMARY MODE TRANSMISSION: SEXUAL CONTACT (MOTHER TO FETUS)

Question 3

CHARACTERISTIQUES

Answer 3

• EVOLUTION 3 STAGES
• HIGHLY INFECTIOUS: DURING FIRST 2 STAGES
• PREGNANT WOMEN: CAN TRANSMIT TO FETUS DURING THE LATENT STAGE
• CONGENITAL SYPHILIS: CLINICAL CHANGES SECONDARY TO THE FETAL INFECTION

Question 4

STAGES

Answer 4

• PRIMARY SYPHILIS:
• CHANCRE/CLINICALLY EVIDENT (3- 90 DAYS)
• ORAL LESIONS: LIP (MOST COMMONLY)/BUCCAL MUCOSA/TONGUE/PALATE/GINGIVA/TONSILS
• CHANCRE: SOLITARY PAINLESS ULCERATION (NO EXUDATE)
• REGIONAL LYMPHADENOPATHY: BILATERAL (MOST)
• UNTRATED: INITIAL LESION HEALS 3-8 WEEKS
• SECONDARY (DISSEMINATED) SYPHILIS:
• CLINICALLY 4-10 WEEKS AFTER INITIAL INFECTION
• SYSTEMIC SYMPTOMS (PAINLESS LYMPHADENOPATHY/SORE THROAT/MALAISE/HEADACHE/WEIGHT LOSS/FEVER/MUSCULOSKELETAL PAIN
• ORAL SYMPTOMS: REDDISH BROWN MACULOPAPULAR CUTANEOUS RASH/MUCOSAL ULCERS (SNAIL’S TRACK ULCERS - MUCOUS PATCHES)
• ELEVATED BROAD-BASED VERRUCAL PLAQUES (CONDYLOMATA LATA - SKIN/MUCOSAL SURFACES)
• TERTIARY SYPHILIS:
• AFTER SECOND STAGE, FREE LESIONS/SYMPTOMS (LATENT SYPHILIS - 1 TO 30 YEARS)
• MOST SERIOUS COMPLICATIONS: VASCULAR/CENTRAL NERVOUS SYSTEM (CNS) CAN BE AFFECTED SIGNIFICANTLY (NEUROSYPHILIS)
• CHARACTERISTIC LESIONS: SCATTERED FOCI OF GRANULOMATOUS INFLAMMATION (SKIN, MUCOSA, SOFT TISSUE, BONES, INTERNAL ORGANS - GUMMA)
• GUMMA: INDURATED, NODULAR OR ULCERATED LESION PRODUCE EXTENSIVE TISSUE DESTRUCTION (PALATE - PERFORATE TO NASAL CAVITY/TONGUE)
• GENERALIZED GLOSSITIS (MUCOSAL ATROPHY)
• CONGENITAL SYPHILIS:
• CAUSED INFECTION (BACTERIA) DURING FETAL DEVELOPMENT
• COMMON PATTER: HUTCHINSON TRIAD:
  1) INFLAMMATORY REACTION CORNEA (INTERSTITIAL KERATITIS)
  2) EIGHTH-NERVE DEAFNESS
  3) DENTAL ABNORMALITIES (HUTCHINSON TEETH)
• INFANTS INFECTED: DISPLAY SIGNS 2-3 WEEKS OF BIRTH
• ANTERIOR TEETH ALTERED BY SYPHILIS: HTCHINSON INCISORS (CROWNS SHAPED LIKE STRAIGHT-EDGE SCREWDRIVERS)
• ALTERED POSITON TEETH: MULBERRY MOLARS (CONSTRICTED OCCLUSAL TABLES WITH A DISORGANIZED SURGACE ANTOMY RESEMBLES BUMPY SURFACE OF A MULBERRY

Question 5

DIAGNSOSIS

Answer 5

DEMONSTRATING THE SPIRAL ORGANISM BY BIOPSY OR DARK-FIELD EXAMINATION OF A SMEAR OF AN ACTIVE LESION

Question 6

TREATMENT

Answer 6

PENICILIN (DOSE/ADMINISTRATION VARY ACCORDING STAGE/NEUROLOGIC INVOLVEMENT/IMMUNE STATUS)