Lecture 2: Syphilis

Question 1

How can treponema be visually detected?

Answer 1

Darkfield microscopy.

Can’t culture or gram stain.

Question 2

How does invasion progress with Treponema pallidum?

Answer 2

Directly to lymphatics and blood - no build-up.

Question 3

The virulence of syphilis is dependent on…

Answer 3

Immune evasion. Low inflammation.

Question 4

How is Treponema Pallidum spread?

Answer 4

Sexual contact or congenital infection.

Question 5

How are yaws and pinta transmitted?

Answer 5

Skin contact

Question 6

What characterizes the antibody response to treponema?

Answer 6

Large quantities of mostly useless abs (reagin).

Question 7

Describe the stages of treponema pallidum infection.

Answer 7

1. Primary chancre
2. Secondary body-wide rashes, condyloma lata, patchy alopecia

Latent period

3. Tertiary gummas, cardiac involvement, neurosyphilis.

Question 8

What are symptoms of neurosyphilis?

Answer 8

Meningitis, tabes dorsalis, general paresis.

Check for Argyll-Robertson pupil (does not constrict to light, does constrict to near focus on an object)

Question 9

Describe complications of congenital syphilis infection.

Answer 9

50% fetus and newborns die.

Survivors: Bone deformities, interstitial keratosis, progress rapidly to secondary and tertiary symptoms of syphilis.

Question 10

What are the best labs for Syphilis management?

Answer 10

Syphilis serology for reagin (VDRL, RPR) test for disease-in-progress and efficacy of treatment.

Confirm exposure with treponeme-specific antibodies.

Question 11

What drug should be used to treat syphilis?

Answer 11

Penicillin G.