November 30, 2015 - Syphilis

Question 1

Why Syphilis is a Public Health Nightmare

Answer 1

1. Very contagious disease (33% risk)
2. Long incubation period
3. Infectious before disease is visible
4. Long period of infectivity
5. Easy to ignore symptoms
6. May be asymptomatic
7. Potentially fatal complications (25% chance)
8. Spread from mother to fetus

Question 2

Natural History of Syphilis

Answer 2

Primary - a painless chancre (open sore) forms. This will heal up if not treated, and the disease will progress to the secondary state.

Secondary - the disease disseminates through all the tissues of the body. This can lead to the development of a rash, alopecia, bone pain, and genital warts.

Latent (asymptomatic) - the disease goes dormant.

Teriary - in 25% of patients the bacteria “wakes up” and can cause neurovascular problems, cardiovascular problems, gummatous problems, and congenital problems.

Question 3

Chancre

Answer 3

A painless ulcer that is present in syphilis.

Question 4

Papulosquamous Rash

Answer 4

Can be a sign of secondary syphilis.

This occurs on the palms of the hands and/or the soles of the feet. VERY FEW THINGS WILL AFFECT THIS AREA. THIS IS CHARACTERISTIC OF SYPHILIS.

Question 5

Neurosyphilis

Answer 5

Asymptomatic…

Meningovascular (typically 5 years later)

General Paresis of the Insane (usually 20 years later)

Tabes dorsalis (Usually 40 years later - lose ability to know where limbs are)

Gummatous neurosyphilis (basically brain tumor)

Question 6

Snuffles

Answer 6

In babies that are hours old.

This is pathopneumonic of syphilis.

Question 7

Syphilis Diagnosis

Answer 7

Done by lab tests.

Extremely sensitive ( ~100%)