Sephilys Flashcards
Primary stage of Syphilis
Painless genital ulcer (chancre)
Secondary Syphilis manifestations
• Diffuse rash (palms & soles)
• Lymphadenopathy (epitrochlear)
• Condyloma latum
• Oral lesions
• Hepatitis
Tertiary Syphilis manifestations
CNS (tabes dorsalis, dementia)
• Cardiovascular (aortic aneurysm/insufficiency)
• Cutaneous (gummas)
Secondary syphilis typically occurs weeks to months after patients are exposed to
Treponema pallidum
Syphilis is diagnosed using a combination of
nontreponemal (eg, rapid plasma reagin) and treponemal-specific (eg, T pal/idum enzyme immunoassay) serologic tests.
Treatment for secondary syphilis is the same as for primary syphilis
one dose of intramuscular penicillin G
benzathine-which provides up to 3 weeks of treatment-dose penicillin
Secondary syphilis is characterized by
systemic symptoms (fever, malaise), widespread lymphadenopathy (particularly epitrochlear), and a diffuse maculopapular rash that begins on the trunk and extends to the extremities, including the palms and soles.
Risk factors for Neisseria gonorrhoeae infection are shared with many other sexually transmitted pathogens and include age <25, new or
multiple sexual partners, substance abuse, and men who have sexual encounters with men.
Include :
Chlamydia trachomatis infection 40%
HIV, syphilis, and hepatitis B virus.
This reaction is seen primarily in patients with early syphilis treated with antibiotic medication.
Jarisch-Herxheimer reaction.
Jarisch-Herxheimer reaction. Due to
rapid destruction of spirochetes
Manifestations of Jarisch-Herxheimer reaction. are usually self-limited and resolve spontaneously within………… hours.
48
Clinical presentation of Jarisch-Herxheimer reaction
• Acute onset of fevers, chills, myalgias
• Rash progression in secondary syphilis
Although either category may be used to screen for syphilis,………… tests have higher false-negative rates (20%-30°/o) in patients with
primary syphilis
nontreponemal
……… has the highest diagnostic sensitivity (>97%) in patients with early primary syphilis
FTA-ABS
Primary (chancre)
Tx : Penicillin G (IM) x 1 dose
Alternating?
Doxycycline x 14 days
Secondary (diffuse rash)
Tx : Penicillin G (IM) x 1 dose
Alternating?
Doxycycline x 14 days
Latent (asymptomatic)
Tx : Penicillin G (IM) x 3 doses
Alternating ?
Doxycycline x 28 days
Tertiary (eg, CV, gummas)
Tx : Penicillin G (IM) x 14 days
Alternating?
Ceftriaxone x 14 days
