Sexual Health Flashcards
Syphilis HIV co-infection
40%
How many women screen positive for syphilis require treatment in pregnancy?
40%
Risk factors for syphilis in pregnancy
Low socioeconomic status
Multip
History STIs
Illicit drug use before 18yo
>3 sexual partners in 12 months
How many patients exposed to syphilis will contract infection
1/3
What is Early latent syphilis
Infection within the past 1 year
What is late latent syphilis
Infection more than 1 year ago
How long do chancres take to heal?
3-8 weeks
Risk of secondary syphilis without treatment
25%
How long does it take for secondary syphilis to resolve?
1-3 months
What is secondary syphilis?
Syphilis 4-10 weeks after primary infection
Mucocutaneous rash
Malaise and loss of appetite
Infectious condylomata
Risk of tertiary syphilis if left untreated
30%
When can spirochete bacteria cross the placenta?
From 14 weeks
Consequence of fetal syphilis
Fetal loss 40%
1/3 congenital syphilis
FGR
PTB
NND
Hepatomegaly
Thrombocytopenia
Anaemia
Ascites
Transmission risk of primary, early latent and late latent syphilis
100%
40%
10%
USS features of syphilis infection
Ascites
Hydrops
Hepatosplenomegaly
Placentomegaly
Intrahepatic calcification
Incubation period of syphilis
6-12 weeks
Causes of false positive tests for syphilis
Endocarditis
SLE
Yaws
Optimal treatment time of syphilis before delivery?
30 days minimum
Treatment of early syphilis 1st and 2nd trimester
Stat 2.4 MU IM benzathine penicillin G
OR
500mg ceftriaxone IM for 10/7
Treatment of early syphilis in 3rd trimester
Benzathine penacillin 2.4MU IM weekly for 2 doses
OR
Ceftriaxone 500mg IM OD for 10/7
What is Jarish-Herxheimer reaction?
Fever + rigours + skin rash following syphilis treatment
Can cause uterine contractions
Risk of jarisch-herxheimer reaction in pregnancy?
50% in primary syphilis
90% secondary syphilis
25% latent syphilis
When does Jarisch-Herxheimer reaction occur?
Within 24 hours of syphilis treatment
Asymptomatic Congenital syphilis
2/3 at birth
When do symptoms of congenital syphilis occur?
3-8 weeks of life
Signs of early congenital syphilis?
Skin rashes
Stigmata of meningitis
Jaundice
Hepatosplenomegaly
Anaemia
Periositis
Syphilitic rhinitis - bloody snuffles
Early congenital syphilis
First 2 years of life
Late congenital syphilis
After first 2 years of life
Signs of late congenital syphilis
Hutchinson’s teeth
8th nerve deafness
Interstitial keratitis
Saddle nose
Sabre shins
Asymptomatic neurosyphilis
Treatment of late latent, cardiovascular and gummatous syphilis in pregnancy
Benzathine penicillin G 2.4 million units IM weekly days 1,8 and 15
For cardiac - 40-60mg prednisolone OD for 3/7 24 hours prior to abx
Treatment of neurosyphilis in pregnancy
Procaine penicillin G 2.4 million units IM OD + pro-benecid 500mg PO QDS for 14/7
Benpen 1.8-2.4g IV 4 hourly for 14/7
