STD - Treponema Pallidum (Syphilis)

Question 1

Morphology

Answer 1

Spirochete

Motile

Question 2

Classification/Diagnosis

Answer 2

Cannot be cultured
Cannot see under light microscope
test by Darkfield microscopy
Two step serologic test (screening test of IgM/IgG against neotrponemal antigen, confirmatory test of IgM/IgG against T.pallidum)

Question 3

Pathology

Answer 3

enters mucosa, proliferates, activates macrophages
Travels to lymph nodes, bloodstream, sometimes invades CNS
Immunity present with chronic infection but lost after treatment

Question 4

Epidemiology

Answer 4

Direct contact with active lesions or infected membranes
Congenital
Bloodborne
MSM (men sex with men) at higher risj

Question 5

Diseases/Symptoms

Answer 5

Primary infection (single painless ulcer/chancre around 21 days)
Secondary disease (protean manifestations within 2-8 weeks after chancre, rash, condylomata lata, alopecia, constitutional symptoms, CNS disease, etc.)
Latent disease (asymptomatic)
tertiary disease (gummatous lesions in 10-15 yrs, cardiovascular thoracic aortic aneurysm in 20-30 yrs, meningovascular neurosyphilis in 5-10 yrs, parenchymatous neurosyphilis in 20 yrs, tabes dorsales in 25 yrs)

Question 6

Treatment/Vaccinations

Answer 6

penicillin G

Doxycycline if allergic to penicillin (if non-pregnant, non-HIV)