STI's- Syphilis

Question 1

What is it caused by?

Answer 1

Treponema Pallidum

Question 2

What are the stages and symptoms associated with the stages?

Answer 2

Primary- small, painless sore or local ulcer (chancre)
Secondary- rash, mucosal ulceration, neuro symptoms, patchy alopecia etc
Early Latent- no symptoms but <2 years since caught
Late Latent- no symptoms but >2 years since caught
Tertiary- neurological, cardiovascular or gummatous (soft, non-cancerous growth- form of granuloma)

Question 3

what is the epidemiology?

Answer 3

> 90% of cases are in MSM

Question 4

what are complications of syphilis?

Answer 4

• neurosyphilis - cranial nerve palsies are commonest

- congenital syphilis

Question 5

what is the incubation period?

Answer 5

9 to 90 days until appearance of chancre

Question 6

how do you diagnose it?

Answer 6

• clinical signs
• serology for Treponema Pallidum
• PCR on sample from an ulcer

Question 7

What’s the treatment?

Answer 7

Early (<2 years and no neurological involvement) - Benzathine Penicillin once OR Doxycycline for 2 weeks
Late (>2 years and no neurological involvement) - Benzathine Penicillin 3 doses AND Doxycycline for 28 days