Syphilis Flashcards
What is syphilis?
Treponema pallidum
Transmitted by?
Sex
Trans-placental/during birth
Staging of syphilis?
Early infectious
- Primary
- Secondary
- Early latent
Late non-infectious:
- Late latent
- Tertiary
Presentation of primary syphilis?
Lesion is traditionally known as primary chancre (painless)
Lesions appear at site of inoculation
Non-tender local lymphadenopathy
Secondary syphilis presentation?
Skin: macular, follicular or pustular rash on palms and soles
Lesions of mucous membranes
Generalized lymphadenopathy, fever, sore throat
Malaise
Anterior uveitis
Cranial nerve lesions
Condylomata lata
Testing for syphilis if symptomatic?
Symptomatic: Cervical microscopy (gram stain) Vaginal microscopy (gram stain) Urethral microscopy (gram stain)
Why would you do Amies swab?
Recurrent/persistent discharge -Vaginitis of unknown cause -Pregnant -Post partum Post gynae surgery/instrumentation or signs of PID
Investigation for signs of treponoma pallidum?
Dark field microscopy
PCR
What is condylomata lata?
Highly infectious lesion in syphilis
Exudes serum teeming with treponemes
Treating early syphilis?
2.4 MU benzathine (penicillin stat)
Late syphilis treatment?
2.4 MU benzathine penicillin weekly x3 weeks
Following up syphilis treatment?
Until RPR is negative or serofast
Titres should decrease fourfold by 3-6 months in early
-Concern re serological relapse/reinfection if titres increases by 4 fold
Serologcal testing of non-treponmeal?
VDRL: Venereal disease research lab
RPR: Rapid plasma reagin
Serological testing for treponemal?
ELISA/EIA
TPPA
INNO-LIA
FTA abs
Syphilis organism
Spirochete bacteria treponema pallidum
Doesn’t gram stain: diagnosis relies on PCR or serological tests
Dark field microscopy
Test to monitor syphilis?
RPR
4 stages of syphilis?
Primary
Secondary
Latent
Tertiary
Primary stage?
10-90 days
Primary chancre
Appears at site of inoculation
Heal within 2-6 weeks
Secondary stage?
Between 6-10 weeks after primary chancre get snail track ulcers Red maculopapular rash on palsm and soles of feet Typically not itchy Malaise Generalized lymphadenopathy Anterior uveitis Fever Sore throar
Latent stage?
Early latent:<2 years after acquiring
Late latent >2 years after infection
Tertiary stage?
-2-30 years
Gummatous growths
CVS syphilis causes aortitis, aortic regurg, aneurysms if ascending aorta and coronary artery
Stenosis
Neurosyphilis: meningovascular damage and endarteritis of small vessels of brain and SC causing general paralysis of insane
