Syphilis Flashcards
What is the causative agent of syphilis?
Treponema pallidum.
How is syphilis transmitted?
Sexual, congenital, and bloodborne.
What is the primary disease progression of syphilis?
Painless ulcer ~ 3 weeks after infection.
What is the secondary disease progression of syphilis?
~1-2 months after primary progression, a systematic dissemination will occur: rash; lymphadenopathy; possible neurological symptoms.
What is the latent disease progression of syphilis?
No clinical symptoms; remains dormant. Mother can pass off to unborn fetus (congenital syphilis).
What is the tertiary disease progression of syphilis?
Appears 10-30 years later if left untreated. Granulomas on bones, skin and tissues. Cardiovascular complications. Neurosyphilis.
What happens to babies born to mothers with untreated syphilis?
Stillborn or die from infection.
What are the two methods for syphilis laboratory diagnosis?
Direct and serological detection.
What testing method is used for direct detection in syphilis?
Fluorescent antibody testing (tissue fix on slide).
What must be present in order for direct detection of syphilis to be accurately measured?
Skin lesions.
What testing method is used for serological detection in syphilis?
Nontreponemal testing: screening
Treponemal testing: confirmatory
Screening for syphilis has a high sensitivity, and low specificity, which may produce what kind of results?
False-positives.
Describe what nontreponemal testing detects.
Presence of reagin that forms against cardiolipin that is released from damaged cells.
Describe VDRL testing for syphilis.
Flocculation - precipitation reaction that occurs over a narrow range of particle concentration.
What is the microscopic results for the following VDRL results: nonreactive, weakly reactive, and reactive?
Nonreactive - no clumping
Weakly reactive - small clumps present
Reactive - medium to large clumps present
Describe the RPR test for syphilis testing.
RPR (rapid plasma reagin) uses agglutination reaction that uses cardiolipin bound to charcoal.
Describe Treponemal testing.
Fluorescent treponeme antibody absorption test; indirect fluorescent antibody.
Describe the Treponemal testing process.
Nonpathologic T. Pallidum strain is fixed a slide, patient antibodies are added, incubated, and washed.
AHG with fluorescent tag is added, incubated, than washed again.
What type of agglutination is T. pallidum particle agglutination for confirmatory testing?
Passive.
What should a patient be tested for syphilis?
Pregnant women; sexually active MSM; HIV and sexually active patient.
What type of serological testing can be used for presumptive diagnosis?
A nontreponemal test and confirmatory treponemal test.
