Syphilis Flashcards
Explain syphillis to a patient.
A sexually transmitted infection that can cause kidney, liver, pregnancy, blood vessel, and brain problems.
What bacteria causes syphilis?
Treponema pallidum
What is the primary stage of syphilis?
Occurs within 3 weeks of exposure
Highly infectious.
Usually a painless genital chancre +/- swollen lymph nodes
What is the secondary stage of syphilis?
Brown, maculopapular rash that usually involves the palms and soles of the feet and mucous membranes
Usually have associated constitutional symptoms
What is the latent stage of syphilis?
Symptoms of primary and secondary syphillis have resolved
Can still be contagious
Can last upwards of 20 years
What is tertiary syphilis?
Very destructive symptoms, such as gummata (large sores on the skin)
Aneurysms
Neuropathies, meningitis, and dementia
What is first line treatment for syphilis?
Benzathine penicillin (Bicillin)
A patient was treated for syphillis and presents with fever, chills, headache, and a rash. What is the diagnosis?
Jarisch-Herxheimer reaction to Bicillin.
Explain the problem of syphilis and pregnancy to a patient.
40% of pregnancies will be stillborn or the infant will die as a newborn.
Infants who survive can have bone, anemia, liver, spleen, or CNS disease.
40% of pregnancies will be stillborn or the infant will die as a newborn.
Infants who survive can have bone, anemia, liver, spleen, or CNS disease.
Pathophysiologically speaking, why are people with syphilitic chancres more prone to HIV infections?
Chancres have lymphocytes; serves as excellent portal of entry and transmission of the HIV virus.
What demographic is most at risk for syphilis?
Men who have sex with men.
What is the test of choice to screen for syphilis, and what is the limitation of this test?
Syphilis enzyme immunoassay (EIA)
Once positive, will always be positive, even if successfully eradicated disease in the past.
What is the Rapid Plasma reagin (RPR) test for syphilis?
Reflects disease burden; can base treatment response and re-infection based on this result.
You treated a person with new onset syphilis infection. What are the next steps to monitor response?
Repeat rapid plasma reagin (RPR) test in 6 and 12 months.
Tell me about the EIA, RPR, and TPPA tests for syphilis.
Enzyme immuno assay: Measures antibodies, once positive always positive.
Rapid plasma reagin: Measures disease activity, monitors treatment response, and re-infection.
Treponema pallidum particle agglutination test: Confirms EIA positive specimens, only done when positive for the first time.
