Syphilis Flashcards
Syphilis is caused by what spirochete bacteria?
Treponema pallidum
How is Syphilis most commonly transmitted?
Sex
What is the risk of transmitting Syphilis during unprotected sex?
30 - 50%
Most cases of Syphilis are seen among what population?
Men who have sex with Men (MSM)
How often should MSM be screened for Syphilis?
Every 3 - 6 months
When should pregnant patients be screened for Syphilis?
First Prenatal Visit
Third Trimester
Delivery (if high risk)
Includes primary lesions of chancre (painless) that are usually on the penis, labia, cervix, anorectal, and sometimes in the oropharynx?
Primary Syphilis
How soon after inoculation does Primary Syphilis occur
10 - 90 days
A painless, “punched out” appearing ulcer, that is indurated with a raised border, and a red and smooth base with very little serous secretions.
Chancre
A type of Syphilis test that detects antibodies to lipoidal antigens.
Non-Treponemal Tests
What are the two Non-Treponemal Tests used to screen for Syphilis?
VDRL and RPR
- Venereal Disease Research Laboratory
- Rapid Plasma Reagin
What can be used to confirm the diagnosis of Syphilis following a non-treponemal test?
Treponemal Test
What are the two Treponemal Test used to diagnose Syphilis?
TPPA and FTA-ABS
- (T. pallidum Particle Agglutination)
- (Fluorescent Treponemal Antibody Absorption Test)
What two immunoassays can be used to diagnose or screen for Syphilis?
EIA-Enzyme
CIA-Chemiluminescence
Without treatment, how long will it take for the Chancre to resolve?
1 - 3 weeks
Once a Syphilis Chancre resolves on its own, what happens next?
Patient will still progress to Secondary or Latent infection
What is the treatment for Primary Syphilis?
Penicillin G (IM)
2.4 million units
Stage of Syphilis that is asymptomatic but highly infectious and occurs within one year of Primary Syphilis. It can convert to Secondary Syphilis if not adequately treated.
Latent Syphilis (Early)
What is the treatment for Latent Syphilis (Early)
Penicillin G (IM)
2.4 million units
Syphilis infection that occurs a few weeks to 6 months after Chancre. Presents with systemic signs such as a fever and lymphadenopathy. Infectious lesions will be distant from the site of inoculation.
Secondary Syphilis
What is the most common finding in Secondary Syphilis?
Skin and Mucosal Lesions
(Maculopapular Rash)
Wart-like, weeping papule on moist skin that resemble genital warts and are seen in Secondary Syphilis.
Condyloma Lata
What is seen in 80% of cases of Secondary Syphilis?
Rash of Palms and Soles
How is Secondary Syphilis diagnosed?
Serologic Testing
What is the treatment for Secondary Syphilis?
Penicillin G (IM)
50,000 units per Kg
What reaction is commonly seen in Syphilis patients being treated with antibiotics?
Jarisch-Herxheimer Reaction
Type of Latent Syphilis that occurs after one year of being infected with Syphilis. It can still be transmitted to the fetus and diagnosis can only be made if there is no evidence of tertiary disease or neurosyphilis. It may last a lifetime.
Latent Syphilis (Late)
What is the treatment for Latent Syphilis (Late)
Penicillin G (IM)
1 dose per week for 3 weeks
2.4 million units per dose
Stage of Syphilis that may occur anytime after Secondary stage (1 - 20+ years)
Tertiary Syphilis (Late)
Infiltrative tumors of the skin, bones and liver that are seen in Tertiary Syphilis. Localized with a rapid onset and respond to treatment.
Gummas
Specific type of Tertiary Syphilis that causes aortitis, aneurysms, and aortic regurgitation.
Cardiovascular Syphilis
Type of Syphilis that can occur at any stage of infection. Presents with headaches, meningitis, dementia, vision and hearing loss, incontinence and psychosis. Can be disabling and life-threatening.
Neurosyphilis
Bilateral, small, irregular pupils that constrict with accommodation but do not react (constrict) when exposed to bright light. Seen in Neurosyphilis.
Argyll Robertson Pupil
Demyelination of posterior columns and spinal nerve roots, leading to areflexia, burning pain, weakness, severe unprovoked radicular pain as well as ataxia caused by loss of proprioception. Seen in Neurosyphilis and Congenital.
Tabes dorsalis
Treatment for Tertiary Syphilis
Penicillin G (IM)
2.4 million units x3 weeks
Treatment for Neurosyphilis
High Dose PCN (IV)
18 - 24 million units per day
x10 - 14 days
Rash, condylomas, mucous membrane patches, and nasal discharge are the most common findings of what type of Syphilis?
Congenital
Congenital Syphilis that usually presents between ages 2-8 weeks with persistent clear, purulent, or bloody rhinorrhea and a maculopapular rash. May also have Hepatomegaly or Splenomegaly. Lymphadenopathy, skeletal abnormalities, joint pain, and pseudoparylsis.
Early-Onset Disease
(2 years old or younger)
Congenital Syphilis that has similar manifestations as Early-Onset Disease, but may also include visual changes, tabes dorsalis, nystagmus, headache, hearing loss, Hutchinson Teeth, Clutton’s Joints, and Saddle Nose deformity.
Late Onset Disease
(2+ years old)
How do the majority of Neonates with Syphilis present at birth?
Asymptomatic
