Syphilis Flashcards
How is T palidum tested (3)
serologically
biopsy of lesion
LP
What technique is used in serological syphilis testing
microscopic detection by darkfield exam or immunofluorescence
2 types of serologic testing for T palidum
non-treponemal (VDRL & RPR) and treponemal
How long after infection before Venereal Disease Research Lab (VDRL) comes up positive for T palidum
4-6 weeks
false positives for VDRL (5)
old age, CTD, HCV, HIV, mono
what is the danger of the Rapid Plasma Reagent test for Treponema palidum
may sero-convert back to negative despite presence of tertiary syphilis
What is the danger of non-treponemal tests
extremely high titres can be false negatives - go to treponemal test!
what test should be used to measure efficacy of Syphilis TX
non-treponemal Ab test(VDRL, RPR)
what type of test is Fluorescent Treponemal Antibody (FTA)
treponemal Ab test
most sensitive test for syphilis
FTA
what do you do if syphilis highly suspected but VDRL comes back negative
confirm with FTA (treponemal Ab test)
where are the painless ulcers of primary syphilis found (5)
genitalia, perianal, rectum, pharynx, tongue
how long after exposure before primary syphilis rears its ugly head? How much longer before serologic tests come up positive?
2-6 weeks chancre, then 1-2 weeks later serologic tests confirm
secondary sign of primary and secondary syphlis
non-tender regional lymph adenopathy
what will appear in labs of folks presenting with primary syphilis lesions right away
dark field treponemes (95%)
and CSF pleocytosis (increased CSF WBC)
4 differential diagnoses for syphilitic chancre
chancroid,
lymphogranuloma venereum,
genital herpes
neoplasm
3 choices of drugs to use in treating primary AND secondary syphilis
benzathine PCN G
doxycycline
ceftriaxone
how does primary syphilis lesion differ from that of secondary
primary has painless ulcer @ infection site
secondary has mucous membranous, weeping papules
why is secondary syphilis called “the great imposter”
generalized maculopapular rash
how long after chancres do secondary syphilis signs appear
Weeks to 6 months after primary lesions
describe maclopapular rash of syphilis (2)
annular like ringworm
MC on palms and soles
what are condyloma lata
fused WEEPING papules on moist areas of skin and mucous membranes
signs of late latent syphilis
late latent syphilis does not present with physical signs! (neurosyphilis may also present with no signs)
how do we know someone has latent syphilis
declared hx of syphilis (possible decades ago)
+ serological test
