Syphilis Flashcards
Types
acquired and congenital
Acquired occurs as
Primary
Secondary
Tertiary
Primary
It manifests as primary chancre of the vestibule of nose. It is rare.
Secondary
Rarely recognized. It manifests as simple rhinitis with crusting and fissuring in the nasal ves- tibule. Diagnosis is suggested by the presence of mucous patches in the pharynx, skin rash, fever and generalized lymphadenitis.
the stage in which nose is commonly involved.
Tertiary
Typical manifestation in Tertiary
formation of a gumma on the nasal septum. Later, the septum is destroyed both in its bony and cartilaginous parts. Perforation may also appear in the hard palate. There is offensive nasal discharge with crusts. Bony or car- tilaginous sequestra may be seen. Bridge of the nose collapses causing a saddle nose deformity.
Congenital occurs in
Early form.
Late form.
Early form.
seen in the first 3 months of life
Manifestation of early form
snuffles
Soon the nasal discharge becomes purulent. This is associated with fissuring and excoriation of the nasal vestibule and of the upper lip.
Late form age of manifestation
manifests around puberty
Clinical pic- ture of late form
Gummatous lesions destroy the nasal structures. Other stigmata of syphilis such as corneal opacities, deafness and Hutchinson’s teeth are also present.
DIAGNOSIS
VDRL
biopsy of the tissue with special stains to demonstrate Treponema pallidum
drug of choice
benzathine penicillin 2.4 million units i.m. every week for 3 weeks with a total dose of 7.2 million units
TREATMENT
Penicillin
Nasal crusts are removed by irrigation with alkaline solution. Bony and cartilaginous sequestra should also be removed. Cosmetic deformity is corrected after disease becomes inactive.
COMPLICATIONS
Syphilis can lead to vestibular stenosis, perforations of nasal septum and hard palate, secondary atrophic rhinitis and saddle nose deformity.
