Syphilis Flashcards
What bacteria causes Syphilis?
Treponema pallidum
How is syphilis spread?
- Direct contact with infected secretions
2. Transplacental passage of bacteria during pregnancy
What happens in primary syphilis?
- In earliest stages, the initial manifestation is the ‘chancre’
- Chancre is a single, painless genital lesion
- Regional lymphadenopathy is present
What happens in secondary syphilis?
‘Desseminated disease’
1. Wide spread erythematous rash
- Oral / genital mucous lesions named ‘conddylomata lata’ in the anogenital region
What happens in tertiary syphilis?
‘Complications’
1. Gummatous lesions - granulomatous locally destructive lesions affecting skin and bone.
- Cardiovascular involvement - aortitis, valvular abnormalities
- Neurological involvement - meningitis. 8th nerve palsy, deafness
Dx of syphilis
- PCR
2. Serological tests looking for antibodies and specific tests
Syphilis specific investigations (2)
- Rapid plasma reagin
2. T. pallidum particleor haemogglutination assays ( TPPA)
Faetal complications of syphillis
A B C D E S
What does a high Rapid plasma regain mean?
- Usually high RPR means active infection
2. RPR and/or TPPA will be positive long term, even after successful treatment.
What indicates successful treatment of syphillis
4 fold drop in RPR indicates successful treatment.
Tx of syphyllis
Penicillin – Benzathine penicillin
• Others – Doxycycline, Erythromycin, Azithromycin, Amoxycillin, Ceftriaxone
Complication with Tx of syphillis
Jarisch-herxheimer reaction. – Acute febrile illness with treatment of syphilis.
Steroids are given in some instances prior to syphilis treatment, to prevent worsening of local infection (eg in eye and aorta involvement).
What are the follow ups required for syphilis?
Sexual contacts should be traced and followed up
- Window period of 12 weeks
- Follow up post treatment until RPR is dropped by at least four fold and stable.
