Syphilis (Treponema pallidum) Flashcards
Venereal syphilis
T. pallidum ss pallidum
Yaws
T. pallidum ss pertenue
Bejel
T. pallidum ss endemicum (aka endemic syphilis)
Pinta
T. pallidum ss carateum
Syphilis: Chancre and regional lymphadenitis
Primary syphilis
Syphilis: Painless papule appears at site of entry ___ after inoculation
2-6 weeks
Clean, painless, highly contagious ulcer with raised borders
Chancre
T/F Chancre is highly contagious
T
Symptoms related to spirochetemia
Secondary syphilis
Secondary syphilis symptoms are noted when
2-10 weeks after chancre heals
Syphilis: Generalized non-pruritic maculopapular rash, notable involving the palms and soles
Secondary syphilis
Condyloma lata
Secondary syphilis
Gray-white to erythematous wartlike plaques in moist areas around the anus and vagina
Secondary syphilis (condyloma lata)
Meningitis occurs in ___% of patients with syphilis characterized by CSF pleocytosis and elevated protein
30
Syphilis: Relapses can occur with secondary manifestations when
Early latent period
Asymptomatic late syphilis
Late latent period
Symptomatic late syphilis
Tertiary syphilis
Gummas
Tertiary syphilis
Syphilis: Neurologic, cardiovascular, and gummatous lesions
Tertiary syphilis
Nonsuppurative granulomas of the skin and musculoskeletal system resulting from host’s hypersensitivity reaction
Tertiary syphilis
Untreated syphilis during pregnancy has a vertical transmission rate approaching ___
100%
Early signs of congenital syphilis are analogous to the ___ stage of acquired syphilis
Secondary
Characteristic anemia in congenital syphilis
Coombs’ negative hemolytic anemia
Osteochondritis and periostitis of long bones (rarely the skull) and a mucocutaneous erythematous maculopapular or vesiculobullous lesions followed by desquamation of the hands and feet in a neonate
Congenital syphilis
Persistent rhinitis or snuffles in a neonate
Congenital syphilis
Metaphyseal demineralization of the medial aspect of the proximal tibia
Wimbergerr’s lines (congenital syphilis)
Painful osteochondritis seen in congenital syphilis resulting in irritability and refusal to move involved extremity
Pseudoparalysis of Parrot
Late manifestations of congenital syphilis seen in children >2 years of age result primarily from
Chronic granulomatous inflammation of bone, teeth, and CNS
Syphilis: Bony prominence of the forehead due to persistent or recurrent periostitis
Olympian brow
Syphilis: Unilateral or bilateral thickening or the sternoclavicular third of the clavicle
Higoumenakis sign
Syphilis: Anterior bowing of the midportion of the tibia
Saber shins
Syphilis: Convexity along the medial border of the scapula
Scaphoid scapula
Syphilis: Peg-shaped upper central incisors
Hutchinson teeth
Syphilis: Abnormal 1st lower molars characterized by small biting surface and excessive number of cusps
Mulberry molars
Syphilis: Depression of the nasal root with destruction of bone and cartilage from syphilitic rhinitis
Saddle nose
Syphilis: Linear scars that extend in a spoke-like pattern from previous mucocutaneous fissures of the mouth, anus, and genitalia
Rhagades
Syphilis: Latent meningovascular infection, rare, and typically occursduring adolescence with behavioral changes, focal seizures, or loss of intellectual function
Juvenile paresis
Syphilis: Rare spinal cord involvement and cardiovascular involvement with aortitis
Juvenile tabes
Syphilis: Hutchinson triad
Hutchinson teeth, interstitial keratitis, 8th nerve deafness
Syphilis: Unilateral or bilateral PAINLESS joint swelling (usually involving the knees) due to synovitis with sterile synovial fluid
Clutton joint
Diagnosis of primary syphilis is confirmed with
Dark field microscopy or direct fluorescent antibody testing
Specimen that can be used for diagnosis of primary syphilis
Skin lesions, placenta, umbilical cord
Principal means for diagnosis of syphilis
Serologic testing
Sensitive nontreponemal tests for syphilis
RPR and VDRL
VDRL and RPR detect
Antibodies against phospholipid antigens on treponeme surface that cross-react with mammalian cardiolipin-lecithin-cholesterol antigen
DOC for syphilis
Penicillin
Acute systemic febrile reaction due to massive release of endotoxin-like antigen during bacterial lysis in patients with syphilis treated with Penicillin
Jarisch-Herxheimer reaction
Jarisch-Herxheimer reaction occurs in ___% of patients treated with Pen
15-20%
T/F Jarisch-Herxheimer reaction is an indication to discontinuing penicillin therapy
F
Persons exposed >90 days before diagnosis in a sex partner of a person with syphilis should be treated if
Seropositive OR serologic test not available
