Syphlis

Question 1

Safety point in syphilis

Answer 1

Clinic contact
Be a ware of late booker
Interpretation
How she sateled in UK
Refer pt to sexual health clinic for STI
Partner notification
Safe sex
Mention reaction to penicillin
Risk to baby and mother

Answer 2

Self introduction
• If recent migration: well supported, job, settled?
• Assesses ideas, concerns, 14d expectatipns; involyy patient in decision making
• Clear signposting (Questions related to sexual partners, STI symptoms,
treatment etc)
• Explain risks, treatment and side effects
• Confidentiality
1:11:28 / Ri32559tes a mutually agreed acceptable, safe, plan
Contact number

Question 3

What are the information gathering in syphilis

Answer 3

Information Gathering
• HOPI: Painless ulcer/groin swollen gland/palm soles rash/warty
growth/flu/any systemic(eye, bone etc)
• Partner: Similar lesion/symptoms/new partner
• Recent UPS,STI treatment
• Medical: Treatment outside (specially if from outside UK), BT
• Present pregnancy details : Late booking, 20w scan, booking blood etc
• Social: Smoking/Alcohol/IVDU/DV/Occupation/Mental health

Question 4

What are pt safety

Answer 4

Patient Safety
• Patient ID
• Elicit main concerns
• Allergy
• Open and honest about the risks
• Safe sex (can recur in future)
• Rule out other STI
• Partner notification/ Contact tracing
• Jarisch Herxheimer reaction
• Follow Up: 3 mon, 6 mon, 12 mon blood test till negative

Question 5

Safety

Answer 5

ALL patients diagnosed with syphilis, or with
suspected syphilis, should be referred to a
Sexual Health service for treatment, follow-up
testing and partner notification.

Question 6

Risk CCT of syphilis to baby

Answer 6

Syphilis can be acquired by the fetus during pregnancy or at birth. Infection before 16 weeks
of gestation is rare. Infection later in pregnancy can result in miscarriage, stillbirth, neonatal
death or disease or latent infection. Untreated syphilis infection in pregnancy has a fetal loss
rate of approximately 50%.
Most infected neonates are asymptomatic at birth. Neonatal disease may manifest as rhinitis,
a diffuse maculopapular, desquamative rash with extensive sloughing of the epithelium,
particularly on the palms and soles, splenomegaly, anemia, thrombocytopenia and jaundice.
If clinical signs are present at birth, 50% of infants will die in the neonatal period