Syphylis Dan Flashcards
What is the organism responsible for syphylis?
Treponema (genus) pallidum (species) pallidum (subspecies)
T/F
T. pallidum is a protoza
False
A spirochete
T/F
T. pallidum is microaerophilic
True
needs a small amount of O2, not too much
T/F
T. pallidum can be cultured in vitro
False
Cannot be cultured in vitro
Cannot survive outside an animal host
T/F
T. pallidum is slow growing
True
What is the organism responsible for endemic syphylis?
treponema pallidum endemicum
T/F
Syphylis is the main cause of genital ulcers in low income countries
True
In Australia what populations are most at risk of syphylis?
most new cases are in MSM
with possible exception of in NT where still high rates of indigenous syphylis
What is syphylis d’emblee
syphylis acquired by deep innoculation e.g. via needlestick - rare
Is usuallly through contact with through mucous membranes or abraded skin
T/F
All stages of Syphylis are equally infective
False
primary and secondary more than tertiery
T/F
After innoculation treponemes disseminate to local lymph nodes and internal organs within hours
True
T/F
Replication time for T pallidum is about 3 days
False
30 hours
What proportion of infected pts develop secondary syphylis?
almost 100%
What proportion of those with secondary syphylis clear spontaneously?
1/3 clear
2/3 progress to latent disease
T/F
25% of pts in latent phase syphylis have relapses of symptoms of secondary syphylis
True
What is the fate of pts with untreated latent syphylis?
1/3 Asymptomatic with negative RPR but positive specific serology (may be self cured or in RPR-ve latent phase)
1/3 Asymptomatic with positive RPR and positive specific serology (ongoing latent disease)
1/3 develop tertiary syphilis – mucocutaneous>CVS>neurosyphylis
T/F
tertiery syphylis has a mortality of 10%
False
up to 50% if untreated
How long is the latent period after contracting syphylis until symptoms of primary syphylis appear?
9-90 days
average 3 weeks
What are the features of primary syphylis?
Chancre is characteristic lesion
Painless, firm, indurated, circumscribed round/oval ulcer
sometimes >1
with non-tender rubbery regional lymphadenopathy
Typically ulcer at 3 wks, unilat LNs at 4 wks, bilat LNs at 5 wks
resolves in 1-3 months, sometimes scars
How is primary syphylis diagnosed?
Chancre is full of treponemes esp at edge - swab and dark ground microscopy is traditional but rarely performed
Can swab for fluorescence microscopy or for PCR
Usually diagnosed by serology - RPR and specific tests
- if serology negative repeat in 2 weeks
T/F
80% of primary syphylis cases will be positive for RPR
True
T/F
40% of primary syphylis cases will be positive for specific serology tests
False
90% positive
T/F
Dark field miscroscopy can be reliably performed on chancre swabs from the mouth
False
There are resident spirochetes on mucosal surfaces
can only be performe don skin chancre swabs
T/F
Dark field miscroscopy is the most sensitive and specific diagnostic test in primary syphylis
True
but rarely performed