syphilis
syphilis
introduction
-
it was relatively common until the widespread use on
penicillins in the 1950's when it became rare in Western cultures but has been gradually increasing with increased general sexual promiscuity and drug use in the 1980's but massive campaigns against
HIV / AIDS and advice of
safe sex reduced its prevalence in the 1990's. Unfortunately, it is again on the rise in line with massive rises in other
sexually transmitted infections (STDs/STIs) as adherence to safe sex practices are no longer widespread.
cannot be cultivated in vitro and is too small to be seen under the light microscope, but can be detected using dark-field microscopy or direct immunofluorescence staining of fixed smears
rapidly penetrates intact mucous membranes or microscopic dermal abrasions
it can also be spread:
incubation period from exposure to development of primary lesions 10-90 days with average of 3 weeks
pathology is characterised by obliterative endarteritis
congenital syphilis
high rate of spontaneous abortion and stillbirth
the first 2 years of life, symptoms are similar to severe adult secondary syphilis with widespread condylomata lata and rash
Snuffles” describes the mucopurulent rhinitis caused by involvement of the nasal mucosae
“saddle nose” (due to destruction of the nasal septum)
“saber shins” (due to inflammation and bowing of the tibia)
“Clutton’s joints” (due to inflammation of the knee joints)
“Hutchinson’s teeth” (in which the upper incisors are widely spaced and notched)
“mulberry molars” (in which the molars have too many cusps)
Tabes dorsalis and general paresis may develop
8th cranial nerve deafness and optic nerve atrophy may occur
4 classical stages of acquired syphilis
primary syphilis
secondary syphilis
develops about 4-10 weeks after the appearance of the primary lesion as the bacteria spread throughout the body and multiply
clinical features can be diverse but usually include:
immune reaction is at its peak
latent syphilis
resolution of features of secondary stage but patient remains seropositive
may have recurrence of rash
1/3rd will develop tertiary syphilis
remainder will remain asymptomatic
tertiary syphilis
Dx of acquired syphilis
syphilis.txt · Last modified: 2014/01/10 17:58 (external edit)