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Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
Std   syphilis
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Std syphilis

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  • 1. SYPHILIS
  • 2. SYPHILIS IS : a sexual transmitted disease caused by spirochetal bacterium Treponema pallidum , a motile anaerobic
    • Transmission
    • of syphilis is almost always through sexual contact or congenitally through the placenta to a fetus or at birth from an infected mother.
  • 3. Different manifestations occur depending on the stage of the disease
  • 4.  
  • 5.
    • Primary Syphilis:
    • it’s the first stage after infection
    • painless & localized ulcer with rolled edge (chancres).
    • single or multiple.
    • appear 2-3 weeks after contact.
    • most common site are cervix , vagina , vulva , anus and mouth.
    • regional L.N become enlarged.
    .
  • 6. PRIMARY SYPHILIS (The Chancre)
    • Incubation period 9-90 days, usually ~21 days.
    • Develops at site of contact/inoculation.
    • Classically: single, painless, clean-based, indurated ulcer, with firm, raised borders. Atypical presentations may occur .
    • Mostly anogenital, but may occur at any site (tongue, pharynx, lips, fingers, nipples, etc...)
    • Non-tender regional adenopathy
    • Very infectious.
    • May be darkfield positive but serologically negative.
    • Untreated, heals in several weeks, leaving a faint scar.
  • 7. SECONDARY SYPHILIS (Cont.)
    • The skin rash:
      • Diffuse,
      • often with a superficial scale (papulosquamous).
      • May leave residual pigmentation or depigmentation .
    • Condylomata Lata:
      • Formed by coalescence of large, pale, flat-topped papules.
      • Occur in warm, moist areas such as the perineum.
      • Highly infectious.
    • Mucosal lesions:
      • ~ 30% of secondary syphilis patients develop mucous patch (slightly raised, oval area covered by a grayish white membrane, with a pink base that does not bleed).
      • Highly infectious
  • 8.
    • Secondary Syphilis:
    • Systemic
    • 1-6 months after contact
    • fever, malaise, general adenopathy and non-itchy maculopapular skin rash “money spot” .
    • involve the palms of the hands and the soles of the feet.
    • Mucous patches and linear (snail track) ulcers are seen on the mucosal surfaces.
  • 9. SECONDARY SYPHILIS
    • Seen 6 wks to 6 mos after primary chancre
    • Usually w diffuse non-pruritic, indurated rash, including palms & soles.
    • May also cause:
      • Fever, malaise, headache, sore throat, myalgia, arthralgia, generalized lymphadenopathy
      • Hepatitis (10%)
      • Renal: an immune complex type of nephropathy with transient nephrotic syndrome
      • Iritis or an anterior uveitis
      • Bone: periostitis
      • CSF pleocytosis in 10 - 30% (but, symptomatic meningitis is seen in <1%)
  • 10. SECONDARY SYPHILIS Differential diagnosis
    • The rash may be confused with
      • Pityriasis rosea (usually has a herald patch and lesions seen along lines of skin cleavage)
      • Drug eruptions
      • Acute febrile exanthems
      • Psoriasis
      • Lichen planus
      • Scabies
    • The mucous patch may be confused with oral thrush.
    • Malaise, sore throat, generalized adenopathy, hepatitis, & rash may be confused with infectious mononucleosis.
    • Fortunately, the serologic tests for syphilis are positive in 99% of secondary syphilis pts.
  • 11. LATENT SYPHILIS
    • Positive syphilis serology without clinical signs of syphilis (& has normal CSF).
      • It begins with the end of secondary syphilis and may last for a lifetime.
      • Pt may or may not have a h/o primary or secondary syphilis.
      • Diseases known to cause occasional false-positive nontreponemal test reactions for syphilis, such as systemic lupus erythematosus (SLE), and congenital syphilis must be excluded before the diagnosis of latent syphilis can be made .
    • Is divided into early and late latency.
  • 12. LATENT SYPHILIS (cont.)
    • Early latent :
      • The first year after the resolution of primary or secondary lesions, or
      • A reactive serologic test for syphilis in an asymptomatic individual who has had a negative serologic test within the preceding year.
      • Infectious.
    • Late latent:
      • Usually not infectious, except for the pregnant woman, who may transmit infection to her fetus.
  • 13. LATENT SYPHILIS ‘Tertiary Syphilis’
    • Is the destructive stage of the disease.
    • Lesions develop in skin, bone, & visceral organs (any organ).
    • The main types are:
      • Late benign (gummatous)
      • Cardiovascular &
      • Neurosyphilis
    • Can be crippling and life threatening
    • Blindness, deafness, deformity, lack of coordination, paralysis, dementia may occur
    • It is usually very slowly progressive, barring certain neurologic syndromes which may develop suddenly due to endarteritis and thrombosis in the CNS
    • Late syphilis is noninfectious.
  • 14. LATENT SYPHILIS
    • Positive syphilis serology without clinical signs of syphilis (& has normal CSF).
      • It begins with the end of secondary syphilis and may last for a lifetime.
      • Pt may or may not have a h/o primary or secondary syphilis.
      • Diseases known to cause occasional false-positive nontreponemal test reactions for syphilis, such as systemic lupus erythematosus (SLE), and congenital syphilis must be excluded before the diagnosis of latent syphilis can be made .
    • Is divided into early and late latency.
  • 15.
    • Latent syphilis
    • Absent of symptoms or physical finding.
    • 13 proceed to tertiary.
    • Tertiary syphilis
    • Ocurre 1-10 years after infection
    • gummas: ulcerative nodule in the skin, bone and nervous system as a result of hypersensitivity reactions.
    • Systemic manifestation: CVS, CNS and bone
  • 16. Congenital Syphilis
    • Mode of transmission:
    • - trans placental passage from infected mother
    • - at birth
    • Congenital infection is associated with several adverse outcomes including:
    • -low birth wt -congenital anomalies
    • -premature birth -miscarriages or death of baby
  • 17. Congenital Syphilis
    • Early:
    • -skin lesions , maculopapular tissue
    • -Lymphadenopathy
    • -Hepatosplenomegaly
    • -failure to thrive
    • -jaundice , anemia
    • - osteochondritis
    • Late:
    • -gummatous ulcers
    • -bony prominence of forehead
    • -Saddle nose
    • -Short maxilla
    • -keratitis, 8 nerve deafness and dental deformities
  • 18. Prevention
    • Treatment
    • The first-choice treatment for all manifestations of syphilis is penicillin.
    • Parenteral penicillin G is the only therapy with documented effect during pregnancy.
    • Non-pregnant individuals who have severe allergic reactions to penicillin
    • may be effectively treated with oral tetracycline or doxycycline
  • 19. THANX THANX

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