This document provides information about syphilis, caused by the spiral bacteria Treponema pallidum. It can affect all organs and cause a variety of manifestations. Syphilis is classified as either acquired or congenital. Acquired syphilis progresses through primary, secondary, early latent, and late stages. Primary syphilis causes painless ulcers. Secondary syphilis presents with rashes and mucous membrane lesions. Tertiary syphilis can cause gummas or damage to internal organs. Neurosyphilis can also occur. Congenital syphilis is transmitted from mother to child and can cause early symptoms or late complications if untreated. Diagnosis involves blood and CSF tests. Treatment depends on the
2. • Infectious disease due to Treponema pallidum
of great chronicity, systemic from the onset
and capable of affecting all organs with florid
manifestations as well as years of latency.
3. TREPONEMA PALLIDUM
• Coiled, slender, regular spiral org.
• 6-15 m in length, 0.25 m width
• 8-24 coils
• Axial bundle & spirally wound filaments
• Movt. of locomotion & change of shape
• Seen by dark ground, phase contrast or
electron microscope or silver impregnation
4.
5. CLASSIFICATION
ACQUIRED SYPHILIS
• EARLY INFECTIOUS- Primary, Secondary,
Recurrent & Early Latent
• LATE NON-INFECTIOUS-
Late latent & Tertiary
• Cardiovascular & Neurosyphilis
7. CLINICAL FEATURES
• PRIMARY SYPHILIS
• IP - 10-90d
• Round ,regular,clearly defined ulcer with dull red
clean looking granulation tissue
• Characteristically painless ulcer with indurated
base
• Manipulation produces serous exudate which
contains treponemes
8.
9. • Discrete,painless firm & rubbery LNE
• Often B/L
• 1o stage absent in syphilis d’ emblee
• Males- coronal sulcus, glans, prepuce, ext urinary
meatus, shaft of penis
• Female- labia, fourchette, clitoris or near urethral
orifice
• Diagnosis- DGI
10. SECONDARY SYPHILIS
• Occur 6-8wks after start of primary
• Constitutional symptoms +/-
• Cut lesions- any generalised eruption except
vesicle or bulla; widespread symmetrical
• Types- Macular Papulosquamous
Papular Pustular
20. LATE LATENT SYPHILIS
• After 2nd yr syphilis enters late stage
• No clinical signs/symptoms
• Non-Infectious
• Diag based +ve blood tests
• Examine CSF to R/O neurosyphilis
21. TERTIARY SYPHILIS
3-10 yrs after primary
Characteristic lesions are called GUMMA
CUTANEOUS-
Nodular
Squamous or psoriasiform
Subcutaneous gummata
28. CARDIOVASCULAR SYPHILIS
SYPHILIS OF GREAT VESSELS
o Uncomplicated aortitis- bruit de tabourka(S2),
Linear calcification of ascending aorta
o Coronary ostial stenosis-angina pectoris
o Aortic regurgitaion d/t dialatation of aortic
ring +/- involvement of cusps
29. • ANEURYSM
o Ascending aorta-m/c; aneurysm of signs
o Arch of aorta- aneurysm of symptoms
o Descending thoracic aorta- aneurysm of no
symptoms and no signs
o Abdominal aorta
o Other sites raraely
30. • Syphilis of heart
Diffuse myocarditis
Gumma of myocardium
• Syphilis of medium sized arteries
33. GENERAL PARALYSIS OF INSANE
• Period of onset-insidious,congestive attack or brain
storm
• Period of full development-psychosis. Grandiose /
deteriorated&demented
• Period of decline-dementia
• Dysarthria
• Impairment of handwriting
• Trombone tremor- on protrusion of tongue
• Mild spastic paraplegia
34. SYPHILIS OF SPINAL CORD
• Motor > Sensory tracts
• Meningeal-Dorsolumbar, cervical, syphilitic
amyotrophy
• Vascular-spinal shock-paraplegia in
flexion,loss of pain &temp on opp side
• GUMMA
• PARENCHYMATOUS-TABES DORSALIS
38. EARLY CONG. SY
• Appear before 2y age, Infectious
• Cutaneous-Bullae/vesicles on palms &soles,supf
desquamation, petechiae, papulosquamous
lesions
• Mucosal-rhinitis/Snuffles, mucous patches
• Bone osteochondritis, osteitis, periostitis
• HSM, Jaundice, LNP
• Anemia, thrombocytopenia, leukocytosis
39.
40. LATE CONG. SY
• After 2y age, Non infectious
• Cardiovascular syphilis
• Interstitial Keratitis
• 8th nerve deafness
• Reccurent arthropathy, Clutton’s joints
• Asymptomatic neurosyphilis
41. STIGMATA
• STIGMATA OF EARLY LESIONS- saddle nose,
bulldog facies, hutchinsons teeth,moons or
mulberry molars, rhagades, pepper and salt
fundus
• STIGMATA OF LATE LESIONS-ghost vessels in
cornea, perforations in nose & palate, frontal
bossing, sabre shin, nerve deafness, optic atrophy
43. NEURO SYPHILIS
• AQUEOUS CRYSTALLINE PENICILLIN 18-24
MILLION UNITS /DAY
• GIVEN AS
• 3-4 MILLION UNITS IV EVERY 4HOURS OR
• CONTINUOUS INFUSION FOR 10-14 DAYS