This document discusses syphilis, a sexually transmitted disease caused by the spirochete Treponema pallidum. It provides details on the classification, signs and symptoms, diagnosis, and treatment of syphilis. Key points include that syphilis presents in primary, secondary, latent, and tertiary stages, and can cause ocular manifestations such as uveitis. Diagnosis involves serological tests like VDRL and FTA-ABS. Treatment depends on the stage of syphilis and may include penicillin or doxycycline. Congenital syphilis is also discussed.
4. Syphilis : called as
great pox, acquired its
name from great
Veronese poet &
physician Giralamo
Fracastoro – great
imitator.
1905- Schauldin &
Hoffman : isolated
spirochete from skin
lesion.
7. Chancre – 4 weeks after infection & heals
in 1-2 months in untreated individuals.
Erythematous papule which later erodes
Genitals
Eyelids & conjunctiva.
9. In the first year of infection, may have
recurrences – early latent.
After an year – latent. Relapses are rare.
30 % experience tertiary syphilis.
13. 5-10 %
Positive VDRL in CSF.
Uveitis & hearing loss –
early
U/l or B/l cranial nerve
palsies
Headache,neck stiffness,
dizziness, lassitude &
blurred vision.
Argyll Robertson pupil
commonly seen in
meningovascular syphilis.
Parenchymatous
neurosyphilis : prog. Loss
of vision.
Altered mental status
Irritability
Poor judgement
Confusion delusion.
CSF is hypercellular &
has a positive VDRL .
Tabes dorsalis
Charcot’s arthropathy
14. Transplacental.
Preventable.
Signs & symptoms
usually comes after
several days of birth.
Rash, snuffles,
jaundice,
Hepatosplenomegaly,
Anorexia,&
Pseudoparalysis.
Osteochondritis (90%)
Chorioretinitis
Diagnosis : FTA-ABS.
Late C S : after 2 years.
CVS
Meningovascular
syphilis with
neurological
manifestation
8th nerve palsy.
Acute syphilitic
meningitis, Gen. paresis
& Tabes dorsalis.
Hutchinson teeth
21. FTA-ABS is more sensitive than VDRL .
False positive results are seen in SLE,
Biliary cirrhosis, RA.
Immediate diagnosis requires Dark Field
Microscopy
VDRL test is excellent screening test for
later primary syphilis & secondary syphilis.
Infants with congenital syphilis have
positive VDRL & FTA-ABS & CSF
examination.
22. Primary & Secondary
Syphilis
Latent & tertiary ,
Including
Neurosyphilis
Congenital Syphilis
Procaine penicillin , 2.4
million units IM daily &
Probenecid 1 gm po QD
for 14 days or
Benzathine penicillin G,
2.4 million units IM in a
single dose
In case of allergy,
Doxycycline 200 mg BD
or Tetracycline 500 mg
QID for 15 days.
Aqueous crystalline
penicillin G, 3-4 million
units IV q 4h x 10-14
days or benzathine
penicillin G, 2.4 million
units IM weekly for 3
days.
Procaine penicillin ,
50,000 units/kg/day IM x
10 days, or aqueous
crystalline penicillin G,
50,000 units/kg/day IV in
two divided doses x 10
days.