Syphilis is a sexually transmitted infection caused by Treponema pallidum, characterized by stages: primary (chancre), secondary (rash and lymphadenopathy), latent, and tertiary (organ involvement). Diagnosis involves serological tests, while management typically includes benzathine penicillin. Complications can affect various systems, potentially leading to severe health issues if untreated.

1. Syphilis
DR. BIJAY KR.YADAV
Holly vision technical campus
Shankhamul, Kathmandu

6. Syphilis
 Syphilis is a STD caused by Treponema pallidum
characterized by the appearance of a painless ulcer
initially and secondary and tertiary stages later.
 It is caused by infection, through abrasions in the skin
or mucous membranes

7. Mode of transmission :
Transmitted by :
i. Contact with infections, moist lesions, most commonly during oral,
anal or vaginal sexual intercourse
ii. Kissing
iii. Blood Transfusion
iv. Mother to child transmission

8. Not transmitted by :
i. Toilet seats
ii. Swimming pool
iii. Hot tubs
iv. Sharing clothes

9. Classification :
STAGES OF SYPHILIS
1. Primary
2. Secondary
3. Latent
 Early latent
 Late latent
4. Late or tertiary - May involve any organ, but main parts
are:
 Neurosyphilis
 Cardiovascular syphilis
 Late benign (gumma)

11. Primary syphilis
 Incubation period : 21 days (average). range : 9 to 90
days.
 Skin Lesion:
Chancre (Hunterian): A non-tender firm papule that
ulcerates with raised border and clean surface.
 Lesions most common on the genital sites
 Regional lymphadenopathy : Appears within a week.
 Nodes are firm ,non-tender, discreet and usually
unilateral.
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15. Laboratory Diagnosis
 Dark field examination.
 Serological tests for syphilis (STS).—Reaction develops 1
week after appearance of chancre.
Two type STS:
1. Non specific tests: Veneral disease research laboratory
test.( VDRL.)
2. Specific tests: Treponemal Haemagglutin assay (TPHA).
Fluorescent treponemal antibody absorption test.(FTA-
ABS)
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16. Secondary Syphilis
 Usually appears 2 to 6 months after
primary infection or 2 to 10 weeks after
appearance of chancre.
 Acute illness syndrome: headache,
chills, fever, arthalgia, malaise.
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Disseminated spirochetemia
8 weeks after infection
Skin rash is common feature
Alopecia ; moth-eaten appearance
Atypical facial plaques
Mucosal ulcerations
Condylomata lata
Painless generalized lymphadenopathy

18. Moth-eaten appearance & Mucous
patches
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19. Skin lesions
 Asymptomatic Maculo-papular rash on the trunk
palms and soles.
 Later lesions maybe papulosquamous, pustular
 Lesions are scattered, discrete and symmetric.
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20. Secondary Syphilis
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21. Secondary syphilis
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22. Secondary Syphilis
 Generalized lymphadenopathy
 Condylomata lata:
Lesions are soft ,flat ,topped, moist, papules or
plaques which may become confluent.
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23. Mucous membranes
 Mucous patches - small asymptomatic, round or oval
slightly elevated flat topped macules and papules covered
by white or gray membrane.
 Other findings : Fever(+-) splenomegaly, iritis, hair loss,
Arthritis, Periostitis
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24. Latent Syphilis (LS)
 There are no clinical S/S of infection. Only the
serological tests for syphilis are positive. CSF is
normal.
 Early latent <2 years
 Late latent >2 years.
 A pregnant woman with LS can infect her fetus.
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25. Tertiary Syphilis :
 It is now very rare.
 Noduloulcerative syphilides : Simulate lupus
vulgaris.
 Gumma : Deep granulomatous lesion found in
the S/C tissue having tendency for necrosis
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26. Tertiary syphilis: noduloulcerative type
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27. Tertiary syphilis - Gumma
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28. Management
1. Primary and secondary Syphilis:
Recommended regimen:
Benzathine penicillin 2.4 million units I/M in one
dose.
Children: Benzathine Penicillin 50,000 units /kg
IM in a single dose
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29. Alternative regimen
 Doxycycline 100mg bid for 2 weeks
 Erythromycin 5oomgqid for 2 weeks.
 Inj. Ceftriaxone 250mgIM OD for 10 days.
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30. 2. Tertiary Syphilis or syphilis : of unknown
duration : 7.2 million units total given in 3
doses of 2.4 m IM weekly.

31. Management of Sex Partners.
 Sex partners should be reffered for evaluation and
treatment.
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32. Complications of syphilis
:
 Chancre
 Neck stiffness
 Numbness
 Weakness
 Fever
 Seizures
 Headache
 Sore throat
 Patchy hair loss
 Swollen glands through the body
 Mental illness
 Blindness
 Neurological problems
 Heart disease
 Death

33. THANK YOU