177 Syphilis

Question 1

Organism that causes Syphilis

Answer 1

Treponema pallidum

Question 2

Incubation period of syphilis

Answer 2

Average of 2-6 weeks

Median incubation period in humans: ~21 days

Question 3

4 genera of Spirochaetales

Answer 3

Leptospira species (leptospirosis)

Borrelia species (relapsing fever and Lyme disease)

Brachyspira species (gastrointestinal infections)

Treponema species (syphilis and the endemic treponematoses)

Question 4

Disease caused by T. pallidum subsp. pallidum

Answer 4

Venereal syphilis

Question 5

Disease caused by T. pallidum subsp. pertenue

Answer 5

Yaws

Question 6

Disease caused by T. pallidum subsp. endemicum

Answer 6

Endemic syphilis or Bejel

Question 7

Disease caused by T. carateum

Answer 7

Pinta

Question 8

TRUE OR FALSE: The T. pallidum subspecies cannot be cultured in vitro.

Answer 8

TRUE

Question 9

The only known natural host for T. pallidum subsp. pallidum

Answer 9

Human

Question 10

The animal model that best reflects the human disease and immunopathology of syphilis

Answer 10

Rabbit

Question 11

Most common mode of transmission of syphilis

Answer 11

Sexual

Question 12

Site of primary lesion of syphilis

Answer 12

Site of inoculation

Question 13

Duration of persistence of primary and secondary lesions

Answer 13

Primary 4-6 weeks, then heals spontaneously

Secondary 2-6 weeks

Question 14

How long before secondary syphilis manifests

Answer 14

~6-12 weeks after infection (primary and secondary may occasionally overlap; or map skip secondary)

Question 15

Characteristic lymphadenopathy in primary syphilis

Answer 15

Regional (usually inguinal), firm, nonsuppurative, and painless

Inguinal lymphadenopathy is bilateral

Question 16

Characteristic lymphadenopathy in secondary syphilis

Answer 16

Generalized and nontender

Question 17

Possible cause of the paradoxical appearance of secondary manifestations even after the development of an immune response that clears primary lesions

Answer 17

Immune evasion due to antigenic variation of surface antigens

Question 18

TRUE OR FALSE: The latent stage of syphilis is detectable only by serologic testing.

Answer 18

TRUE

Question 19

Typical primary lesion of syphilis

Answer 19

Chancre - begins as a single painless papule that rapidly becomes eroded and usually becomes indurated, with a characteristic cartilaginous consistency on palpation of the edge and base of the ulcer

Question 20

TRUE OR FALSE: The primary chancre and associated lymphadenopathy will heal within 4-6 weeks (range, 2-12 weeks).

Answer 20

FALSE. The lymphadenopathy may persist for months.

Question 21

Protean manifestations of secondary syphilis

Answer 21

Mucocutaneous or cutaneous lesions and generalized nontender lymphadenopathy

Question 22

Initial lesions of secondary syphilis

Answer 22

Pale red or pink, nonpruritic, discrete macules distributed on the trunk and extremities, then progress to papular lesions that are distributed widely and that frequently involve the palms and soles

Question 23

Severe necrotic lesions that may appear in secondary syphilis that are more commonly reported in HIV-infected individuals

Answer 23

Lues maligna

Question 24

Broad, moist, pink or gray-white, highly infectious lesions that occur in warm, moist, intertriginous areas in secondary syphilis

Answer 24

Condyloma lata

Question 25

Typical mucous patch of secondary syphilis

Answer 25

Painless silver-gray erosion surrounded by a red periphery

Question 26

Most common constitutional symptom of secondary syphilis

Answer 26

Sore throat (15-30%)

Question 27

TRUE OR FALSE: Hepatic involvement is rare in syphilis, but usually severe.

Answer 27

FALSE. Hepatic involvement is common in syphilis; although it is usually asymptomatic, up to 25% of patients may have abnormal liver function tests.

Question 28

Most manifestations of the secondary stage of syphilis resolve spontaneously, within _____.

Answer 28

1-6 months

Question 29

Timing of “early latent” and “late latent” syphilis

Answer 29

Early latent syphilis is limited to the first year after infection.

Late latent syphilis is defined as that of >=1 year’s duration.

Question 30

TRUE OR FALSE: Latent syphilis in a pregnant woman may infect the fetus in utero.

Answer 30

TRUE