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Flashcards in Syphilis Deck (39)
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What is the etiologic agent of syphilis?

A spirochete, Treponema pallidum


Can T. pallidum be grown in the lab?

No, but it can be propagated in rabbit testes


Does syphilis have distinct sequential phases?

Yes, including latent phases


Can T. pallidum cross the placenta?

Yes, resulting in congenital syphilis


What is the pathology of syphilis largely due to?

Host's cellular inflammatory response, it resembles and AI response


What is the hallmark feature of primary syphilis?

Non-painful ulcer called a chancre, developing at site of entry of treponeme


Secondary syphilis is what kind of infection?

Systemic, characterized by fever, swollen LNs, mucous membrane lesions, and sometimes a skin rash that eventually includes soles and palms and/or wart-resembling lesions (condylomata kata)


What is Lab Dx of syphilis done by?

Serology, and by microscopic examination of scrapings


What are all forms of syphilis treated with?

Penicillins, most commonly Pen G; prevention with abstinence and use of condoms


What type of bacterium is T. Pallidum?

Helical/spiral-shaped bacterium


T. pallidum is very thin, what does this mean?

Too thin to be seen by standard direct light transmission microscopy (gram stain useless)


What method is T. pallidum seen by?

Indirect light microscopy method called darkfield microscopy


What is dark field useful for?

Useful Dx method early in disease process, before antibodies develo


What do spirochetes resemble?

gram negative bacteria


What membranes to spirochetes have?

An inner membrane, a periplasm with peptidoglycan and an outer sheath/membrane


What is different about the outer sheath in spirochetes?

It's proteins are mainly lipoproteins and lipids (not LPS) that probably contribute to the pathogenic inflammatory process


What is the immune response to spirochetes?

Rigorous humoral and cellular response that does not eliminate the infection; Host's cellular immune response probably controls the infection but also responsible for pathology (tert sylph)


Does T. pallidum have a latent phase?

Yes, unknown mechanism and if untreated infection and continue for life/can progress to tertiary stage


What is the incubation time and symptom resolution time of primary syphilis?

2-3 week incubation w/ resolution in 3-6 weeks


What is the manifestation and resolution time of 2ndary syphilis?

1-2 months after infection; resolve in a month or so w/o tx


What is early latent syphilis?

The 1-2 yr period after resolution of 2ndary syphilis


What is late latent syphilis?

Begins 1-2 years post infection, may last lifetime, may progress to tertiary or resolve spontaneously


What can be affected in tertiary syphilis?

Almost any organ system can be affected


Will symptoms be present at birth with congenital syphilis?

Sometimes, stigmata may develop 2 yrs or more after birth


What are the signs/sx of primary syphilis?

Painless ulcer (chancre) at sight of entry, nontender inguinal LAD


What are the signs/sx of secondary syphilis?

Disseminated infection, hyperpigmented maculopapular rash over entire body that with time extends to palms and soles; mucous membrane patches in mouth and genitals a.k.a. snail track lesionsl condylomata lata; and the patient is sick (fever, headache, diffuse LAD); may also have mild meningitis


What 4 diseases have a rash on palms and soles?

Secondary syphilis, RMSF, hand foot mouth dz, and rarely meningococcemia


What are the signs/sx of early latent Syphilis?

No symptoms, positive serology, may relapse to secondary (can spread in utero)


What are the signs/sx of late latent syphilis?

No symptoms, positive serology, no relapse to secondary (not infectious even to fetus)


What are the signs/sx of tertiary syphilis?

Progressive, inflammatory disease that may take years to develop; Tertiary S in endarteritis, few spirochetes can be detected in lesions, Gummas, CV and CNS S can take years to develop (Any organ system can be involved here... LOTS of symptoms)