Syphilis

Question 1

What is syphilis?

Answer 1

Bacterial infection caused by Treponema pallidum, a spirochete bacteria

Question 2

How long is the incubation period for syphilis?

Answer 2

21 days

Question 3

Forms of transmission for syphilis?

Answer 3

Oral, vaginal, anal sex
Vertical transmission from mother to baby
IVDU
Blood transfusions
Transplants

Question 4

Explain stages of syphilis?

Answer 4

Primary syphilis - chancre on genitals, local lymphadenopathy

Secondary syphilis - fever, maculopapular rash, condylomata lata, alopecia, oral lesions. Lasts 3-12 weeks.

Latent syphilis - Asymptomatic. Early latent syphilis is within 2y of infection, late latent is after 2y of infection

Tertiary syphilis - gummas, aortic aneurysms, neurosyphilis

Question 5

Symptoms of neurosyphilis?

Answer 5

Headache
Dementia
Tabes dorsalis
Ocular syphilis
Paralysis
Sensory impairment

Question 6

Investigations for syphilis?

Answer 6

Antibody testing for T. pallidum
If +ve -> refer to GUM clinic for…
…dark field microscopy
…PCR
Rapid plasma reagin test, and venereal disease research labaratory test are non specific but sensitive for syphilis

Question 7

Management of syphilis?

Answer 7

Single dose deep IM benzathine benzylpenicillin

In late/neurosyphilis -> ceftriaxone, amoxcillin or doxycycline