Syphilis

Question 1

Organism responsible for syphilis?

Answer 1

Treponeumum Pallidum - spirochete

Question 2

Clinical presentation of primary?

Answer 2

3 weeks post infection

Chancre (painless single lesion)
Inguinal lymphadenopathy

Question 3

Clinical presentation of secondary?

Answer 3

5 weeks after primary –> 2 years

Proliferation in skin and mucous membranes:
Rash on soles and palms, anogenital + axillae, mouth, throat, vagina

Condyloma lata - wart like lesions on genitals

Generalised lymphadenopathy

Anterior uveitis

Question 4

Clinical presentation of tertiary?

Answer 4

5-40 years

neurosyphilis - dementia, tabes dorsalis

Cardiosyphilis - syphilitis aortitis
Aortic aneurysm

Gummata - granulomas in liver (also brain, heart and skin

Question 5

Investigations

Answer 5

Serology: RPR (rapid plasma regain)
Dark field microscopy
FTA-ABS

Consider:
LP
CXR, echo
CT/MRI brain
HIV
Foetal USS

Question 6

Treatment

Answer 6

Penecillin
Contact tracing - potentially over several years
Refrain from sexual contact until partner is Tx

Question 7

Complications?

Answer 7

TORCH infection:
preterm delivery
stillbirth
congenital syphilis