Syphilis - Treponema Pollidum

Question 1

Transmission of Treponema Pallidum

Answer 1

intimate contact (oral-genital, genital-genital, rarely kiss), with an ACTIVELY infected partner

Note:
–> Transmission depends on, age, sex, HIV status, other STDs, BUT mostly syphilitic stage

Question 2

T.Pallidum invades?

Answer 2

Highly invasive –> can disseminate thourgh lymphs and blood, affecting almost every organ

Question 3

Explain the primary stage of Syphilis (Incubation period, CM, Recovery time)

Answer 3

incubation: 10-90 days

CM:
1) Chancer formation
(Single, painless ulcers w/ raised borders, smooth base, clean w/o exudates)
2) Bilateral inguinal painless adenopathy

recovery: Heals spontaneously within 3-8 weeks leaving no trace

                  **HIGHLY INVASIVE STAGE**

Question 4

Explain the secondary stage of Syphilis (Incubation period, CM, Recovery time)

Answer 4

incubation: 4-10 weeks after appearnce of chancer

CM:
1) Rash –> Brownish-red papules on the entire skin (+ palms &soles) Lesions are CONTAGIOUS
2) Conylomata lata –> “Mucous pathches” (on labial, lingual, gingival, buccal mucosa & moist surfaces of genitalia)
–> shallow ulcers, covered with grey-whitish silvery membrane

          **Conylomata lata --> HIGHLY CONTAGEOUS**

Secondary syphilis affects every organ: CNS, Livern eyes, nodes, bones etc

Question 5

Explain the Tertiray stage of Syphilis (Incubation period, CM, Recovery time)

Answer 5

incubation period: 5-30 yrs after intial infection
CM:
1) cardiovascular syphilis in 10% after> 10 yrs
–> Asymptomatic aortitis

2) Gummatous Syphilis in 15% after > 5yrs
–> Gumma (local destructive disease)

3) Neurosyphilis after 2 yrs / Mengiovascular syphilis >1 yr
–> Megalomania-personality change

        **NOT INFECTIOUS**

Question 6

prevention of Congenital syphilis

Answer 6

100% PREVENTABLE
–> test all pregenant women
(utero transmission first 4 yrs after after infection)

Question 7

Diagnosis of Syphilis

Answer 7

darkfield microscopy
-skin exudates of 1ry, 2ry or congenital syphilis. DO NOT use on oral or rectal lesion

Question 8

mehtods of choice for diagnosing and Tx Follow up of Syphilis

Answer 8

serology

Question 9

Remember non treponemal tests are NOT specific…
A confirmation of Syphilis is considered if?

Answer 9

1) Persistant (+)low titiers (<1:8) of non-treponemal, PLUS (-)ve treponemal test, PLUS one of the folloing:
- HIV (+)
- Viral infections (varicells, EBV, Measles)
- Multiple blood transfusion

Remember…
* High titres (>1:16 are almost never false (+))