Flashcards in SyphilisInfections Deck (35):
How does syphilis infection begin:
With usually ONE, PAINLESS INDURATED lesion at the point of entry (genital ulcer)
Secondary syphilis manifestation:
Maculopapular rash of secondary syphilis enters what phase if untreated:
latency phase - which may be CLEARED by the immune system
If latency stage of syphilis is not cleared by the immune system:
It may reappear as tertiary syphilis years to decades later.
How many people are infected with syphilis in the US per year?
Causative agent of Syphilis:
**Features of Treponema Pallidum:
Gram (-) spirochete, Motile, Microaerophilic, Have flexible peptidoglycan wall
Culturing Treponema Pallidum
Does not grow in cell free culture. Very difficult to grow in cell culture
Why can Treponema Pallidum not be seen with light microscopy:
The spirochetes are too thin. GRAM STAINING NOT RECOMMENDED
Two diagnostic techniques for Treponema Pallidum:
Dark field microscopy or Direct Fluorescent Antibody Test.
Transmission of Treponema Pallidum:
Sexual contact or congenital
Treponema Pallidum infection has a higher incidence in what patient demographic:
**Characteristics of Primary Syphilis
USUALLY ONE skin lesion (chancre) at site where spirochete penetrated. This lesion is PAINLESS AND INDURATED.
**Secondary syphilis onset time:
2-8 weeks post chancre
**Presentation of Secondary Syphilis:
*Flu-like syndrome. Prominent skin lesions dispersed over the entire body including PALMS and SOLES. Condyloma lata may occur, also.
Raised lesions in skin folds that have a soft, flat, moist, pink-tan papule/nodule appearance. Occur with secondary syphilis or congenital syphilis.
Characteristics of Latent Syphilis:
It is an asymptomatic period with continued infection. Transmission is still possible.
What percent of untreated syphilis patients will proceed to tertiary/late syphilis?
Result of tertiary syphilis:
Can cause devastating destruction of virtually any organ or tissue (arteritis, dementia, blindness)
Granulomatous Lesions may be found in bone, skin and other tissues. Present in tertiary/late syphilis-presenting patient.
Case Presentation of Neurosyphilis:
Progressive cognitive decline and behavioral changes over 18 months. Testing revealed impaired memory and attention along with mild to moderate dementia and executive dysfunction.
Treatment of Neurosyphilis:
High-dose IV penicillin
Tuskegee Syphilis importance:
beginning of informed consent for research subjects and much information garnered about tertiary syphilis
Mothers with Syphilis have risk of:
transmission to fetus resulting in fetal loss or congenital syphilis
Features of Congenital Syphilis that develop after birth:
Rhinitis (leads to saddle nose), Maculopapular Rash, Condyloma Lata (around mouth often in infants)
Additional Features of Congenital Syphilis that develop:
Teeth (Hutchinson's teeth) and bone deformation, Blindness, Deafness, Cardiovascular Syphilis
Most common diagnostic test for Syphilis:
Nontreponemal Test used for Syphilis diagnosis:
Measured antibody directed against cardiolipin (lipid complex)
Treponemal Test used for Syphilis diagnosis:
Detect antibody SPECIFIC to Treponema Pallidum
Treatment of Syphilis:
blunted teeth, blindness, deafness (hallmark of **congenital syphilis** infections)
Examples of Nontreponemal Tests for Syphilis Diagnosis:
Rapid Plasma Reagin (RPR) and Venereal Disease Research Laboratory (VDRL)
Examples of Treponemal Tests for Syphilis Diagnosis:
Fluorescent treponemal antibody + Microhemagglutination
Person infected with Syphilis will have a positive Treponemal and Nontreponemal test when:
Throughout UNTREATED infection