Syphilis - Clinical Manifestations and Treatment



1) Primary Syphilis

 • Direct lesion contact during sex is responsible for most cases of transmission

 • Incubation period: Appears 21 days after initial infection (range 3 - 90 days)

 • Presentation: Painless papule → Ulcerates to produce a chancre → Bilateral regional lymphadenopathy

 • Location: Genitalia, oropharynx, rectum

 • Chancres heal spontaneously within 3-6 weeks even in the absence of treatment.



2) Secondary Syphilis

 • Incubation period: 2 weeks to a few months after the chancre develops

 • Presentation: Fever, headache, malaise, anorexia, sore throat, myalgias, and weight loss

 • Skin: Rash is the most characteristic finding, diffuse. Trunk and extremities. Symmetric macular or papular; Alopecia

 • Renal: Albuminuria, nephrotic syndrome, or acute nephritis with hypertension and acute renal failure

 • Neurological: Headache, meningitis, ocular syphilis, otosyphilis, meningovascular disease, or stroke

 • Gastrointestinal: Syphilitic hepatitis. The entire GI tract may become extensively infiltrated or ulcerated

 • MSK: Synovitis, osteitis, and periostitis



3) Tertiary

 • 25-40 % of individuals with untreated infection

 • Incubation period: 1 to 30 years after primary infection

 • Cardiovascular: Aortitis, ascending thoracic aorta resulting in a dilated aorta and aortic valve regurgitation. Coronary artery disease

 • Gummatous Syphilis: Very uncommon, gummas have been reported in individuals with HIV (Any viscera or connective tissue)

 • Neurological: General paresis and tabes dorsalis 



Latent Syphilis:

 • Patient is infected without symptoms

 • Early latent <I year after infection

 • Late latent >1 year after infection



Treatment:

 • Primary, secondary and early latent

 • Late latent and Tertiary (no neuro)

 • Neurosyphilis



By @TheIDtrivia



#Syphilis #stages #diagnosis #management #Treatment