Syphilis: Difference between revisions

No edit summary
No edit summary
Line 12: Line 12:


==Clinical Features==
==Clinical Features==
[[File:Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|thumbnail|Chancres on the penile shaft due to a primary syphilitic infection]]
[[File:Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|thumbnail|Chancres on the penile shaft due to a primary syphilitic infection]
*single '''nonpainful''' lesion with punched out base and rolled edges
=Primary Syphilis=
**lesion is highly infectious
*Primary lesion appears after an incubation of 2-6 weeks
*Single painless papule that becomes eroded and indurated, cartilaginous consistency on palpation
**Minority of patients can have multiple lesions or atypical appearance
**Occurs at point of contact: penis, rectum, mouth, external genitalia, cervix, or labia
**Heals in 4-6 weeks but ranges from 2-12
*Regional lymphadenopathy that is painless and firm


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 15:05, 22 December 2014

Background

  • Syphilis is caused by the spirochete Treponema pallidum.
  • Usually sexually transmitted
  • Causes a wide range of systemic manifestations that are characterized by episodes of active disease interrupted by periods of latency
  • Approximately 30% of asymptomatic contacts examined within 30 days of exposure have infection

Pathogenesis

  • Spirochetes penetrate intact mucous membranes or microscopic dermal abrasions.
  • Transmission through sexual contact with infectious lesions, infection in utero, blood transfusion, and organ transplantation
  • Blood from a patient with incubating or early syphilis is infectious.
  • Characterized by multiple stages separated by periods of latency: primary, secondary, latent and tertiary

Clinical Features

[[File:Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|thumbnail|Chancres on the penile shaft due to a primary syphilitic infection]

Primary Syphilis

  • Primary lesion appears after an incubation of 2-6 weeks
  • Single painless papule that becomes eroded and indurated, cartilaginous consistency on palpation
    • Minority of patients can have multiple lesions or atypical appearance
    • Occurs at point of contact: penis, rectum, mouth, external genitalia, cervix, or labia
    • Heals in 4-6 weeks but ranges from 2-12
  • Regional lymphadenopathy that is painless and firm

Differential Diagnosis

Workup

Management

  • Benzathine penicillin G 2.4 million units IM x 1 (for primary or secondary infection)

Disposition

See Also

Source

  • Emedicine