Syphilis history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}} | {{CMG}}; {{AE}} {{AA}}{{NRM}} {{Maha}} | ||
{{Syphilis}} | {{Syphilis}} | ||
==Overview== | ==Overview== | ||
The history and symptoms of syphilis depends on stage of disease. The hallmark of syphilis infection is painless [[chancre]]. A positive history of painless chancre on genitalia, and presence of risk factors such as unprotected sex, multiple sexual partners, residence in highly prevalent area and previous history of sexually transmitted infections may be suggestive of syphilis infection. The most common symptoms of syphilis infection include painless [[chancre]] which progresses to [[ulcer]] with regional [[lymphadenopathy]] in primary syphilis. Secondary syphilis is characterized by [[rash]] and constitutional symptoms. Syphilis infection in tertiary syphilis can involve any organ system, hence named the "Great Imitator".<ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456 }} </ref><ref name="pmid21694502">{{cite journal| author=Carlson JA, Dabiri G, Cribier B, Sell S| title=The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. | journal=Am J Dermatopathol | year= 2011 | volume= 33 | issue= 5 | pages= 433-60 | pmid=21694502 | doi=10.1097/DAD.0b013e3181e8b587 | pmc=3690623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694502 }} </ref><ref name="pmid17560432">{{cite journal| author=Wöhrl S, Geusau A| title=Clinical update: syphilis in adults. | journal=Lancet | year= 2007 | volume= 369 | issue= 9577 | pages= 1912-4 | pmid=17560432 | doi=10.1016/S0140-6736(07)60895-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560432 }} </ref> | |||
== History and symptoms== | == History and symptoms== | ||
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! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Stage of syphilis}} | ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Stage of syphilis}} | ||
! style="background: #4479BA; width: | ! style="background: #4479BA; width: 500px;" | {{fontcolor|#FFF|History and symptoms}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Primary syphilis''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Primary syphilis''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*History of risk factors (MSM, unprotected sex, multiple sex partners) | |||
*Onset within 3 weeks of contact | *Onset within 3 weeks of contact | ||
*[[Chancre]]: | *[[Chancre]]: | ||
:*Rapidly progresses an ulcerated | :*Single painless firm raised [[papule]] | ||
:*Rapidly progresses to an ulcerated lesion | |||
:*Usually located on the [[glans penis]], [[cervix]], [[labia]], anal canal, [[rectum]] or [[oral cavity]] | :*Usually located on the [[glans penis]], [[cervix]], [[labia]], anal canal, [[rectum]] or [[oral cavity]] | ||
*Regional [[lymphadenopathy]] | *Regional [[lymphadenopathy]] | ||
*Heals spontaneously within 4-6 weeks; however, regional lymphadenopathy may persist for longer periods | *Heals spontaneously within 4-6 weeks; however, regional lymphadenopathy may persist for longer periods | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |'''Secondary syphilis''' | | style="padding: 5px 5px; background: #DCDCDC;" |'''Secondary syphilis''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Develops 6-8 weeks after the appearance of primary [[chancre]] | *Develops 6-8 weeks after the appearance of primary [[chancre]] | ||
*Generalized systemic symptoms such as [[malaise]], [[fatigue]], [[headache]] and [[fever]] may be present | *Generalized systemic symptoms such as [[malaise]], [[fatigue]], [[headache]] and [[fever]] may be present | ||
*Skin eruptions may be subtle and asymptomatic | *Skin eruptions may be subtle and asymptomatic | ||
*Classic: | *Classic: | ||
:*Non-pruritic bilateral symmetrical mucocutaneous rash | :*Non-pruritic bilateral symmetrical mucocutaneous rash | ||
:*Non-tender regional [[lymphadenopathy]] | :*Non-tender regional [[lymphadenopathy]] | ||
:*Condylomata lata | :*Condylomata lata | ||
:*Patchy [[alopecia]] | :*Patchy [[alopecia]] | ||
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|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Tertiary syphilis''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Tertiary syphilis''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |Clinical manifestation of this stage depends on organ system involved: | ||
'''Neurosyphilis''' | |||
*[[Altered mental status]] | *[[Altered mental status]] | ||
*[[Dementia]] | *[[Dementia]] | ||
*Focal neurodeficit affecting hearing and vision | *Focal neurodeficit affecting hearing and vision | ||
'''Cardiovascular syphilis''' | |||
*Aortic | *[[Aortic Regurgitation]] | ||
:*[[Dyspnea on exertion]] | :*[[Dyspnea on exertion]] | ||
:*[[Orthopnea]] | :*[[Orthopnea]] | ||
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:*[[Chest pain]] (if [[left ventricular end diastolic pressure]] compromises coronary perfusion) | :*[[Chest pain]] (if [[left ventricular end diastolic pressure]] compromises coronary perfusion) | ||
*[[Congestive heart failure]] | *[[Congestive heart failure]] | ||
*[[Dyspnea|Dyspnea on ordinary exertion]] | :*[[Dyspnea|Dyspnea on ordinary exertion]] | ||
* [[Fainting]] | :*[[Fainting]] | ||
* [[Fatigue]] | :*[[Fatigue]] | ||
* [[Hemoptysis]] or frothy sputum | :*[[Hemoptysis]] or frothy sputum | ||
* [[Nocturia]] or [[urination during the night]] | :*[[Nocturia]] or [[urination during the night]] | ||
* [[cough|Nocturnal cough]] | :*[[cough|Nocturnal cough]] | ||
* [[Orthopnea]] or [[sleeping on pillows]] | :*[[Orthopnea]] or [[sleeping on pillows]] | ||
* [[Palpitation]]s or [[extra heart beats]] | :*[[Palpitation]]s or [[extra heart beats]] | ||
* [[Paroxysmal nocturnal dyspnea]] | :*[[Paroxysmal nocturnal dyspnea]] | ||
* [[Shortness of breath]] | :*[[Shortness of breath]] | ||
'''Gummatous lesions''' | |||
* | *Presents with any organ system involved. | ||
* | *Nodular papular lesions in case of cutaneous [[gumma]]. | ||
|- | |- | ||
|} | |} | ||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
[[Category:Bacterial diseases]] | [[Category:Bacterial diseases]] | ||
[[Category:Sexually transmitted diseases]] | [[Category:Sexually transmitted diseases]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Urology]] | |||
[[Category:Neurology]] | |||
Latest revision as of 00:29, 21 September 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]Nate Michalak, B.A. Maha Jaffar Azhar, M.D.
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Overview
The history and symptoms of syphilis depends on stage of disease. The hallmark of syphilis infection is painless chancre. A positive history of painless chancre on genitalia, and presence of risk factors such as unprotected sex, multiple sexual partners, residence in highly prevalent area and previous history of sexually transmitted infections may be suggestive of syphilis infection. The most common symptoms of syphilis infection include painless chancre which progresses to ulcer with regional lymphadenopathy in primary syphilis. Secondary syphilis is characterized by rash and constitutional symptoms. Syphilis infection in tertiary syphilis can involve any organ system, hence named the "Great Imitator".[1][2][3]
History and symptoms
The history and symptoms of syphilis according to the stage of disease are described below:[1][2][3]
| Stage of syphilis | History and symptoms |
|---|---|
| Primary syphilis |
|
| Secondary syphilis |
|
| Latent syphilis |
|
| Tertiary syphilis | Clinical manifestation of this stage depends on organ system involved:
Neurosyphilis
Cardiovascular syphilis
Gummatous lesions
|
References
- ↑ 1.0 1.1 Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.
- ↑ 2.0 2.1 Carlson JA, Dabiri G, Cribier B, Sell S (2011). "The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity". Am J Dermatopathol. 33 (5): 433–60. doi:10.1097/DAD.0b013e3181e8b587. PMC 3690623. PMID 21694502.
- ↑ 3.0 3.1 Wöhrl S, Geusau A (2007). "Clinical update: syphilis in adults". Lancet. 369 (9577): 1912–4. doi:10.1016/S0140-6736(07)60895-2. PMID 17560432.