Syphilis history and symptoms: Difference between revisions
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:*Single painless firm raised papule. | :*Single painless firm raised papule. | ||
:*Rapidly progresses to an ulcerated lesion. | :*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]] | ||
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| 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]] | ||
| Line 42: | Line 42: | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Latent syphilis''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Latent syphilis''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Previous history of chancre or rash | *Previous history of chancre or rash. | ||
*Asymptomatic | *Asymptomatic | ||
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*Focal neurodeficit affecting hearing and vision | *Focal neurodeficit affecting hearing and vision | ||
'''''Cardiovascular syphilis''''' | '''''Cardiovascular syphilis''''' | ||
*Aortic | *[[Aortic Regurgitation]] | ||
:*[[Dyspnea on exertion]] | :*[[Dyspnea on exertion]] | ||
:*[[Orthopnea]] | :*[[Orthopnea]] | ||
| Line 71: | Line 71: | ||
:*[[Shortness of breath]] | :*[[Shortness of breath]] | ||
'''''Gummatous lesions''''' | '''''Gummatous lesions''''' | ||
*Presents with any organ system involved | *Presents with any organ system involved. | ||
*Nodular papular lesions in case of cutaneous gumma. | *Nodular papular lesions in case of cutaneous gumma. | ||
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==Latent syphilis== | ==Latent syphilis== | ||
Revision as of 13:14, 28 September 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Syphilis is a curable sexually transmitted disease caused by the Treponema pallidum spirochete. The route of transmission of syphilis is almost always by sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero. The signs and symptoms of syphilis are numerous; before the advent of serological testing, precise diagnosis was very difficult.
- Hx number of sexual partners, condom use,
- Hx of sexually transmitted disease, intravenous drug use, exposure to blood products
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 |
Neurosyphilis
Cardiovascular syphilis
Gummatous lesions
|
Latent syphilis
- Asymptomatic during latency and disease is detected only by serology
Tertiary syphilis
- Slowly progressive phase
- Develop within 3-10 years of primary infection
- Appear almost anywhere in the body including in the skeleton.
- Chronic and represent an inability of the immune system to completely clear the organism.
- Gummas produce a chronic inflammatory state in the body with mass-effects upon the local anatomy.
- Soft, tumor-like balls of inflammation known as granulomas.
- Other characteristics of untreated tertiary syphilis is the neurological manifestations that include:
- Altered mental status
- Dementia
- Focal neurodeficit affecting hearing and vision
- Cardiovascular manifestations:
- Insidious in onset
- Syphilis infects the ascending aorta causing dilation and aortic regurgitation. This can be heard with a stethoscope as a heart murmur.
- Syphilitic aortitis can cause de Musset's sign,[4] a bobbing of the head that de Musset first noted in Parisian prostitutes.
- The infection of the coronary arteries may cause narrowing of the vessels
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Sapira JD (1981 Apr). ""Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations"". South Med J. 74 (4): 459–67. Check date values in:
|date=(help)