Syphilis

Question 1

What causes syphilis?

Answer 1

Treponema pallidum

Spirochete bacteria

Question 2

How is syphilis transmitted?

Answer 2

Any type of sexual intercourse
Vertical transmission
IVDU
Blood transfusions

Question 3

How does syphilis present?

Answer 3

Primary
Painless genital ulcer chancre
Local lymphadenopathy

Secondary
After the chancre heals
- Condylomata lata (grey wart-like lesions around genitals and anus)
- Alopecial
- Oral lesions
- Low-grade fever
- Lymphadenopathy
- Maculopapular rash

Tertiary
- Gummatous lesions
- Aortic aneurysms
- Neurosyphilis

Question 4

How does neurosyphilis present?

Answer 4

Can occur at any stage of infection if it reaches CNS

• Tabes dorsalis (demyelination affecting spinal cord posterior columns
• Ocular syphilis
• Paralysis
• Dementia
• Altered behaviour
• Headaches
  Argyll-Robertson pupil- constricted pupil that accommodates when focusing on near object but does not react to light

Question 5

How is syphilis diagnosed?

Answer 5

Antibody testing to T.pallidum
- Dark field microscopy
- PCR

Question 6

How is syphilis managed?

Answer 6

IM benzathine benzylpenicillin

Ceftriaxone, amoxicillin and doxycycline are alternatives