Syphilis

Question 1

What kind of microbe is involved in syphilis and what is its shape?

Answer 1

• Treponema pallidum

- Spirochete (spiral shape)

Question 2

What is the transmission of syphilis?

Answer 2

• Shedding lesions
  
  • Eg: Abraded skin & membranes during sexual
    contact

Question 3

T of F:

Syphilis cannot cross the placenta.

Answer 3

F, it can and may affect the embryo

Question 4

Is the microbe in syphilis local or systemic?

Answer 4

Both! Proliferates locally, then (possibly) spreads systemically via blood and lymph

Question 5

What are 3 possible complications of syphilis?

Answer 5

• Ocular complications
• Cardiac complications
• Paralysis

Question 6

Is syphilis life threatening?

Answer 6

Without timely intervention, yes

Question 7

What 2 main things take place during the first stage of syphilis?

Answer 7

• Lesions: painless chancre at site of exposure

- Development of regional lymphadenopathy

Question 8

Explain the lesions seen in syphilis? how do they differ from men to women?

Answer 8

• Vagina, cervix (can remain undetected & unTx in
  women)
• Penis (exposed, more easily detectable)
• Appear ~1 mt post exposure
• Resolve in 3-12 wk

Question 9

How long does the 2nd stage of syphilis last and when might it start?

Answer 9

• Up to 6 m in duration

- Appears 6-8 wk post infection if not treated

Question 10

What mnfts are seen during the 2nd stage of syphilis?

4

Answer 10

• Patches appear on mucous membrane (e.g. on tongue)
• A maculopapular (spotty, pimple-like) rash develops on
  the palms & soles
• Lymphadenopathy become systemic
• Fever, malaise

Question 11

During the 2nd stage of syphilis, the bacterium becomes latent, what does this mean for the pt? Can they still infct other people?

Answer 11

• Disease is now subclinical but patient can be
  seropositive (i.e. blood test detects Abs) for up to 50 yr
• Patient is infective in the early stage of latency

Question 12

Explain the 3rd stage of syphilis?

Answer 12

• ~⅓ of infection progress to this stage, anywhere from 1-35 yrs following an unTx 1st stage
• Permanent systemic damage sets in affecting for example the CVS, NS & joints

Question 13

What is used to Dx syphilis?

Answer 13

Serology

Question 14

What is the Tx for syphilis, and why is it this specific type of Abx?

Answer 14

• Long-acting penicillin
• Long-acting because spirochetes have a long
  generation time which is the time required for a colony
  to double in number
  
  • Spirochetes require about 30 hr while E. coli has a
    generation time of 20 min