Syphilis classification: Difference between revisions

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__NOTOC__
__NOTOC__
{{CMG}}
{{CMG}}{{AE}}{{AA}}; {{NRM}}
{{Syphilis}}
{{Syphilis}}
==Overview==
==Overview==
Syphilis can be congenital or acquired and is classified as primary, secondary, latent and tertiary.
 
Syphilis may be classified according to the development of disease into 2 groups: [[congenital]] and acquired.  Acquired syphilis may be classified further into 4 subtypes: primary, secondary, latent and tertiary syphilis.
 
==Classification==
==Classification==
Syphilis can be classified into
There is no established clasification system for syphilis. However, it may be classified into following subtypes:<ref name="pmid17235095">{{cite journal| author=French P| title=Syphilis. | journal=BMJ | year= 2007 | volume= 334 | issue= 7585 | pages= 143-7 | pmid=17235095 | doi=10.1136/bmj.39085.518148.BE | pmc=1779891 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17235095  }} </ref><ref name="pmid18208988[uid]">{{cite journal| author=Chakraborty R, Luck S| title=Syphilis is on the increase: the implications for child health. | journal=Arch Dis Child | year= 2008 | volume= 93 | issue= 2 | pages= 105-9 | pmid=18208988[uid] | doi=10.1136/adc.2006.103515 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18208988  }} </ref><ref name=abc>http://www.cdc.gov/std/stats10/app-casedef.htm Accessed on September 19, 2016</ref><ref name="pmid23324972">{{cite journal| author=Lago EG, Vaccari A, Fiori RM| title=Clinical features and follow-up of congenital syphilis. | journal=Sex Transm Dis | year= 2013 | volume= 40 | issue= 2 | pages= 85-94 | pmid=23324972 | doi=10.1097/OLQ.0b013e31827bd688 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23324972  }} </ref><ref name="pmid16210105">{{cite journal| author=Woods CR| title=Syphilis in children: congenital and acquired. | journal=Semin Pediatr Infect Dis | year= 2005 | volume= 16 | issue= 4 | pages= 245-57 | pmid=16210105 | doi=10.1053/j.spid.2005.06.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16210105  }} </ref><ref name="pmid23324972">{{cite journal| author=Lago EG, Vaccari A, Fiori RM| title=Clinical features and follow-up of congenital syphilis. | journal=Sex Transm Dis | year= 2013 | volume= 40 | issue= 2 | pages= 85-94 | pmid=23324972 | doi=10.1097/OLQ.0b013e31827bd688 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23324972  }} </ref><ref name="pmid6318372">{{cite journal| author=Rathbun KC| title=Congenital syphilis. | journal=Sex Transm Dis | year= 1983 | volume= 10 | issue= 2 | pages= 93-9 | pmid=6318372 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6318372  }} </ref><ref name="pmid15247352">{{cite journal| author=Hook EW, Peeling RW| title=Syphilis control--a continuing challenge. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 2 | pages= 122-4 | pmid=15247352 | doi=10.1056/NEJMp048126 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15247352  }} </ref><ref name="pmid16179782">{{cite journal| author=Kennedy JL, Barnard JJ, Prahlow JA| title=Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction and death. | journal=Cardiology | year= 2006 | volume= 105 | issue= 1 | pages= 25-9 | pmid=16179782 | doi=10.1159/000088337 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16179782  }} </ref><ref name="pmid9518283">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 10-1998. A 46-year-old man with chest pain and coronary ostial stenosis. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 13 | pages= 897-903 | pmid=9518283 | doi=10.1056/NEJM199803263381308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9518283  }} </ref><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>
* Congenital
=== Congenital===
** Early
Congenital Syphilis is transmitted from mother to child by vertical transmission during pregnancy, or during delivery in cases of maternal active lesions. Congenital syphilis may be classified according to latency of onset as follows:<br>
** Late
*'''Early''': Manifests before 2 years of age<br>
* Acquired
*'''Late''': Manifests after 2 years of age
** Primary
===Acquired===
** Secondary
The mode of transmission in acquired syphilis is primarily by direct contact with infectious lesions (usually on oral or genital contact). Acquired syphilis presents in progressive stages as follows:
** Tertiary
====Primary====
** Latent
*Manifests as [[papule]] which breaks to form painless [[chancre]]<ref name="musher">Musher, Daniel M. "Early syphilis." Sexually Transmitted Diseases. 3rd ed. New York: McGraw-Hill (1999): 479-487.</ref>
** Neurosyphilis
*Lasts for 3 to 6 weeks
====Secondary====
*Develops weeks to months after chancre<ref name="pmid7455863">{{cite journal| author=Chapel TA| title=The signs and symptoms of secondary syphilis. | journal=Sex Transm Dis | year= 1980 | volume= 7 | issue= 4 | pages= 161-4 | pmid=7455863 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7455863  }} </ref>
*Manifests with constitutional symptoms such as [[fever]], [[headache]], [[malaise]], [[lymphadenopathy]] and localized or diffuse rash called [[condyloma lata]]
*Lasts 1-6 months
==== Latent syphilis====
Stage of syphilis in which patient is serologically positive for [[treponema pallidum]] but is asymptomatic.
*'''Early latent''': Asymptomatic < 2 years<br>
*'''Late latent''': Asymptomatic > 2 years
 
====Tertiary or Gummatous syphilis====
Late syphilis characterised by complications involving:
*[[Cardiovascular system]]<ref name="pmid16179782">{{cite journal| author=Kennedy JL, Barnard JJ, Prahlow JA| title=Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction and death. | journal=Cardiology | year= 2006 | volume= 105 | issue= 1 | pages= 25-9 | pmid=16179782 | doi=10.1159/000088337 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16179782  }} </ref><ref name="pmid17988342">{{cite journal| author=Pereira TM, Fernandes JC, Vieira AP, Basto AS| title=Tertiary syphilis. | journal=Int J Dermatol | year= 2007 | volume= 46 | issue= 11 | pages= 1192-5 | pmid=17988342 | doi=10.1111/j.1365-4632.2007.03438.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17988342  }} </ref><ref name="pmid24365430">{{cite journal| author=Berger JR, Dean D| title=Neurosyphilis. | journal=Handb Clin Neurol | year= 2014 | volume= 121 | issue=  | pages= 1461-72 | pmid=24365430 | doi=10.1016/B978-0-7020-4088-7.00098-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24365430  }} </ref>
*[[CNS]]
:*Asymptomatic
:*Meningiovascular
:*[[Tabes dorsalis]]
:*Parenchymatous
*Other parts of the body


==References==
==References==
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Latest revision as of 00:23, 30 July 2020

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Overview

Syphilis may be classified according to the development of disease into 2 groups: congenital and acquired. Acquired syphilis may be classified further into 4 subtypes: primary, secondary, latent and tertiary syphilis.

Classification

There is no established clasification system for syphilis. However, it may be classified into following subtypes:[1][2][3][4][5][4][6][7][8][9][10]

Congenital

Congenital Syphilis is transmitted from mother to child by vertical transmission during pregnancy, or during delivery in cases of maternal active lesions. Congenital syphilis may be classified according to latency of onset as follows:

  • Early: Manifests before 2 years of age
  • Late: Manifests after 2 years of age

Acquired

The mode of transmission in acquired syphilis is primarily by direct contact with infectious lesions (usually on oral or genital contact). Acquired syphilis presents in progressive stages as follows:

Primary

Secondary

Latent syphilis

Stage of syphilis in which patient is serologically positive for treponema pallidum but is asymptomatic.

  • Early latent: Asymptomatic < 2 years
  • Late latent: Asymptomatic > 2 years

Tertiary or Gummatous syphilis

Late syphilis characterised by complications involving:

  • Other parts of the body

References

  1. ↑ French P (2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
  2. ↑ Chakraborty R, Luck S (2008). "Syphilis is on the increase: the implications for child health". Arch Dis Child. 93 (2): 105–9. doi:10.1136/adc.2006.103515. PMID [uid 18208988[uid]] Check |pmid= value (help).
  3. ↑ http://www.cdc.gov/std/stats10/app-casedef.htm Accessed on September 19, 2016
  4. ↑ 4.0 4.1 Lago EG, Vaccari A, Fiori RM (2013). "Clinical features and follow-up of congenital syphilis". Sex Transm Dis. 40 (2): 85–94. doi:10.1097/OLQ.0b013e31827bd688. PMID 23324972.
  5. ↑ Woods CR (2005). "Syphilis in children: congenital and acquired". Semin Pediatr Infect Dis. 16 (4): 245–57. doi:10.1053/j.spid.2005.06.005. PMID 16210105.
  6. ↑ Rathbun KC (1983). "Congenital syphilis". Sex Transm Dis. 10 (2): 93–9. PMID 6318372.
  7. ↑ Hook EW, Peeling RW (2004). "Syphilis control--a continuing challenge". N Engl J Med. 351 (2): 122–4. doi:10.1056/NEJMp048126. PMID 15247352.
  8. ↑ 8.0 8.1 Kennedy JL, Barnard JJ, Prahlow JA (2006). "Syphilitic coronary artery ostial stenosis resulting in acute myocardial infarction and death". Cardiology. 105 (1): 25–9. doi:10.1159/000088337. PMID 16179782.
  9. ↑ "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 10-1998. A 46-year-old man with chest pain and coronary ostial stenosis". N Engl J Med. 338 (13): 897–903. 1998. doi:10.1056/NEJM199803263381308. PMID 9518283.
  10. ↑ 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.
  11. ↑ Musher, Daniel M. "Early syphilis." Sexually Transmitted Diseases. 3rd ed. New York: McGraw-Hill (1999): 479-487.
  12. ↑ Chapel TA (1980). "The signs and symptoms of secondary syphilis". Sex Transm Dis. 7 (4): 161–4. PMID 7455863.
  13. ↑ Pereira TM, Fernandes JC, Vieira AP, Basto AS (2007). "Tertiary syphilis". Int J Dermatol. 46 (11): 1192–5. doi:10.1111/j.1365-4632.2007.03438.x. PMID 17988342.
  14. ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.

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