Syphilis history and symptoms: Difference between revisions
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| 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;" | | ||
*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]] | ||
| Line 60: | Line 60: | ||
:*[[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''''' | '''''Gummatous lesions''''' | ||
* | *Presents with any organ system involved | ||
* | *Nodular papular lesions in case of cutaneous gumma. | ||
|- | |- | ||
|} | |} | ||
Revision as of 13:10, 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
|
Primary syphilis
- Onset within 3 weeks of contact
- Rapidly progresses an ulcerated, indurated lesion
- Single painless firm raised papule
- Usually located on the glans penis, cervix, labia, anal canal, rectum or oral cavity
- Regional lymphadenopathy accompanies primary lesion.
- Primary chancre heals spontaneously within 4-6 weeks; however, regional lymphadenopathy may persist for longer periods.
Secondary syphilis
- Develops 6-8 weeks after the appearance of primary chancre
- Generalized systemic symptoms such as malaise, fatigue, headache and fever may be present.
- Skin eruptions may be subtle and asymptomatic
- Classic:
- Non-pruritic bilateral symmetrical mucocutaneous rash
- Non-tender regional lymphadenopathy
- Condylomata lata
- Patchy alopecia
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:
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