Syphilis - Clinical Manifestations and Treatment 1) Primary Syphilis • Direct lesion contact during sex is responsible for most cases of transmission • Incubation period: Appears 21 days after initial infection (range 3 - 90 days) • Presentation: Painless papule → Ulcerates to produce a chancre → Bilateral regional lymphadenopathy • Location: Genitalia, oropharynx, rectum • Chancres heal spontaneously within 3-6 weeks even in the absence of treatment. 2) Secondary Syphilis • Incubation period: 2 weeks to a few months after the chancre develops • Presentation: Fever, headache, malaise, anorexia, sore throat, myalgias, and weight loss • Skin: Rash is the most characteristic finding, diffuse. Trunk and extremities. Symmetric macular or papular; Alopecia • Renal: Albuminuria, nephrotic syndrome, or acute nephritis with hypertension and acute renal failure • Neurological: Headache, meningitis, ocular syphilis, otosyphilis, meningovascular disease, or stroke • Gastrointestinal: Syphilitic hepatitis. The entire GI tract may become extensively infiltrated or ulcerated • MSK: Synovitis, osteitis, and periostitis 3) Tertiary • 25-40 % of individuals with untreated infection • Incubation period: 1 to 30 years after primary infection • Cardiovascular: Aortitis, ascending thoracic aorta resulting in a dilated aorta and aortic valve regurgitation. Coronary artery disease • Gummatous Syphilis: Very uncommon, gummas have been reported in individuals with HIV (Any viscera or connective tissue) • Neurological: General paresis and tabes dorsalis Latent Syphilis: • Patient is infected without symptoms • Early latent 1 year after infection Treatment: • Primary, secondary and early latent • Late latent and Tertiary (no neuro) • Neurosyphilis By @TheIDtrivia #Syphilis #stages #diagnosis #management #Treatment
