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Questions and Answers
What is the most likely result of cardiolipin and antitreponemal antibody tests in a patient with secondary syphilis?
Which of the following is NOT a characteristic of chancroid infection?
What is the preferred alternative to penicillin for treating early and late latent syphilis?
What is the laboratory diagnosis method that is NOT mentioned in the text?
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What is the significance of a positive treponemal antibody test in a patient with old syphilis or partially treated syphilis?
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What is the requirement for treating syphilis associated with HIV infection?
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What is the primary reason for bleeding being avoided during the collection of specimens from a chancre?
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What is the primary purpose of using fluorescein-labeled anti-treponemal serum in the diagnosis of primary syphilis?
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What is a common complication of tertiary syphilis?
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What is the primary mode of transmission of congenital syphilis?
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What is the primary purpose of using a nucleic acid probe in the diagnosis of primary syphilis?
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What is a common symptom of congenital syphilis?
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What is the primary purpose of using a serology test in the diagnosis of primary syphilis?
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What is the primary reason why cardiolipin antibodies may be negative in early primary syphilis?
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What is the typical incubation period for Primary Syphilis?
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What is a common symptom of Secondary Syphilis?
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What is the name of the lesion that appears in Primary Syphilis?
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What is the purpose of Serology tests in Syphilis diagnosis?
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What is a complication of Tertiary Syphilis?
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What is the name of the virus that causes Genital Herpes?
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During which stages of Syphilis is it transmissible?
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What is the name of the laboratory diagnosis method that amplifies specific DNA sequences?
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Study Notes
Syphilis
- Caused by Treponema pallidum
- Three distinct clinical stages: primary, secondary, and tertiary stages
- Latent periods of varying duration occur between secondary and tertiary stages
- Transmissible during the primary and secondary stages, and the early latent period
- Non-transmissible during late latent and tertiary stages
Primary Syphilis
- Appearance of a hard chancre (papule that ulcerates with a clean indurated base) at the site of entry of the pathogen
- Chancre filled with spirochetes
- Chancre heals spontaneously in 3 to 6 weeks, but by then the spirochete has moved into the circulation
- Lymph nodes draining the affected region become enlarged and firm
Secondary Syphilis
- Occurs 3 weeks to 6 months after the chancre heals
- Generalized symptoms of infection: fever, headache, sore throat
- Generalized lymphadenopathy
- Maculo-papular rash on all skin surfaces
- Mucous patches, and condyloma lata (papules) in moist warm areas
- Hair often falls out
- Lesions contain viable spirochetes and disappear spontaneously in a few weeks
- Major complications occur in bones, joints, liver, eyes, and brain
Latent Syphilis
- Serum samples: all serological tests are positive, although the patient appears well
- can last for 20 years or longer
Late Syphilis
- Cardiovascular syphilis: weakens the arteries (aortic aneurysm) and neurosyphilis
- Gummas develop in tissues such as the liver, skin, bone, and cartilage
- Major complications occur by this stage
Congenital Syphilis
- Spirochetes pass trans-placenta to fetus
- Inhibits fetal growth
- Some die through miscarriage or stillbirth
- Others develop Congenital Syphilis: interstitial keratitis, Hutchinson's teeth, saddle nose, and CNS anomalies
Laboratory Diagnosis of Syphilis
- Primary stage:
- Specimens: exudate from a chancre
- Detection of Treponema: dark ground microscopy, immunofluorescent microscopy, and nucleic acid probe and PCR techniques
- Serology: cardiolipin antibodies (reagin) and fluorescent treponemal antibody (FTA) test
- Secondary stage:
- Specimens: exudate from skin lesions, mucous patches or condyloma lata
- Detection of Treponema: nucleic acid probes and PCR techniques
- Serology: to detect antibodies in patient serum
Chancroid
- Caused by Haemophilus ducreyi
- Infection usually begins as a soft papule at the point of contact
- Develops into a soft chancre (painful in men, but may be unnoticed in women)
- Inguinal lymph nodes can become swollen and tender
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Description
This quiz covers the diagnosis and testing of syphilis, including microscopy, PCR techniques, serology, and antibody tests.
