1 / 17

Syphilis The Great Mimic

Syphilis The Great Mimic. What is Syphilis?. Caused by the bacterium Treponema pallidum Time between infection and start of first symptom is 10-90 days Diagnosed by Dark field microscopy of material taken from a lesion or lymph node Serologic tests ( RPR & VDRL) 1.

morrell
Download Presentation

Syphilis The Great Mimic

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. SyphilisThe Great Mimic

  2. What is Syphilis? • Caused by the bacterium Treponema pallidum • Time between infection and start of first symptom is 10-90 days • Diagnosed by • Dark field microscopy of material taken from a lesion or lymph node • Serologic tests (RPR & VDRL)1 • CDC. 2014. STD treatment guidelines.

  3. Stages of Syphilis • Disease has 4 distinct phases: • Primary • Secondary • Latent (early & late) • Tertiary

  4. How Do I Get Syphilis? • Bacteria enter body through minute abrasions in skin • Transmitted through contact with moist lesions, especially during sexual activity • Rate of transmission from infected sexual partner is about 30%-60%1 • Primary, secondary, and early latent stage account for nearly all transmission • Syphilis may also be acquired congenitally (at birth) 1. Augenbraun M. 2003. In: Dale DC.

  5. Syphilis • Syphilis has been around since at least the 15th century. • National public reporting of syphilis cases began in 1941. • In the year 2000, the rate of primary and secondary (P&S) syphilis hit an all time low. • In 2013, the total case counts (all stages) were the highest recorded since 1996. • From 2012 to 2013, there was a 13.1% increase in overall cases. .

  6. Syphilis and MSM • 75% of primary and secondary syphilis in 2013 was associated with men having sex with men (MSM). • Syphilis cases among MSM are characterized by high rates of HIV co-infection and high-risk sexual behaviors. • In 2006, the rate was highest among men ages 35 – 39 years. • In 2013 the rate was highest in men 20 -29 years old. CDC, “2013 STD Surveillance Syphilis”

  7. Syphilis and Youth • 20% of all newly diagnosed cases are in young people, ages 15 – 24.1 • Racial disparities in young people ages 15 – 19 • Rates among black males were 11.7 times higher than white males in the same age group. • Rates among black females were 18.2 times higher than white females in the same age group. CDC, “Sexuallly Transmitted Infections Among Young Americans”

  8. Reported Cases of Syphilis Source: CDC. 2010. STD Surveillance.

  9. What is Primary Syphilis? • Single or multiple sores (chancres) • Firm, round, painless; indicates point of bacterial entry • Typically occurs on genital skin and mucosa • May also occur in mouth, hands, or other parts of the body • Chancre heals by itself in 3-6 weeks • Neurosyphilis can occur during any stage of syphilis, including primary and secondary syphilis.1

  10. What is Secondary Syphilis? • Symptoms are caused by the spread ofthe bacteria • Fever, sore throat, rash, lymph gland swelling, loss of hair1 • External genital lesions called condylomalata • Lesions resolve in 3-12 weeks2 • Augenbraun M. 2003. In: Dale DC. • Sparling PF. 2008. In: Holmes KK, et al.

  11. Syphilis chancre

  12. What is Latent Syphilis? • Latent stage can be divided into early and late stages • Mostly asymptomatic and contagious • Early latent stage usually during first year of infection • One-fourth of patients in early latent stage have a relapse (ie, become symptomatic again) • Relapse is rare in late latent syphilis • May resolve by itself or advance to the tertiary stage1 • Sparling, PF. 2008. In: Holmes KK, et al.

  13. What is Tertiary Syphilis? • Occurs in 1/3 of the cases, months or years after latency1 • Causes walls of major arteries to weaken and balloon out; these aneurysms can rupture and may be fatal • Affects the brain and its coverings to cause paralysis, mental confusion, insomnia, and headaches • Gummas - destructive lesions in skin, bones, and other organs2 • Augenbraun M. 2003. In: Dale DC. • Sparling PF.2008. In: Holmes KK, et al.

  14. Stages of Syphilis (approximate duration) 1-3 wks Incubation 3-6 wks Primary 3-12 wks Secondary < 1 yr Early latent 1-5 yrs Late latent many years Tertiary Infectious & symptomatic Infectious & asymptomatic Noninfectious & symptomatic Noninfectious & asymptomatic

  15. How is Syphilis Treated? • Effectively treated with antibiotics (penicillin) • Repeated tests are important to confirm cure • 2-to-5 fold increased risk of HIV infection with syphilis1 • Syphilis is on the increase in HIV positive homosexual males2 • All patients with syphilis should be tested for HIV • CDC. 2010. Fact Sheet. • CDC. 2010. STD Surveillance.

  16. Reducing Syphilis Risk • Syphilis is a dangerous STI • 100% consistent use of condoms may reduce the risk of transmission, but does not eliminate the risk.1 • Screening of all pregnant females is recommended2 • All infants born to infected mothers shouldbe treated2 • Koss. 2009. Sexually Trans. Diseases • CDC. 2010. STD Treatment Guidelines.

  17. Avoiding Syphilis • For unmarried individuals, sexual abstinence is the only practical and certain way to avoid syphilis • For those who choose to be sexually active, a marriage (mutually faithful, life-long relationship with an uninfected sexual partner) is the healthiest choice.

More Related