SYPHILIS

DIFINITATON

• SYPHILIS IS A CHRONIC INFLAMATORY INFECTIOUS

SEXUALLY TRANSMITTED DISEASE CAUSED BY

• TREPONEMA PELLIDUM- A SPIROCHETE • TRANSMITTED MOSTLY BY SEXUAL CONTACT WITH

INFECTED LESIONS OR BODY FLUIDS AND LESS COMMENLY THROUGH TRENSPLACENTLLY FROM MOTHER TO UNBORN CHILD & THROUGH BLOOD TRANSFUSIONS RARELY THROUGH ACCIDENTAL INOCULATION OR PUNCTURE WITH CANTAMINATED INSTUMENTS.

• DISEASE HAS GREAT VARIABILTY IN IT’S CLINICAL

PRSEANTATION AND COURSE- MIMICING VERY MANY DISEASES IN THE FIELD OF MEDICINE & SURGERY

• TREATED SUCSSESFULLY BY PENCILLINS UPTO

PRESUPTION

TREPONEMA PELLIDUM

SILVER STAIN

STAGES OF SYPHILIS AQUIED SYPHILIS REMISSION CONTACT 1/3 INFECTED | 9 TO 90 DAYS PRIMARY | 3 TO 12 WEEKS SECONDARY | 4 TO12 WEEKS EARY LATENT WITH IN 1 YEAR OF CONTACT | LATE LATENT MORE THEN 1 YEAR || / \\ TERTIARY LATE BENIGN-16% CARDIOVASULAR -9.5% NEUROSYPHILIS-6.5%

CLINICAL PRESENTATION

• CHANCRE

SYPHILITIC CHANCER

MULTIPLE PRIMARY LESIONS AT MALE ENITALIA

CHANCRE AT FEMALE GENITALIA

MACULAR SYPHILIDS

PAPULOPUSTULAR SYPHILIDS

MUCOUS PATCHES

CONDYLOMATA LATA

PRINATAL SYPHILIS

BULLOUS LESIONS AT SOLES IN PRINATAL SYPHILIS

SEROLOGICAL TESTS FOR SYPHILIS

1. SCREENING TEST

CARDIOLIPIN BASED NONTREPONEMAL TEST (REAGINIC TEST) FLOCULATION TEST -VDRL,RPR ANTIGEN IS CARDIOLIPIN+CHOLESTROL+LACITHIN ANTBODIES- IgM,IgG IN SERUM OF PATIENT BECOME REACTIVE IN 4 TO 5 WEEKS OF INFECTION REVERT TO NON REACTIVE WITH IN 4 TO 6 MONTS OF TRATMENT BIOLOGICAL FALSE REACTIVE TEST

2. SPECIFIC TREPONEMAL TEST

– SPECIFIC BUT POSITIVE IN -3 WEEKS AFTER INFECTION & REMAIN + EVEN AFTERTREATMNET FTA-ABS MOST SENSITIVE & SPECIFIC TEST, 95-100% MHA-TP CAPTIA (IgM)EIA U SEFUL IN DIAGNOSIS OF REINFECTION , CONGENITAL SYHILIS, NEUROSYPHILIS IS + IN CSF

INTERPRETATION OF STS

• • • • • • • • RPR MHA-TP CAPTIA IgM -

INCUBATING

-

NO SYPHILIS OR +VE EARLY PRIMARY SYPHILIS + + + PRIMARY/SECONDARY SYPHILIS + + EARLY INFECTION + + SYPHILIS LATE SECONDARY/LATENT + BIOLOGICAL FALSE POSITIVE + LATE INFECTION/ TREATED CASE/BIOLOGICAL FALSE POSITIVE > + > REINFECTION/RELAPSE