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33 Cards in this Set
- Front
- Back
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How is syphilis transmitted?
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1. Sexually transmitted (higher incidence with homosexual)
2. Contact with lesion (must be through broken skin) 3. Congenital Unable to survive drying or chemicals |
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What is the incubation period for syphilis?
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Usually about 21 days (10-90 range)
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Primary infection of syphilis is manifested where?
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At site of entrance into the body, no widespread distribution yet.
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What is the 1st clinical sign of syphilis?
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Painless chancre (red and raised) usually at site of infection.
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Will a primary syphilitic chancre have antibodies?
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No. Serotipically negative.
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What are the key symptoms of the secondary phase of syphilis?
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1. Generalized skin rash (doesn't itch or hurt). Raised, reddish and rubbery.
2. Rash especially present on palms of hands and soles of feet 3. Occur 6-10 weeks after primary chancre 4. Infectious and serology is positive (antibodies present) 5. Disappear within 2-6 weeks |
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How does serology differ between the primary and secondary phases of syphilis?
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Primary phase: Serology negative.
Secondary phase: Serology positive. |
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In the early latent period of syphilis is the host infectious?
How is someone diagnosed during this period? |
Only while symptoms are present.
Diagnosis with a blood test. |
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Late latent period of syphilis:
About how long w/o symptoms? Infectious? |
After about 1 year w/o symptoms.
Can still pass on infection congenitally (across placenta). |
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What % of people with late latent syphilis progress to tertiary syphilis?
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About 33%.
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What are the 3 types of tertiary syphilis?
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Benign
Cardiovascular Neurosyphilis |
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Benign tertiary syphilis:
What is it caused by? What are some symptoms? |
Caused by immune response attacking the latent pathogen.
Gumma (large, degradatory ulcers) in connective tissues, skin, muscles, organs, eye, endocrine glands About 17% of untreated cases. |
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Cardiovascular syphilis:
What symptoms? %? |
Damage to heart and major blood vessels. Can progress to heart failure.
10% of untreated cases. |
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Neurosyphilis:
What symptoms? %? |
Attacks brain and spinal cord to bring on paralysis and/or insanity.
About 8% of untreated cases. |
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In congenital syphilis, when may the organism be transferred to the fetus?
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After the 20th week (teratogenic bacteria).
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What are some possible disfigurements that can result from congenital syphilis?
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1. Saddle nose (bridge of nose)
2. Hutchinson's teeth (Upper incisors deformed) 3. Saber shin (forward bowing of the tibias) 4. Corneal opacity (blindness) 5. Deafness |
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How do we test for congenital syphilis?
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Non-specifically.
Not testing for antibodies but are identifying materials released from damaged cells and materials associated with treponema. |
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What is the Wasserman test?
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Extract of fetal liver of child that died of congenital syphilis.
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What is a Reagin test?
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IgG & IgM Ab against lipoproteins released from damaged cells & also present on treponemal cell surface.
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What is used to treat early stage syphilis?
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Doxycycline (100 mg 2x/day for 2 weeks)
Benzathine penicillin (long acting) Tetracycline, erythromycin, chloramphenicol |
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What is used to treat late & congenital syphilis?
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Penicillin G
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What is used to treat neurosyphilis?
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penicillin or chloramphenical
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What is necessary in follow-up testing for someone with:
1. Primary syphilis? 2. Secondary syphilis? |
1. Sexual contacts in past 3 months
2. Sexual contacts in past 6 months |
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Borrelia:
1. Size vs. Treponemas? 2. Stain? 3. Aerobic? 4. Growth rate? |
1. Larger than treponemas.
2. Can be stained with Giemsa stain in peripheral blood smears 3. Microaerophilic 4. Slow growth |
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Lyme disease:
1. What is the reservoir? 2. What is the vector? 3. What is the species (microbe)? |
1. Rodents, deer, pets, hard shelled ticks
2. Hard-shelled tick 3. Borrelia burgdorferi |
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Relapsing fever:
1. Incubation period? 2. Initial symptoms? 3. Next? |
1. Few days
2. Headache, non-prod. cough, lethargy, bacteremia (high fever) 3. Antibodies clear bacteremia, but antigen-antibody complex may trigger rash. Fever returns and disappears. High mortality rate (4-40%) |
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Relapsing fever:
What species causes it? |
Borrelia recurrentis
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Lyme disease:
1. Incubation? 2. Initial symptoms? |
1. 3-30 days
2. Skin lesion at bite site. Erythema chronicum migrans (bulls-eye lesion surrounded by progressive erythematic rings). Malaise, headache, fever, achy. Lesion will disappear within weeks. |
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Lyme disease:
1. Secondary symptoms? 2. Late manifestations? 3. Treatment? 4. Vaccine? |
1. Transient subsequent lesions in 85% of patients.
2. Neurologic symptoms (meningitis, encephalitis, peripheral neuropathy), arthralgia & arthritis. Importance of early detection. 3. Tetracycline or Doxycycline Erythromycin Ceftriaxane for neurologic disease phase. 4. It exists but not widely used b/c of adverse reactions to it. |
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Leptospira:
1. Aerobes? 2. Growth rate? 3. Epidemiology? |
1. Obligate aerobes
2. Slow growers 3. Mostly colonized wild and domestic animals (cattle, swine, dogs, racoons) |
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Anicteric Leptospira (usual manifestation):
1. Incubation period? 2. Early symptoms? 3. Second stage? |
1. 4-19 days (usually 10)
2. Myalgia, headache, abd. pain, vomiting, fever 3. Meningitis, uveitis, rash, fever |
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Icteric Leptospira (Weil's syndrome):
1. Symptoms? 2. Mortality rate? |
1. Secondary phase right away-Jaundice, hemorrhage, renal failure, myocarditis
2. 10% mortality rate. No permanent liver or kidney damage in survivors. |
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Leptospira:
1. Diagnosis? 2. Treatment? |
1.Specific antibody detection.
FA technique 2. Penicillin or tetracycline Doxycycline |
