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 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 || / \\ REMISSION 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, % 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 NO SYPHILIS OR INCUBATING - - +VE EARLY PRIMARY SYPHILIS PRIMARY/SECONDARY SYPHILIS EARLY INFECTION LATE SECONDARY/LATENT SYPHILIS BIOLOGICAL FALSE POSITIVE LATE INFECTION/ TREATED CASE/BIOLOGICAL FALSE- POSITIVE > + > REINFECTION/RELAPSE