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Late Latent Syphilis


Presentation

  • In this case report, we present a 47-year-old man with late latent syphilitic infection and fundoscopic, as well as angiographic findings consistent with acute syphilitic posterior placoid chorioretinitis.[ncbi.nlm.nih.gov]
  • Presents outstanding photographs for virtually every common skin disorder.[books.google.com]
  • There have also been documented cases of syphilis where there was so much antibody present in a patient's blood that the RPR test was non-reactive. Your body did not clear the infection, but the Penicillin shots will take care of it.[thebody.com]
  • Its diagnosis is based on clinical presentation and serological studies. The clinical course is marked by four stages: primary, secondary, tertiary and latent.[sjkdt.org]
Sputum
  • Case report A 58-year-old white female patient was admitted to the hospital with altered mental status, shortness of breath, chest pain, increased sputum production, and cough.[ajhp.org]
Sputum Production
  • Case report A 58-year-old white female patient was admitted to the hospital with altered mental status, shortness of breath, chest pain, increased sputum production, and cough.[ajhp.org]
Failure to Thrive
  • Fred Ferri’s popular "5 books in 1" format provides quick guidance on menorrhagia, Failure to Thrive (FTT), Cogan’s syndrome, and much more.[books.google.com]
Chest Pain
  • A 58-year-old white woman was admitted to the hospital for symptoms including altered mental status, shortness of breath, and chest pain. The initial workup isolated syphilis immunoglobulin G antibody.[ncbi.nlm.nih.gov]
  • Case report A 58-year-old white female patient was admitted to the hospital with altered mental status, shortness of breath, chest pain, increased sputum production, and cough.[ajhp.org]
Fracture
  • Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula.[ncbi.nlm.nih.gov]
Muscle Weakness
  • Her medical history included ESRD requiring hemodialysis three days a week, chronic obstructive pulmonary disease, type II diabetes, hyperlipidemia, neuropathy, muscle weakness, seizure, and acute bacterial endocarditis secondary to mitral valve replacement[ajhp.org]
Visual Hallucination
  • Three patients developed a progressive impairment of their cognitive function in the form of visual hallucination and peripheral neuromuscular affections.[sjkdt.org]
Facial Swelling
  • However, such testing is not routinely available at the admitting facility, and the documented prior allergic reaction to penicillin (facial swelling) was serious enough to warrant desensitization.[ajhp.org]
Limb Weakness
  • Progressive painless lower limbs weakness in a dialyzed patient: Undiagnosed tertiary syphilis: A case report. Cases J 2010;3:23. [ PUBMED ] 5. French P, Gomberg M, Janier M, Schmidt B, van Voorst Vader P, Young H; IUST.[sjkdt.org]

Workup

  • The initial workup isolated syphilis immunoglobulin G antibody. A treponemal test was reactive, and a nontreponemal test was nonreactive; analysis of cerebrospinal fluid did not indicate neurosyphilis.[ncbi.nlm.nih.gov]
  • During a workup for altered mental status, the patient tested positive for the presence of syphilis immunoglobulin G (IgG) antibody, which warranted further testing.[ajhp.org]
Rectal Ulceration
  • Earlier manifestations of syphilis include primary genital or rectal ulcers or lesions. Later symptoms include rash, mucocutaneous lesions, and lymphadenopathy.[ajhp.org]
Borrelia Burgdorferi
  • Borrelia burgdorferi and Treponema pallidum: A comparison of functional genomics, environmental adoptions and pathogenic mechanisms. J. Clin. Invest., 107(6), 651-656. Rompalo, A. M., Joesoef, M. R., O'Donnell, J.[degruyter.com]

Treatment

  • Only a small percentage of serologic tests will be appreciably altered by treatment with penicillin. The treatment of this stage of the disease is intended to prevent the late sequelae.[health.am]
  • Prescribe effective dermatologic treatment with an expanded formulary to the most commonly used drugs; detailed guidance on the use of antibiotics; and the inclusion of the latest drug treatment options.[books.google.com]
  • Lee et al. 9 treated 11 patients who were diagnosed with syphilis and found no significant change in RPR titers up to 36 months after treatment. However, patients in the study had low RPR titers before treatment.[ajhp.org]
  • The patient was diagnosed as having late latent syphilis of unknown duration, for which the standard treatment is intramuscular penicillin G benzathine 2.4 million units once weekly for three weeks.[ncbi.nlm.nih.gov]

Prognosis

  • […] favorable prognosis for patients diagnosed with either primary or secondary syphilis 20% of untreated patients with tertiary syphilis die of the disease prognosis for tertiary syphilis depends on the extent of scarring and tissue damage with adequate[medbullets.com]
  • Syphilis Prognosis Primary, secondary, and early latent syphilis can be treated successfully with antibiotics. Late latency (more than 1 year after the secondary stage) is difficult to treat.[healthcommunities.com]

Etiology

  • Its exact etiology is unclear, although it may be due to an immunological reaction to the rupture of spirochetes. Management of this reaction often involves symptomatic treatment (eg, with antipyretics and analgesics) and observation.[emedicine.medscape.com]
  • […] traumatic ulcer, furuncle (boil), and aphthous ulcer. 12 A selected differential diagnosis is provided in Table 1. 12, 13 View/Print Table TABLE 1 Selected Differential Diagnosis of Genital Lesions Disorder or disease Characteristics of genital lesion Etiology[aafp.org]
  • Fifth, even the physicians did distinguish co-existing cardiac disease or CNS disease that had a different etiology from cardiac or CNS disease at the diagnosis stage, these data were not collected.[nature.com]
  • Section 5 - Management and Treatment of Specific Infections Syphilis Etiology Caused by Treponema pallidum subsp. pallidum.[canada.ca]
  • […] dollars spent on sexually transmitted diseases and HIV infection in the United States (approximately 12.6 billion dollars is associated with the care of persons with HIV infection). [ 8 ] Microbiology and Pathogenesis Organism and Classification The etiologic[std.uw.edu]

Epidemiology

  • Organization of medical conditions provides a brief overview of the basic disease process, epidemiology, pathophysiology, signs and symptoms, laboratory findings, and currently accepted medical therapy of each disorder.[books.google.com]
  • Reexamining syphilis: An update on epidemiology, clinical manifestations, and management. Ann Pharmacother 2008;42:226-36. [ PUBMED ] 10. Singh AE, Wong T, Prithwish DE.[sjkdt.org]
  • The Oslo study of untreated syphilis: An epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material. Acta Derm. Venereol., 35, 3-368. Goh, B. T., Voorst Vader, P. C. (2001).[degruyter.com]
  • Introduction Classification Treponema pallidum spirochete Epidemiology demographics most common during years of peak sexual activity most new cases occur in men and women aged 20-29 years recent rise in syphilis cases among men who have sex with men ([medbullets.com]
  • Ulcers should always be tested for herpes simplex virus and/or chancroid (if epidemiologically appropriate; see Chancroid chapter) and/or lymphogranuloma venereum (if epidemiologically appropriate; see Lymphogranuloma venereum chapter).[canada.ca]
Sex distribution
Age distribution

Pathophysiology

  • Organization of medical conditions provides a brief overview of the basic disease process, epidemiology, pathophysiology, signs and symptoms, laboratory findings, and currently accepted medical therapy of each disorder.[books.google.com]

Prevention

  • Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization[books.google.com]
  • MMWR Morb Mortal Wkly Rep. 2010 ; 55 ( RR-12 ): 1 – 116. 3 Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2011. (accessed 2014 Jan 3). 4 Centers for Disease Control and Prevention.[ajhp.org]

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