Presentation
The amount of scale present is variable. Smaller lesions tend to have little visible scale, whereas larger lesions may be quite scaly. [streetdirectory.com]
The secondary stage of syphilis epitomizes the capacity of the infection to present in myriad ways. The skin, lymph glands and mucosal membranes are the most commonly affected tissues. [unboundmedicine.com]
While most patients presented with multiple skin lesions, two patients presented with single isolated lesions, which makes the diagnosis almost impossible without histologic examination and a high-degree of suspicion [ 20, 25 ]. [omicsonline.org]
Patients may present with CNS vascular insufficiency or outright stroke. [emedicine.medscape.com]
Small, open sores may be present on mucous membranes. The sores may contain pus, or moist sores that look like warts may be present (condyloma lata). In dark-skinned people the sores may be a lighter color than the surrounding skin. [northshore.org]
Entire Body System
- Fatigue
The additional symptoms of secondary syphilis, such as fever, fatigue, and enlarged glands will resolve with antibiotics treatment. Analgesics such as Tylenol can be added to ease muscle aches and other general discomforts. [skincare.lovetoknow.com]
Read more » Rescriptor ...effects and toxicity: Most common side effects include headache, nausea, vomiting, diarrhea, fatigue, elevated liver enzymes, and itchy skin or rash. [thebody.com]
Syphilis About 2 to 10 weeks after the first sore appears, you may develop the following: A skin rash that causes small, reddish-brown sores Sores in your mouth, vagina, or anus Fever Swollen glands Weight loss Hair loss Headache Extreme tiredness ( fatigue [webmd.com]
[…] syphilis) will develop, including A skin rash that can occur anywhere on the body, but is usually present on the palms of the hands and soles of the feet Sores in the mouth and on the genitals or anus Swollen lymph glands Mild fever Sore throat Headache Fatigue [healthychildren.org]
With secondary syphilis there may also be headaches, fever, fatigue, weight loss, sore throat, patchy hair loss, enlarged lymph nodes and loss of appetite. [diagnose-me.com]
- Candidiasis
I will never understand why don�t doctors tell us or investigate more on the subject of candidiasis. Two of my friends, one of them a naturopath had recommended that I try your program. [es.slideshare.net]
They are usually accompanied by a concomitant cutaneous eruption. [5], [6] The differential diagnosis of oral lesions of secondary syphilis includes erythema multiforme, stomatitis, pemphigus, lichen, candidiasis, oral gonorrhea, and other STDs. [7], [ijdr.in]
[…] vesicular, more painful Tinea versicolor Erythema multiforme Chancroid (painful, purulent deep genital ulcers with painful localized lymphadenopathy in 50% of cases) Herpes simplex (often multiple, grouped vesicles which can ulcerate, on erythematous base) Candidiasis [clinicaladvisor.com]
- Anorexia
Appropriate clinical suspicion Known sexual exposure Characteristic rash, lymphadenopathy, fatigue, malaise, anorexia Ocular symptoms There are myriad presentation of secondary syphilis, hence its moniker, “the great pretender.” [clinicaladvisor.com]
Gastrointestinal
- Fecal Incontinence
In the case of lower tabes at the beginning, constipation and urinary retention prevail, followed by urinary and fecal incontinence. The characteristic moment for the tabes is the irregularity of the pupils. [en.medicine-worlds.com]
Spinal cord involvement may cause weakness and wasting of shoulder-girdle and arm muscles, slowly progressive leg weakness with urinary or fecal incontinence or both, and, rarely, sudden paralysis of the legs due to thrombosis of spinal arteries. [msdmanuals.com]
Liver, Gall & Pancreas
- Hepatomegaly
A compilation of early clinical presentations of congenital syphilis in 9 studies involving a total of 212 infants included abnormal bone radiographs (61%); hepatomegaly (51%); splenomegaly (49%); petechiae (41%); other skin rashes (35%); anemia (34%) [emedicine.medscape.com]
Cardiovascular
- Chest Pain
If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately. [healthlinkbc.ca]
These symptoms can include: Destructive tumors, called gummas, in the mouth, nose, tongue, bones, skin, liver or other organs Chest pain or breathing difficulties related to heart valve damage or damage to the wall of the aorta (the major blood vessel [drugs.com]
Jaw & Teeth
- Oral Ulcers
[…] with oral lesions of primary syphilis, which tend to be solitary, painless, indurated ulcers, oral lesions of secondary syphilis are typically painful and multiple. [ijdr.in]
There were no oral ulcers, genital lesions or palmar and plantar rash or lymphadenopathy. She also complained of generalized malaise, fever, chills, arthralgia, and recent unintended 10-pound weight loss. [omicsonline.org]
Ears
- Hearing Impairment
impaired) (03) 9347 8619 Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840 The Centre Clinic, St Kilda Tel. (03) 9525 5866 Equinox Gender Diverse Health Centre Tel. (03) 9416 2889 PRONTO ! [betterhealth.vic.gov.au]
Complications of syphilis may also include such cardiovascular and neurological problems as: Stroke Meningitis Hearing impairment Visual impairment Dementia or memory loss Syphilis in pregnant women can result in miscarriage, stillbirth, or death of the [everydayhealth.com]
Skin
- Sweating
This can cause symptoms, such as high fever, profuse sweating, night sweats, nausea, and vomiting. [poz.com]
[…] or some of the following symptoms may be present in an individual and some can persist for several weeks: Mucous membrane sores - typically in the mouth, vagina, and anus Swollen lymph glands - which are often painful Fever - sometimes accompanied by sweating [skincare.lovetoknow.com]
The symptoms include a sudden fever with headache, sweating, and possibly a rash. This clears up in less than 24 hours. Penicillin stops the infectivity within a day or two, and cures the disease in a week or two. [medbroadcast.com]
It typically manifests as malaise, fever, headache, sweating, rigors, anxiety, or a temporary exacerbation of the syphilitic lesions. The mechanism is not understood, and JHR may be misdiagnosed as an allergic reaction. [msdmanuals.com]
Eyes
- Visual Impairment
impairment, deafness, and incontinence). [verywell.com]
Complications of syphilis may also include such cardiovascular and neurological problems as: Stroke Meningitis Hearing impairment Visual impairment Dementia or memory loss Syphilis in pregnant women can result in miscarriage, stillbirth, or death of the [everydayhealth.com]
Other affected organs may include liver, kidneys, central nervous system ( CNS ), joints and eyes (resulting in visual impairment). Secondary syphilis See more images of syphilis ... [dermnetnz.org]
Musculoskeletal
- Arthralgia
[…] hepatitis), the CNS (headache, meningitis, cranial neuropathy, iritis, and uveitis), and the musculoskeletal system (arthritis, osteitis, periostitis). 4 Patients also may have constitutional symptoms such as fever, malaise, generalized lymphadenopathy, arthralgias [aafp.org]
Generalized lymphadenopathy, fever, malaise, spienomegaly, sore throat, headache, and arthralgia can be present. [meddean.luc.edu]
Less common findings include periostitis, arthralgias, meningitis, nephritis, hepatitis, proctitis, and ulcerative colitis. Go to Interstitial Keratitis for complete information on this topic. [emedicine.medscape.com]
She also complained of generalized malaise, fever, chills, arthralgia, and recent unintended 10-pound weight loss. [omicsonline.org]
He complained of severe headache and arthralgia and reported low-grade fever, fatigue, and weight loss during the previous 4 weeks. Superficial lymphadenopathy was unclear. Fig. 1 Clinicopathological findings. a. Skin lesions before treatment. [diagnosticpathology.biomedcentral.com]
- Bony Swelling
Neurogenic arthropathy (Charcot joints), a painless joint degeneration with bony swelling and abnormal range of movement, is a classic manifestation of neuropathy. [msdmanuals.com]
Urogenital
- Incontinence
[…] may experience severe neurological symptoms including meningitis (inflammation of the membrane surrounding the brain and spinal cord) or tabes dorsalis (a condition characterized by nerve pain, loss of motor skills, visual impairment, deafness, and incontinence [verywell.com]
Patients with parenchymatous neurosyphilis present with ataxia; incontinence; paresthesias; and loss of position, vibratory, pain, and temperature sensations. Paresis and dementia, with changes in personality and intellect, may develop. [emedicine.medscape.com]
In the case of lower tabes at the beginning, constipation and urinary retention prevail, followed by urinary and fecal incontinence. The characteristic moment for the tabes is the irregularity of the pupils. [en.medicine-worlds.com]
Loss of bladder sensation leads to urine retention, incontinence, and recurrent infections. Erectile dysfunction is common. [msdmanuals.com]
Odd movement when walking, urinary incontinence and general tremors are common symptoms of this condition. The second type is called paretic neurosyphilis, and the main symptom is a change in behaviour as dementia slowly sets in. [health24.com]
Neurologic
- Seizure
Seizures, personality changes, hallucinations, dementia, schizophrenia, and stroke can also occur. [verywell.com]
This phase has no symptoms at first, but as the bacteria invade and damage nerves, bones, and the heart and other organs, the patient may experience dizziness, headaches, seizures *, dementia *, loss of coordination, numbness, increasing blindness, and [humanillnesses.com]
In some cases, individuals will experience seizures, headaches, fevers, stiff neck, dementia, and behavioral abnormalities. [rarediseases.org]
General paresis causes paralysis, tremors, seizures, and general mental decline from damage to brain cells. Gummas form anywhere on the brain or spinal cord therefore causing a variety of neurological defects. [plaza.ufl.edu]
Complications : Congenital Syphilis can cause lot of problems to the unborn baby such as deformities, seizures, rashes, anemia and jaundice. People with syphilis develop increased chances of getting affected by AIDS. [diseaseslab.com]
- Confusion
The distribution and morphologic characteristics of the skin and mucosal lesions are varied and may be confused with numerous other skin diseases. As with most other systemic cutaneous diseases, the rash is usually bilaterally symmetric. [dartmouth.edu]
Read more » Am still a bit confused-Syphilis Question (ORAL SEX AND STDs, 2010) I am a 50 year old safe, and usually sane man. That changed 48 Hours ago. In another city on a... [thebody.com]
Rare findings include iritis, with possible adhesion of the iris to the anterior lens, producing a fixed pupil (not to be confused with Argyll Robertson pupil). Go to Neurosyphilis for complete information on this topic. [emedicine.medscape.com]
The occasional presence of the Koebner phenomenon further contributes to this confusion. [dermatologyadvisor.com]
[…] may present with constitutional symptoms such as fever, malaise, headache and lymphadenopathy The skin is involved in over 90% of cases The rash is usually generalised involving the trunk but may just affect the palms and soles The rash can be easily confused [sti.guidelines.org.au]
- Tremor
General paresis causes paralysis, tremors, seizures, and general mental decline from damage to brain cells. Gummas form anywhere on the brain or spinal cord therefore causing a variety of neurological defects. [plaza.ufl.edu]
Tumors may develop on skin, bone, testes, and other tissues; cardiovascular symptoms such as aortic aneurysm and aortic valve insufficiency may develop; degenerative central nervous system disease can produce dementia, tremors, loss of muscle coordination [healthcommunities.com]
Complications of tertiary syphilis include: brain damage: Depending on which part is damaged, symptoms could range from motor effects (such as tremors) to mood disorders (such as having delusions of grandeur). [medbroadcast.com]
Odd movement when walking, urinary incontinence and general tremors are common symptoms of this condition. The second type is called paretic neurosyphilis, and the main symptom is a change in behaviour as dementia slowly sets in. [health24.com]
Tremors of the mouth, tongue, outstretched hands, and whole body may occur; other signs include pupillary abnormalities, dysarthria, hyperreflexia, and, in some patients, extensor plantar responses. Handwriting is usually shaky and illegible. [msdmanuals.com]
- Aphasia
[…] orally four times daily for 4 weeks Tertiary (late) syphilis Gummatous disease, cardiovascular disease Nontreponemal tests (71% to 73%) Treponemal-specific tests (94% to 96%) Same treatment as for late latent syphilis Neurosyphilis Seizures, ataxia, aphasia [aafp.org]
Irritability, difficulty concentrating, deterioration of memory, defective judgment, headaches, insomnia, fatigue, and lethargy are common; seizures, aphasia, and transient hemiparesis are possible. Hygiene and grooming deteriorate. [msdmanuals.com]
[…] orally four times daily for 4 weeks Tertiary (late) syphilis Gummatous disease, cardiovascular disease Nontreponemal tests (71% to Same treatment as for late latent syphilis 73%)Treponemal-specific tests (94% to 96%) Neurosyphilis Seizures, ataxia, aphasia [slideshare.net]
- Convulsions
In the acute case, this is clinically manifested by swelling and swelling of the brain (impaired consciousness, focal neurological symptoms, convulsions ). In the chronic case, a person feels constant headaches of a non-passing nature. [en.medicine-worlds.com]
Mood swings, lack of insight into reality and convulsions are typical of this condition. The third type is called meningovascular neurosyphilis and is a chronic form of meningitis. [health24.com]
Workup
Ultrasound
- Enlargement of the Liver
Some children with congenital syphilis may have no symptoms, or they may have symptoms such as a rash, runny nose (sometimes bloody), inflammation of the bones and enlarged lymph nodes, liver and spleen. [health24.com]
The most common symptoms seen in babies born with syphilis include: [18] Intermittent fevers Enlarged spleen and liver (Hepatosplenomegaly) Swollen lymph nodes Chronic sneezing or runny nose with no apparent allergic cause (persistent rhinitis) Maculopapular [wikihow.com]
Common symptoms that develop over the first couple of years of life include enlargement of the liver and spleen (70%), rash (70%), fever (40%), neurosyphilis (20%), and lung inflammation (20%). [en.wikipedia.org]
Treatment
Syphilis alternative treatments for Late latent and Unknown Duration Syphilis Doxycycline 100mg PO BID x 4 weeks OR complication of PCN treatment in pregnancy Jarish Herxheimer Reaction "acute febrile reaction occuring after PCN treatment can occur at [quizlet.com]
Treatment of Syphilis FIGURE 1. Recommended approach to the treatment of syphilis. [aafp.org]
Treatment of the Rash of Secondary Syphilis The rash of secondary syphilis does not require any specific treatment because it does not usually cause any symptoms such as itching. The rash will resolve on its own with or without treatment. [skincare.lovetoknow.com]
This would provide confirmation of adequate treatment. [medicalnewstoday.com]
Prognosis
What Is The Prognosis? The treatment of syphilis with penicillin can resolve the infection. Patients should have blood tests to confirm that the infectious bacteria have been eliminated. [healthychildren.org]
Course and Prognosis The ulcer of primary syphilis (chancre) appears 2 to 3 weeks after exposure to an infected person. [streetdirectory.com]
Prognosis : The invention of penicillin has reduced the spread of Syphilis which can now be cured without causing permanent damage. [diseaseslab.com]
Prognosis With proper antibiotic treatment, early syphilis infection can be cured without causing permanent damage. Although later stages of syphilis also respond to antibiotics, treatment will not repair any organ damage caused by the disease. [drugs.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
[…] treatment of sex partners principle (for syphilis) syphilis is a reportable disease 70% of syphilis cases are in this population syphilus etiological agent "corkscrew shaped, motile microaerophilic bacterium can't be cultured in vitro cannot be viewed [quizlet.com]
(Etiology) Syphilis is a contagious bacterial infection that is transmitted through sex with an affected individual. [dovemed.com]
Acute syphilitic meningitis does not have any typical symptoms, the clinic is similar to meningitis of a different etiology. A person feels a headache of diffuse and arching nature, fever and vomiting without nausea and not bringing relief. [en.medicine-worlds.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]
Etiology T. pallidum is a motile, corkscrew-shaped spirochete. Spirochetes are gram negative and have a flagellar bundle running through their periplasmic space causing the cells to move in a corkscrew fashion. Its size varies from 6 to 20um. [dermatologyadvisor.com]
Epidemiology
Recent trends in the epidemiology of STI in the European Union. Sex Transm Infect 2004;80:255-63. 8. Lacey HB, Higgins SP, Graham D. An outbreak of early syphilis: cases from North Manchester General Hospital. Sex Transm Infect 2001;77:311-3. 9. [degruyter.com]
Epidemiologic studies in San Francisco, Seattle and New York City, however, have not found an increase in HIV coincident with the significant growth of syphilis in those urban centers. [clinicaladvisor.com]
Syphilis in China from 2000 to 2013: epidemiological trends and characteristics. Chin J Dermatol 5, 6 (2014). 4. Chung, G., Kantor, G. R. & Whipple, S. Tertiary syphilis of the face. [nature.com]
Clinical and epidemiological features of study subjects. Table 1. Clinical and epidemiological features of study subjects. Cellular elements of innate and adaptive immunity in secondary syphilis skin lesions. [academic.oup.com]
"A systematic review of epidemiologic studies assessing condom use and risk of syphilis". Sex Transm Dis. 36 (7): 401–5. doi : 10.1097/OLQ.0b013e3181a396eb. PMID 19455075. ^ a b "Syphilis - CDC Fact Sheet". [en.wikipedia.org]
Pathophysiology
Precise understanding of the pathophysiology of syphilis is compromised by the inability to grow the spirochete in culture, and therefore it has been studied in animal models and in some controversial human studies, for example, the Tuskegee study in [clinicaladvisor.com]
Prevention
Encyclopedia) RPR test (Medical Encyclopedia) Syphilis (Centers for Disease Control and Prevention) Syphilis - primary (Medical Encyclopedia) Syphilis and MSM (Men Who Have Sex with Men) (Centers for Disease Control and Prevention) VDRL test (Medical [icdlist.com]
External resources CDC National Prevention Information Network (NPIN) National Center for HIV, STD and TB Prevention P.O. [drugs.com]
Congenital syphilis can be prevented by treating the mother for syphilis during pregnancy. [everydayhealth.com]
Prevention First As with any other sexually transmitted infection, prevention is the key to avoid being infected with syphilis. Avoid unprotected sex with multiple partners. Insist on the use of condoms with every sexual partner. [skincare.lovetoknow.com]
Therefore, public awareness and education about these infections and the methods of preventing them is important. There really is no such thing as "safe" sex. The only truly effective way to prevent STDs is abstinence. [emedicinehealth.com]