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Pathology

Treponema Pallidum spirochete.

Aetiology

Sexual contact, congenital infection.

Signs

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Symptoms

Primary syphilis
Chancre (painless, raised papule with ulcerated centre)
Lymphadenopathy
Secondary syphilis (4-10 weeks after primary infection)
Systemic mucocutaneous lesions
Fever, malaise, headache, sore throat
Lymphadenopathy
Tertiary syphilis (3-15 years after original infection)
Gummatous: formation of gumma in liver, bone, skin and testes
Cardiovascular syphilis: syphilitic aortitis
Neurosyphilis: Argyll-Robertson pupil, tabes dorsalis..

Investigations

Bloods: VDRL (venereal disease research laboratory), rapid plasma reagin test 
and Treponemal Pallidum particle agglutination
Microscopy: Swabs from chancre serous fluid – dark ground illumination 
microscopy

Treatment

Medical: Antibiotics as per local policy due to differing resistance patterns.

Prognosis

Very good if identified and treated early.
Progression to tertiary syphilis as above.

Key Facts

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Key Images

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Key References

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