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Presentation12.pptxSyphilis Disease
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Introduction
Syphilis – its a treponematoses infectious disease caused by Treponema pallidum transmitted through sexual intercourse (Tipple and Taylor, 2015)
The disease was discover in 1905 by Schaudim and Hoffman
Men and females between the age group 20-40 of years are most prevalent
Structure and physiology of Treponemes
Motility – the bacteria is actively motile though with little translational movement
Chemotaxis – Chemotaxis helps the bacteria to navigate in the body during dissemination
Two strains- Nichol’s and Reiter Strains
Pathogenesis
means of transmission
Infected needles
Sexual behaviour
Blood transfusion
Hospital personnel through indiscriminate handling of infected patients
Syphilis classification
Early-duration is 1 years
Primary stage
Secondary stage
Latent stage
late-after 1 years
Late latent
Tertiary syphilis
Congenital syphilis
Primary syphilis
Usually painless
Usually single
Affects the genitals and anal areas
Heal spontaneously
Very infectious
Secondary syphilis
Incubation period of 2-12 weeks
Manifest as – evanescent copper colored muscular rash
25 percent of pts have abnormal CSF
Symptoms – sore throat, malaise, mucosal rash, and adenopathy
Latent syphilis
Affects people with historical evidence for syphilis
Requires exam of CSF to rule out asymptomatic neurosyphilis
Early latency 1 year from onset of infection
Divide in early and late latency
Tertiary syphilis
Morbidity and mortality occurs due to late manifestation
It develops between 1-20 years from acute infection to clinical onset
Divided into:
Late benign syphilis – characterized by gumma
Cardiovascular syphilis – incubation 15-30 years
Neurosyphilis – resolve spontaneously
Clinical manifestation in summary
Lab diagnosis of syphilis
Test are divided into four phases
Direct microscopic exam – applicable in presence of lesions
Non Treponemal tests – used for screening
Treponemal tests – are confirmatory
Direct antigen detection tests – applied during research
Management of syphilis
Parenteral penicillin is DOC for all syphilis stages
Symptomatic treatment and observation
Syphilis patients should be given HIV serology
Treatment of syphilis
Benzathine penicillin G-24 is administered during primary and secondary stage
latent- Benzathine penicillin G- 2.4 million units intramuscularly week apart for three doses (Ho and Lukehart, 2011)
Tertiary - Benzathine penicillin G- 2.4 million units 1 week apart for three doses
Efficacy of azithromycin on the treatment of syphilis
Penicillin therapy is linked with low cost
Azithromycin has been proved to be effective as penicillin in early syphilis
Azithromycin should only be used when penicillin and doxycycline are not feasible (Clement et al., 2014).
Conclusion
This presentation has demonstrated that a single dosage of azithromycin, orally, is as helpful as the 2.4 million units of benzathine penicillin for curing syphilis (Knaute et al., 2014).
References
Clement, M. E., Okeke, N. L., & Hicks, C. B. (2014). Treatment of syphilis: a systematic review. Jama, 312(18), 1905-1917.
Ho, E. L., & Lukehart, S. A. (2011). Syphilis: using modern approaches to understand an old disease. The Journal of clinical investigation, 121(12), 4584-4592.
Knaute, D. F., Graf, N., Lautenschlager, S., Weber, R., & Bosshard, P. P. (2012). Serological response to treatment of syphilis according to disease stage and HIV status. Clinical infectious diseases, 55(12), 1615-1622.
Tipple, C., & Taylor, G. P. (2015). Syphilis testing, typing, and treatment follow-up: a new era for an old disease. Current opinion in infectious diseases, 28(1), 53-60.
