China
Africa
Explore chapters and articles related to this topic
Chronic erythematous rash and lesions on trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Secondary syphilis occurs about 6 weeks after a primary infection with Treponema pallidum. The skin lesions are preceded by a flu-like illness and painless lymphadenopathy. The rash is very variable and may consist of macules, papules, pustules and plaques ranging in colour from pink to mauve, orange to brown. There are often lesions on the palms and soles (Fig. 8.50), patchy alopecia and flat warty lesions on the genitalia (seeFig. 11.02, p. 259) and perianal skin. The diagnosis can be confirmed by demonstrating T. pallidum on dark ground microscopy (Fig. 11.04, p 259), and a +ve VDRL, which distinguishes it from all the other non-itchy rashes on the skin. For treatment see p. 259.
Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
Syphilis is a systemic disease caused by Treponema pallidum. Syphilis is classified into primary, secondary, early latent, late latent, and tertiary stages. The lesion of primary syphilis, the chancre, usually develops about 21 days after infection and resolves in 1–2 months. Patients with secondary syphilis can present with rash, mucosal lesions, lymphadenopathy, and fever. The rash of secondary syphilis may be maculopapular, papulosquamous, or pustular, and is characteristically found on the palms and the soles. Lues maligna is a rare form of secondary syphilis that is associated with a prodrome of fever, headache, myalgia, and ulcerating lesions [103]. Secondary syphilis can also involve any part of the body, including the lungs, kidneys, cardiovascular system, and central nervous system [104].
Mucosal immune responses to microbes in genital tract
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Syphilis is transmitted through direct contact with a sore, which can occur on the external genitals, vagina, anus, mouth, or in the rectum. Penicillin is used to treat the causative agent of syphilis, the spirochete bacterium Treponema pallidum. However, if untreated, syphilis can result in three stages of disease progression. The primary stage manifests with a single or multiple sores (chancres). The chancre lasts 3–6 weeks, and it heals without treatment. However, if untreated, the infection progresses to the secondary stage. Skin rash (often on palms of the hands and bottoms of the feet) and mucous membrane lesions appear that may be accompanied by fever, fatigue, weight loss, and swollen lymph nodes during secondary syphilis. The symptoms of secondary syphilis will resolve without treatment, but the infection will progress to the latent and possibly late stages of disease. The latent stage of syphilis can last for years. Upon reactivation, a tertiary stage of syphilis ensues, in which the disease may damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can lead to difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, and even death.
Ocular Syphilis: Experience over 11 Years at a German Ophthalmology Reference Centre
Published in Ocular Immunology and Inflammation, 2023
R. Yaici, A. Balasiu, C.R. MacKenzie, M. Roth, K. Beseoglu, C. Holtmann, G. Geerling, R. Guthoff
The assessment of the clinical findings and serology results lead to a diagnosis of a probable clinical stage according to RKI criteria.12 Primary syphilis (syphilis I) is characterized by localized skin lesion (chancre). Secondary syphilis (syphilis II) encompasses generalized symptoms (e.g., fever, headaches, myalgias, weight loss), dermatological, gastrointestinal, renal and neurological findings. Tertiary syphilis (syphilis III) includes involvement of the cardiovascular system and/or gummatous disease. Neurosyphilis is usually assigned to quaternary syphilis (syphilis IV). Additionally, two further stages were defined: Syphilis satis curata (treated and anti-lipoidal antibody negative) and syphilis latens (not previously diagnosed and therefore untreated, anti-lipoidal antibody negative/ or positive, but at a titre of ≤1:4).12
Diagnosis and treatment of syphilis: 2019 Belgian National guideline for primary care
Published in Acta Clinica Belgica, 2022
Vicky Jespers, Sabine Stordeur, Serena Carville, Tania Crucitti, Els Dufraimont, Chris Kenyon, Agnes Libois, Saphia Mokrane, Wim Vanden Berghe
Syphilis is a systemic human disease due to infection with the spirochete bacterium Treponema pallidum subspecies pallidum (T. Performance and detection bias was common across studiesRectal and oral transmission is common in men who have sex with men (MSM) [1–3]. Syphilis can also be passed on through infected blood when sharing needles or rarely via blood transfusion [1]. The infectious ulcer, the sign of primary disease, develops after incubation of generally 3 weeks (range 10–90 days), resolving 3–8 weeks later. Untreated, 25% of patients develop signs of early secondary syphilis affecting multiple organs e.g. generalised rash, hepatitis, uveitis, etc. Secondary syphilis resolves spontaneously in 3–12 weeks and the disease enters an asymptomatic latent stage. This is defined as early during the first year of infection by the European Centre for Disease Prevention and Control (ECDC), and late thereafter (ending with the development of tertiary disease) [4]. Reported cases in Belgium increased from 0.4 to 14 per 100 000 between 2002 and 2018 with registrations mostly in men aged 20–59 years [5].
Secondary syphilis as an initial presentation of HIV
Published in Baylor University Medical Center Proceedings, 2022
Mahir Khan, Tanisha Kaur, Tung Phan, Mohamed Yassin
HIV-infected patients are more likely to present initially with secondary syphilis as well as rapid progression to neurosyphilis.4 In such cases, widely disseminated malignant lues may be a presenting feature in newly diagnosed patients with syphilis and HIV coinfection due to immunosuppression (Figure 1a). Diagnosis of secondary syphilis can be made using a combination of serology and clinical findings. It can be confirmed with histopathology via skin biopsy. The atypical and varied presentation of syphilis in an undiagnosed HIV patient makes it challenging to differentiate syphilis from other possible causes of maculopapular rash, as well as other common pathogens affecting HIV-infected patients, such as disseminated cryptococcal infection and histoplasmosis. Thus, a skin biopsy, in addition to the patient’s CD4 count, is a very beneficial tool in differentiating possible etiologies.