Syphilis secondary

Fig. 24.11 Syphilis, secondary stage hepatitis syphilitica. In the liver parenchyma, massive amounts of corkscrew-shaped syphilis pathogens, 6-10 jm in length, are visible (= treponema palhdmn) (silver impregnation)...

Secondary syphilis Without appropriate treatment, primary syphilis will advance to secondary syphilis, a stage usually apparent from its clinical symptomatology. Symptoms include fatigue, diffuse rash, fever, lymphadenopathy, and genital or perineal condyloma latum. Also, the skin is most often affected and a rash may present as macular, macropapular, or pustular lesions, or involve skin surfaces including the palms of the hands and soles of the feet. 

Early latent Involves the first year after infection and maybe established in patients who have seroconverted in the past year, who have had symptoms of primary or secondary syphilis in the past year, or who have had sex with a partner with primary, secondary, or latent syphilis in the past year. 

Late latent Patients should be considered to have late latent syphilis if the aforementioned criteria (early latent) are not met. In both stages, patients are usually asymptomatic and the lesions noted in the primary and secondary phase usually resolve however, individuals are still seropositive for T. pallidum. 

Treatment modalities administered in primary syphilis are also effective in secondary syphilis and latent syphilis (less than 1 year duration). 

Primary or secondary syphilis diagnosed and treated with Benzathine Penicillin G, 2.4 million units IM (single dose) ... 

The secondary stage of syphilis is characterized by a variety of mucocutaneous eruptions, resulting from widespread hematogenous and lymphatic spread of T. pallidum. 

Signs and symptoms of secondary syphilis disappear in 4 to 10 weeks however, in untreated patients, lesions may recur at any time within 4 years. 

Forty percent of patients with primary or secondary syphilis exhibit CNS infection. 

The majority of patients treated for primary and secondary syphilis experience the Jarisch-Herxheimer reaction after treatment, characterized by flu-like symptoms such as transient headache, fever, chills, malaise, arthralgia, myalgia, tachypnea, peripheral vasodilation, and aggravation of syphilitic lesions. 

CDC recommendations for serologic follow-up ofpatients treated for syphilis are given in Table 46-6. Quantitative nontreponemal tests should be performed at 6 and 12 months in all patients treated for primary and secondary syphilis and at 6, 12, and 24 months for early and late latent disease. 

Primary, secondary, or latent syphilis of less than I-year s duration (early latent syphilis) Latent syphilis of more than 1-yearns duration (late latent syphilis) or syphilis of unknown duration Neurosyphilis... 

Penicillin-allergic patients/1 primary, secondary, or early latent syphilis... 

Brain injury from trauma, stroke, space-occupying brain tumors, brain infection such as HIV and syphilis, and inflammatory conditions such as lupus and multiple sclerosis can all induce these so-called secondary manias (Table 3.15). For this... 

Syphilis Primary, secondary, and /afenf with a negative spinal fluid (adults and children >12 years of age)... 

Sexually transmitted diseases When treating gonococcal infections in which primary and secondary syphilis are suspected, perform proper diagnostic procedures, including darkfield examinations and monthly serological tests for at least 4 months. Resistance The number of strains of staphylococci resistant to penicillinase-resistant penicillins has been increasing widespread use of penicillinase-resistant penicillins may result in an increasing number of resistant staphylococcal strains. 

She denied previous treatment for syphilis. She could not recall signs or symptoms of primary or secondary syphilis in the past year. She had no previous syphilis serology tests for purposes of comparison. Which of the following would be the best treatment for the patient ... 

The practice of trading sex for drugs in places where there is a high prevalence of cocaine abuse has been noted in both metropolitan areas and smaller communities along major interstate highways. In Baltimore, there was a 97% increase in the number of primary and secondary cases of syphilis from 1993 to 1995 (212). 

Anonymous. Outbreak of primary and secondary syphilis—Baltimore City, Maryland, 1995. MMWR Morb Mortal Wkly Rep 1996 45(8) 166-9. 

Some experts recommend multiple doses of benzathine penicillin C or other supplemental antibiotics in addition to benzathine penicillin C in HIV-infected patients with primary or secondary syphilis, HIV-infected patients with early latent syphilis should be treated with the recommended regimen for latent syphilis of more than I -year s duration. 

Acquired immunodeficiency renders a host much more susceptible to secondary infections, including cytomegalovirus, syphilis, herpes zoster, fungi, hepatitis B, tuberculosis, and toxoplasmosis. HIV invades the tissues of the optic nerve and initiates an immune complex-mediated response that results in an optic neittopathy. The primary HIV infection may be responsible for color vision defects, loss of contrast sensitivity, and visual field defects. HIV infection itself may also cause direct degeneration of retinal ganglion cell axons in the optic nerve without a secondary opportunistic infection. 

Ferri lodidi Syrupus (iodine of iron [syrup]) Used in scrofula (inflammation of the lymph nodes, especially in the neck). Also used in secondary syphilis. 

Potasii lodidum (iodide of potassium) Used in secondary and tertiary syphilis. Also, generally used the same as iodine (see number 47). 

Primary and secondary syphilis are effectively treated by benzylpenicillin or procaine penicillin i.m. daily for 10-21 days. Tetracycline or erythromycin orally may be used for penicillin-allergic patients. 

Gschwantler, M., Gulz, W., Schrutka-Kblbi, C., Kogelbauer, G., Schober, G., Bibus, B., Weiss, W. Acute hepatitis as the only symptom of secondary syphilis. Dtsch. Med. Wschr. 1996 121 1457—1461... 

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