Enhanced Verifiable CPD from the
University of Birmingham

Dentaljuce Shorts: 500 words, 10 MCQs, on general medicine and surgery.

Syphilis

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. It can present in four stages: primary, secondary, latent, and tertiary, each with distinct clinical features. Additionally, syphilis can be transmitted from mother to baby, resulting in congenital syphilis.

Signs and Symptoms

Primary

Primary syphilis typically presents 2–6 weeks after exposure with a chancre at the site of infection. This lesion is usually a single, firm, painless, non-itchy skin ulcer. Lymph node enlargement around the area of infection is common.

Chancre on a penis due to primary syphilis
Chancre on a penis due to primary syphilis

Secondary

Secondary syphilis occurs approximately 4–10 weeks after the primary infection. It is known for its varied manifestations, most commonly a symmetrical, reddish-pink, non-itchy rash on the trunk, extremities, palms, and soles. Other symptoms include fever, sore throat, malaise, weight loss, hair loss, and headache.

Typical presentation of secondary syphilis with a rash on the palms of the hands
Typical presentation of secondary syphilis with a rash on the palms of the hands

Latent

Latent syphilis has no symptoms but is detectable by serology. It is divided into early latent (within 2 years of infection) and late latent (after 2 years). Early latent syphilis can still be infectious.

Tertiary

Tertiary syphilis may occur 3 to 15 years after the initial infection and manifests in three forms: gummatous syphilis, late neurosyphilis, and cardiovascular syphilis. Gummatous syphilis involves chronic gummas, which are inflammatory tumours. Cardiovascular syphilis often results in aortic aneurysm formation. Neurosyphilis can lead to stroke, dementia, and other severe neurological symptoms.

Model of a head of a person with tertiary (gummatous) syphilis
Model of a head of a person with tertiary (gummatous) syphilis

Congenital

Congenital syphilis can present with a range of symptoms in infants, including liver and spleen enlargement, rash, fever, neurosyphilis, and lung inflammation. If untreated, it can lead to severe deformities such as saddle nose, sabre shin, and Hutchinson's teeth.

Cause and Transmission

Treponema pallidum is a spiral-shaped, Gramme-negative bacterium that is highly mobile. It is primarily spread through sexual contact or from mother to baby during pregnancy. It can also be transmitted through kissing near a lesion and sharing needles, although these are less common modes of transmission.

Histopathology of Treponema pallidum spirochetes using a modified Steiner silver stain
Histopathology of Treponema pallidum spirochetes using a modified Steiner silver stain

Diagnosis

Syphilis is diagnosed using blood tests and direct visual inspection. Blood tests include nontreponemal tests (VDRL, RPR) and treponemal tests (Treponema pallidum particle agglutination assay, FTA-Abs). Dark field microscopy of serous fluid from a chancre can also be used for immediate diagnosis.

Micrograph of secondary syphilis skin lesions
Micrograph of secondary syphilis skin lesions

Treatment

Early Infections

The first-line treatment for early syphilis is a single dose of intramuscular benzathine benzylpenicillin. Alternatives for those allergic to penicillin include doxycycline and tetracycline. Ceftriaxone may also be effective. Patients should avoid sexual activity until sores are healed.

Late Infections

Neurosyphilis requires large doses of intravenous penicillin G. For other late presentations, intramuscular benzathine penicillin is administered weekly for three weeks.

Jarisch–Herxheimer Reaction

A potential side effect of treatment is the Jarisch–Herxheimer reaction, which includes fever, muscle pains, headache, and a fast heart rate. It occurs due to cytokines released by the immune system in response to rupturing syphilis bacteria.

Jarisch–Herxheimer reaction in a person with syphilis and human immunodeficiency virus
Jarisch–Herxheimer reaction in a person with syphilis and human immunodeficiency virus

Epidemiology

Syphilis remains a significant public health problem globally. In 2015, about 45.4 million people had infections, causing around 107,000 deaths. Rates have been increasing in many countries since the early 2000s, often in conjunction with HIV. Men who have sex with men are particularly affected.

Syphilis deaths per million persons in 2012
Syphilis deaths per million persons in 2012

Self-assessment MCQs (single best answer)

What bacterium causes syphilis?



Which stage of syphilis is characterised by a chancre at the site of infection?



In secondary syphilis, where is the rash most commonly found?



What is the main treatment for early syphilis?



Which stage of syphilis is characterised by chronic gummas?



What is a Jarisch–Herxheimer reaction?



Which diagnostic method involves the use of dark field microscopy?



Which symptom is NOT typically associated with secondary syphilis?



How is syphilis most commonly transmitted?



Which population is particularly affected by increasing syphilis rates?



Dentaljuce

Dentaljuce provides Enhanced Continuing Professional Development (CPD) with GDC-approved Certificates for dental professionals worldwide.

Founded in 2009 by the award-winning Masters team from the School of Dentistry at the University of Birmingham, Dentaljuce has established itself as the leading platform for online CPD.

With over 100 high-quality online courses available for a single annual membership fee, Dentaljuce offers comprehensive e-learning designed for busy dental professionals.

The courses cover a complete range of topics, from clinical skills to patient communication, and are suitable for dentists, nurses, hygienists, therapists, students, and practice managers.

Dentaljuce features Dr. Aiden, a dentally trained AI-powered personal tutor available 24/7 to assist with queries and provide guidance through complex topics, enhancing the learning experience.

Check out our range of courses, or sign up now!

Membership Options

Dentaljuce offers a range of membership options…

Regular Membership

With enhanced CPD Certificates. Dentaljuce is brought to you by the award winning Masters team from the School of Dentistry, University of Birmingham, UK. All have won awards for web based learning and teaching and are recognised as leaders and innovators in this field, as well as being highly experienced clinical teachers. Full access to over 100 courses, no extras to pay.

Buy Now

£89.00 per year

Student Membership

No Certificates. With universities cutting down on traditional lectures, many students are currently having to rely more on online resources. If you don't need CPD Certificates, we are offering an amazing discount on your Dentaljuce personal membership fee. Special student price just £29 for 12 months individual membership.

Buy Now

£29.00 per year

Dr. Aiden has transformed my CPD. I've learned more in the past month than I have in the last year.
MP

© Dentaljuce 2024 | Terms & Conditions | Privacy Policy

Recording CPD time: recorded.