« Back to Infections and Infestations

Syphilis

»	What causes syphilis?
»	Describe the morphologic appearance of T. pallidum.
»	Where did syphilis originate?
»	How is syphilis transmitted?
»	What are the chances of getting syphilis from having sexual intercourse with an infected individual?
»	Following inoculation, how long does it take for the primary chancre to appear?
»	Describe the typical Hunterian chancre.
»	Do syphilitic chancres occur on sites other than the genitalia?
»	What is the best way to diagnose primary syphilis?
»	How is primary syphilis treated?
»	What is the Jarisch-Herxheimer reaction?
»	What is the natural history of the untreated syphilitic chancre?
»	When does secondary syphilis begin?
»	Do patients with secondary syphilis have any symptoms?
»	List the common physical findings in secondary syphilis.
»	Describe the syphiloderm of secondary syphilis.
»	What are condylomata lata? How do they differ from condylomata acuminata?
»	What are mucous patches?
»	Is there anything characteristic about the alopecia of secondary syphilis?
»	How good are physicians at recognizing the signs and symptoms of secondary syphilis?
»	What is the best way to diagnose secondary syphilis?
»	How should secondary syphilis be treated?
»	What stage follows untreated secondary syphilis?
»	How is latent syphilis treated?
»	When should lumbar punctures be done in patients with syphilis?
»	What happens to patients with untreated latent syphilis?
»	Name the three major presentations of tertiary syphilis.
»	What are the mucocutaneous features of late benign syphilis?
»	What was the Tuskegee Study?

How good are physicians at recognizing the signs and symptoms of secondary syphilis?

In a retrospective study of 34 patients with secondary syphilis who had been seen previously by community physicians, only 40% of physicians listed secondary syphilis as the primary diagnosis. Another 14% included secondary syphilis in their differential diagnosis. In sum, almost one half of physicians did not consider the diagnosis.