Syphilis – Lues

 

* Incubation lasts about 21 days; in the absence of treatment canker healed in 3 to 6 weeks. Secondary syphilis occurs inconsistently from the 6th week. It is characterized by a first flowering (roseola) then a second flowering (papular syphilides). Also in the absence of treatment, the natural evolution of secondary syphilis is to the spontaneous disappearance.

* Inability solely on serology to differentiate a non-venereal syphilis tréponé-matosis; difficulty in determining whether she is cured or not.

* These serologic tests become positive on late blight and may become negative in the absence of treatment after many years.

* When done serology become positive dice 5th j canker (reviewed practitioner); the first test is the FTA-abs (immunofluorescence).

TPHA is positive towards the 7th d. (VDRL test Kline) to the 10th day.

* Syphilitic chancre: pink surface erosion, although limited, non-inflammatory, painless, indurated base. ADP painless unilateral inguinal never fistulizing. The seat of the chancre is usually mucous and genital (glans, coronal sulcus …). It is most often unique.

* In treatment, the chancre healed in 1 to 2 weeks; serology is not positivent (if they are not yet positive) or négativent.

Syphilitic chancre - Syphilis

Syphilitic chancre at the lower lip

SECONDARY SYPHILIS:

General

– Post and épitrochléennes cervical ADP; splenomegaly;low-grade fever

– Lymphocytic meningitis, hepatitis, nephritis, arthritis

1st flowering

– Syphilitic roseola (macula non-itchy pink) on the trunk and roots members

– Plaque mucosa (highly contagious) lip, tongue …

Alopecia glade (temporo-occipital)

Second bloom

Papular syphilides; predominate on the face and trunk; a palmar-plantar Has hue is evocative.

* In the absence of treatment, secondary syphilis evolves by successive crops that fade with time but rarely exceed 1 year.

* In treatment, the lesions disappear within 48 hours to 15 days with negativity VDRL (n 2 years); TPHA remains positive indefinitely

* Treatment is based on benzathine benzylpenicillin; the alternative by Cy clines in case of allergy (if pregnant desensitization to penicillin is required).

OTHER genital ulcer disease:

* Chancroid: a short incubation period (3-5 d); Canker is digging with ADP painful inflammatory satellites (fistulizing 1 time 2). The bacillus grows Ducrey is difficult; there are no available serology.

* Lymphogranuloma venereum (Nicolas-Favre disease): The causative agent is Chlamydia trachomatis; same for donovanosis

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