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The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Syphilis

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient

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CLINICAL MANIFESTATIONS

Congenital Syphilis Intrauterine infection with Treponema pallidum can result in stillbirth, hydrops fetalis, or preterm birth or may be asymptomatic at birth. Infected infants can have hepatosplenomegaly, snuffles, lymphadenopathy, mucocutaneous lesions, pneumonia, osteochondritis and pseudoparalysis, edema, rash, hemolytic anemia, or thrombocytopenia at birth or within the first 4 to 8 weeks of age. Skin lesions or moist nasal secretions of congenital syphilis are highly infectious. However, organisms rarely are found in lesions more than 24 hours after treatment has begun. Untreated infants, regardless of whether they have manifestations in early infancy, may develop late manifestations, which usually appear after 2 years of age and involve the central nervous system (CNS), bones and joints, teeth, eyes, and skin. Some consequences of intrauterine infection may not become apparent until many years after birth, such as interstitial keratitis (5–20 years of age), eighth cranial nerve deafness (10–40 years of age), Hutchinson teeth (peg-shaped, notched central incisors), anterior bowing of the shins, frontal bossing, mulberry molars, saddle nose, rhagades, and Clutton joints (symmetric, painless swelling of the knees). The first 3 manifestations are referred to as the Hutchinson triad. Late manifestations can be prevented by treatment of early infection.

Acquired Syphilis Infection with T pallidum in childhood or adulthood can be divided into 3 stages. The primary stage appears as one or more painless indurated ulcers (chancres) of the skin or mucous membranes at the site of inoculation, but chancres may not be recognized. These lesions most commonly appear on the genitalia but may appear elsewhere, depending on the sexual contact responsible for transmission (ie, oral). These lesions appear, on average, 3 weeks after exposure (10–90 days) and heal spontaneously in a few . . . [Go to Full Text]


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