Syphilis
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SYPHILIS 1. Vesicles are rarely or never present in syphilis except in: · Early congenital syphilis (bullous eruption on palms & soles). 2. Serological tests are –ve in early 1 ry stage of syphilis (diagnosed by detection of T. pallidum by dark ground microscope “dark ground illumination”). 3. For diagnosis of congenital syphilis, +ve serology with rising titre should be detected. 4. Treatment of syphilis:
BENZATHINE PENICILLIN 2.4 million units. 1 ry & 2 ry Single. 2.4 million units. BENIGN LATE (GUMMA) Weekly, 3 weeks. NEURO & CARDIO‐VASCULAR “Does not cross to cardiac or nervous tissues (CSF)” SYPHILIS
PROCAINE PENICILLIN 600.000 units. Daily, 10 days. 600.000 units. Daily, 15 days. 600.000 units. Daily, 20 days.
5. Intradermal sensitivity test should be done before giving penicillin. 6. For penicillin allergic patients → tetracycline HCL 500 mg X 4 X 15‐30 days. 7. For pregnant & penicillin allergic patients → erythromycin (not proved efficacy). 8. Treatment of congenital
syphilis:
BENZATHINE PENICILLIN 50.000 units/kg. Single.
PROCAINE PENICILLIN 50.000 units/kg. Daily, 10 days.
9. Penicillin reactions: A. Immediate. B. Delayed. C. Jarisch‐herxheimer reaction (specific for syphilis): · Due to destruction of big number of T. pallidum. · May lead to sudden death due to suffocation. 10. Alopecia in syphilis:
STAGE · Secondary o Early o Late · Tertiary
TYPE OF ALOPECIA
CAUSE
Diffuse Moth‐eaten Cicatricial
Spirochetaemia Folliculitis Gumma
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BENZATHINE PENICILLIN 2.4 million units. 1 ry & 2 ry Single. 2.4 million units. BENIGN LATE (GUMMA) Weekly, 3 weeks. NEURO & CARDIO‐VASCULAR “Does not cross to cardiac or nervous tissues (CSF)” SYPHILIS
PROCAINE PENICILLIN 600.000 units. Daily, 10 days. 600.000 units. Daily, 15 days. 600.000 units. Daily, 20 days.
5. Intradermal sensitivity test should be done before giving penicillin. 6. For penicillin allergic patients → tetracycline HCL 500 mg X 4 X 15‐30 days. 7. For pregnant & penicillin allergic patients → erythromycin (not proved efficacy). 8. Treatment of congenital
syphilis:
BENZATHINE PENICILLIN 50.000 units/kg. Single.
PROCAINE PENICILLIN 50.000 units/kg. Daily, 10 days.
9. Penicillin reactions: A. Immediate. B. Delayed. C. Jarisch‐herxheimer reaction (specific for syphilis): · Due to destruction of big number of T. pallidum. · May lead to sudden death due to suffocation. 10. Alopecia in syphilis:
STAGE · Secondary o Early o Late · Tertiary
TYPE OF ALOPECIA
CAUSE
Diffuse Moth‐eaten Cicatricial
Spirochetaemia Folliculitis Gumma
Esnips.com/user/ma7moud
