PHRM 514 STD's Fall 2012 (1)

Secondary syphilis n occurs after initial infection

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Unformatted text preview: Secondary Syphilis n Occurs after initial infection if untreated or inadequately treated n Multisystem involvement: § Mucocutaneous eruptions § Rash § Lymphadenopathy § Malaise § Headache § Arthralgia § Fever § S o r e t h r o a t § S t o Knodel, LC. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:2011-2028. Secondary Syphilis – Palmar Lesions Secondary stage syphilis sores (lesions) on the palms of the hands. Referred to as "palmar lesions." Centers for Disease Control and Prevention. http://www.cdc.gov/std/syphilis/images/rash-palmar.htm. Updated August 2, 2012. Accessed October 17, 2012. Secondary Syphilis - Rash Secondary syphilis rash on the back. Centers for Disease Control and Prevention. http://www.cdc.gov/std/syphilis/images/rash-gbr.htm. Updated August 2, 2012. Accessed October 17, 2012. Latent Syphilis n Positive serologic test + no evidence of disease n Asymptomatic n Early latency § Acquired within the preceding year § 25% risk of spontaneous relapse n Late latency § 25-30% progress to tertiary syphilis or neurosyphilis n Latent syphilis of unknown duration Knodel, LC. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:2011-2028. Mehring, PM. Sexually transmitted diseases. In: Porth, CM, editor. Pathophysiology Concepts of Altered Health States. 7th Ed. Philadelphia: Porth Lippincott Williams and Wilkins; 2005:1101-1110. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR 2010;59(RR-12):1-116. Neurosyphilis and Tertiary Syphilis n Delayed response of untreated or inadequately treated syphilisà 10-30 years after initial infection n ~30% of untreated patients progress n Neurosyphilis § Cerebrospinal fluid abnormalities consistent with CNS infection § Meningitis, general paresis, dementia, tabes dorsalis, deafness, blindness, ataxia, sensory loss n Tertiary syphilis § Gumma § Rubbery, necrotic, destructive lesions § Can infiltrate any organ or tissue § Most common in skin, bone, soft tissue, and liver § Cardiovascular § Aortitis or aortic insufficiency Knodel, LC. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:2011-2028....
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Secondary Syphilis n Occurs after initial infection if...

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