Q. 47. Define and classify syphilis. Write down the clinical features of primary syphilis & treatment of syphilis ?
Syphilis :- Syphilis is a chronic systemic infection disease caused by Treponema pallidum, usually transmitted by close sexual contact.
 Classification of syphilis :-
A.  Acquired
1.   Early.
(i) Primary
(ii) Secondary
(iii) latent
2.   Late.
(i) Latent
(ii) Tertiary (benign gummatous)
(iii) Quarternary (cardiovascular, neurosyphilis)
B.     Congenital.
1. Early
(i) Clinical and latent.
2. Late
(i) Clinical and latent
(ii) Stigmata (or scars)
 Clinical features of primary syphilis :-
1. Development of a chancre at the site of inoculation within one weeks to 3 months after exposure.
a. Characteristics of chancre :-
(i) Single, punched out, very much red, painless ulcer.
(ii) Indurated base, raised margin, serous discharge.
(iii) May heat contagiously, but if there is secondary infection, then there will be pain and pus discharge.
Where found :-
(i) More common on the genitals (glans penis, vulva, cervix)
(ii) Extra genitals- lips, palate
(iii) Face.
(iv) Breast
(v) Finger
2. Usually there is an accompanying, paints non specific regional Lymphadenopathy.
 Treatment of syphilis :-

Stage
Medication
Regimen.
Primary
Procaine penicillin
600-1200 mg once daily for 12 days

Oxytetracycline
500mg orally 4 times daily for 15 days

Doxycycline
100mg orally 3 times daily for 15 days
Secondary
Procaine penicillin
600-1200 mg 1m once daily for 15 days
Tertiary
Oxytetracycline
500mg orally 4 times daily for 15 days
Latent
Doxycycline
100 mg orally 3 times daily for 15 days
CVS & CNS
Procaine penicillin
90mg Im once daily for 21 days

oxytetracycline
500mg 4 time daily for 28 days

Doxycycline
100mg orally 3 times daily for 28 days