Syphilis | Infection & Infestation

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Syphilis - Infection & Infestation

Author: Dr Atiya Rahman - PNS Shifa Hospital Karachi

A 19-year-old male presented with asymptomatic lesions on the corner of his mouth for the last 2 months. Further dermatological examination revealed well-defined asymptomatic, scaly plaques over the palms, soles, and elbows with subungual hyperkeratosis. Eye examination showed conjunctival injection and 20 cells per field in the vitreous humor.

1 / 5

1. What is the most likely diagnosis ?

Atopic Dermatitis

Muco-cutaneous Candidiasis

Secondary syphilis

Pityriasis rubra pilaris

Warts

2 / 5

2. Regarding the above scenario which statement is true ?

CSF examination should preferable be done

CSF examination is mandatory in this patient

Patient has no neurological symptoms and signs so CSF examination isn’t required

CSF VDRL false positive results correspond to serum VDRL false positive results

Negative CSF VDRL test excludesneurosyphilis

3 / 5

3. Treatment of choice in the above patient is ?

Azithromycin 500 mg PO OD for 10 days

Benzathine penicillin G 2.4 mega units IM single dose or ×2 (days 1 and 8)

Benzyl penicillin 10.8–24 g daily, given as 1.8–2.4 g IV every 4 h for 14–20 days - A

Ceftriaxone 500 mg IM OD for 10 days

Procaine penicillin G 0.6–1.2 mega units IM OD for 14–20 days

4 / 5

4. During follow-up (surveillance) of the patient which criteria indicates successful treatment ?

Twofold decrease in pre-treatment VDRL titres within 3 months

Twofold decrease in pre-treatment VDRL titres within 6 months

Twofold decrease in pre-treatment VDRL titres within 12 months

Fourfold decrease in pre-treatment VDRL titres within 3 months

Fourfold decrease in pre-treatment VDRL titres within 12months

5 / 5

5. In which body part the causative organism might persist despite adequate treatment, especially if the diagnosis is delayed and the disease is treated at the late stage ?

Eyes

Inner ear

Nostrils

Nail matrix

Bones

Your score is

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