Carrada BT

Language: Spanish
References: 21
Page: 517-523
PDF size: 219.92 Kb.

ABSTRACT

Syphilis caused by Treponema pallidum is a systemic and highly polymorphic disease with various clinical manifestations. Diagnosis of syphilis is based on careful clinical evaluation, detection of the organism by darkfield microscopy and disease confirmation by serodiagnostic test. Signs and symptoms of secondary syphilis begin 4 to 10 weeks after appearance of a chancre. Rash has been recorded in more than 70% of patients, but it is found on physical examination in more than 90% of them. A macular rash is characterized by 3 to 10 mm pink, red, or cooper-colored lesions distributed on the flanks, shoulders, arms, chest and back. Untreated macula can become maculo-papular or papulosquamous, affecting hands and soles in 50-60% of cases. The syphilic rash also can be pustular, annular, or follicular, but never vesicular. Secondary syphilis resolves without treatment, although one quarter of the patients develops recurrences during four years after infection, most frequently in the first year. Treponema pallidum cannot be cultured, darkfield examination of exudates plus non-treponemal serologic test (VDRL) provide evidence of infection, with positive results confirmed by treponemal more specific fluorescent test (FTA-abs). A clinical case of secondary syphilis is presented, as well as an epidemiologic research study of 112 sex-workers of Irapuato, Guanajuato, Mexico.

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