A patient presented with palms and soles rash, oral lesions and a unnoticed penile ulcer indicating possible secondary syphilis.
This case highlights the importance of taking a routine sexual history even when symptoms seem unrelated to STIs.
insights INSIGHT
Stages and Presentation of Syphilis
Syphilis progresses through stages: primary with painless chancre, secondary with rash and systemic symptoms, then latent and potentially tertiary disease.
Secondary syphilis can involve oral mucous patches and systemic symptoms, often overlooked but highly infectious.
volunteer_activism ADVICE
Syphilis Testing and Staging
Use two serologic tests for syphilis diagnosis: a non-treponemal test (e.g. RPR) followed by a confirmatory treponemal test (e.g. TPPA).
Distinguish early latent syphilis (treat with single penicillin dose) from late latent (requires prolonged treatment).
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Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the age of growing resistance, and a discussion of partner notification and treatment.
The Curbsiders Internal Medicine Podcast