syphilis ppt.pdf by Himanshi 2nd yr BAMS

SYPHILIS AYURVED + MODERN ASPECTS BY HIMANSHI BAMS 2ND YR

1. Syphilis –
Modern &
Ayurveda
Created by –
Himanshi 2
nd
year BAMS

2. Definition
Syphilis is a chronic, systemic, sexually transmitted infection caused by the
spirochete Treponema pallidum.
Characterized by periods of active disease and latency.
Transmission is mainly sexual, but can also be vertical (congenital) or via
blood transfusion.

3. Causative Organism
Treponema pallidum subsp. pallidum
Thin, spiral-shaped, motile spirochete.
Cannot be cultured in artificial media.
Visualized by dark field microscopy, silver impregnation, or DFA test.

4. Epidemiology
Worldwide distribution.
Higher prevalence in sexually active adults (15–45 years).
Risk factors: unprotected sex, multiple partners, coexisting STDs, MSM
population.

5. Modes of Transmission
1. Sexual contact –primary route.
2. Transplacental –causes congenital syphilis (can occur in any stage;
highest risk in secondary syphilis).
3. Blood transfusion –rare, due to donor screening.
4. Direct contact with infectious lesions.

6. Pathogenesis
Entry via microscopic abrasions in skin/mucosa → local multiplication.
Spread via lymphatics and blood (even in early stage).
Tissue destruction mainly due to host immune response rather than direct
bacterial toxin.

7. Stages of Acquired Syphilis
Primary Syphilis -
Incubation period: 10–90 days (avg. 21 days).
Lesion: Chancre –painless, indurated ulcer with clean base.
Site: genitalia, anus, lips, or other inoculation sites.
Regional painless lymphadenopathy.
Highly infectious.
Lesion heals spontaneously in 3–6 weeks.

8. Secondary Syphilis -
Occurs 4–10 weeks after chancre (systemic dissemination).
Symptoms: Skin rash –maculopapular, symmetrical, involving trunk, limbs, palms & soles.
Condyloma lata–broad, moist, flat, warty lesions in genital region.
Mucous patches in mouth/throat.
Generalized lymphadenopathy.
Systemic symptoms: fever, malaise, sore throat, myalgia.
Rash is non-itchy.
Lesions contain abundant spirochetes → highly infectious.
Spontaneous resolution in weeks to months.

9. Early latent
(less than 1 year since infection) –generally non-
infectious except to fetus.
Late latent
( more than 1 year ) generally non-infectious except to
fetus.
Asymptomatic; diagnosis only by serology.

10. Tertiary Syphilis –
Develops years after untreated infection (10–30 years).
Non-infectious stage.
Manifestations:
1. Gummatoussyphilis –granulomatous lesions in skin, bone, liver.
2. Cardiovascular syphilis –aortitis, aortic aneurysm, aortic regurgitation.
3. Neurosyphilis –tabesdorsalis, general paresis, meningovascular syphilis.
Progressive, destructive.

11. Congenital Syphilis -
Transmission transplacentally.
Early congenital syphilis (2 years): Snuffles (nasal discharge), rash,
hepatosplenomegaly, lymphadenopathy, bone lesions.
late congenital syphilis
Hutchinson's triad:
1. Hutchinson teeth (notched, peg-shaped incisors)
2. Interstitial keratitis
3. Deafness. Saddle nose, frontal bossing, saber shins.

12. Laboratory Diagnosis
A. Direct Detection –
Dark-field microscopy –detects motile spirochetes from chancre or condyloma lata.
Direct Fluorescent Antibody (DFA-TP) test.
B. Serology 1.
1. Nontreponemal tests (screening):
VDRL (Venereal Disease Research Laboratory).
RPR (Rapid Plasma Reagin).
Detect antibodies to cardiolipin-lecithin-cholesterol antigen.
Reported as titers. Useful for monitoring treatment (titers decline after cure).
Biological false positives possible.
2. Treponemal tests (confirmation):
FTA-ABS (Fluorescent Treponemal Antibody-Absorption).
TPHA (T. pallidum Hemagglutination assay). Treponemal EIA.
More specific, usually remain positive for life.

13. Treatment
First-line -
Benzathine Penicillin G:
Early syphilis -
single IM dose of 2.4 million units.
Late latent / tertiary (without neurosyphilis) -
2.4 million units IM weekly ×3 weeks.
Neurosyphilis -
Aqueous crystalline Penicillin G 18–24 million units/day IV for 10–14 days.
Penicillin allergy -
Doxycycline or Tetracycline (except in pregnancy –desensitize and give
penicillin).

15. उपदंश (Syphilis) –Ayurveda

17. Types -