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Cardiovascular Syphilis

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1. Syphilis infection

manifest in a number of ways. Diagnosis is usually straightforward after clinical examination and serological tests. Treatment is with penicillin. Untreated syphilis facilitates HIV transmission and causes considerable morbidity, such as cardiovascular and neurological disease, as well as a congenital syndrome in the newborn. Syphilis in pregnancy is a major cause of miscarriage, stillbirth, and perinatal morbidity and mortality in some parts of the world. Definition Syphilis is a sexually transmitted (...) Syphilis infection Syphilis infection - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Syphilis infection Last reviewed: February 2019 Last updated: May 2018 Summary A common sexually transmitted infection. Approximately 10 million to 12 million new infections worldwide each year. Caused by the spirochaetal bacterium Treponema pallidum , subspecies pallidum . Clinical presentation is often asymptomatic, but can

2018 BMJ Best Practice

2. Diagnosis and management of gonorrhoea and syphilis

% and reoccurrence of early secondary symptoms in 25% Up to 2 years after infection Late Latent • Asymptomatic Tertiary • In one-third of untreated cases: Gummatous disease (15% of patients); cardiovascular (10%) and late neurological complications (7%) 20-40 years after initial infection Note. Stages and symptoms of congenital syphilis were not reported in this table; ECDC: European Centre for Disease Prevention and Control 18 Diagnosis and management of gonorrhoea and syphilis KCE Report 310 Figure 2 (...) Diagnosis and management of gonorrhoea and syphilis 2019 www.kce.fgov.be KCE REPORT 310 DIAGNOSIS AND MANAGEMENT OF GONORRHOEA AND SYPHILIS 2019 www.kce.fgov.be KCE REPORT 310 GOOD CLINICAL PRACTICE DIAGNOSIS AND MANAGEMENT OF GONORRHOEA AND SYPHILIS VICKY JESPERS, SABINE STORDEUR, ANJA DESOMER, SERENA CARVILLE, CLARE JONES, SEDINA LEWIS, MARK PERRY, SAM CORDYN, TINE CORNELISSEN, TANIA CRUCITTI, CELINE DANHIER, IRITH DE BAETSELIER, ANNE-SOPHIE DE CANNIÈRE, WOUTER DHAEZE, ELS DUFRAIMONT, CHRIS

2019 Belgian Health Care Knowledge Centre

3. Syphilis in pregnancy

§ Signs can include: cranial nerve dysfunction, hearing loss, tinnitus, diminished vision, meningitis, stroke (acute), mental status changes/alteration and loss of vibration sense o Cardiovascular disease (cardiosyphilis) § Signs can include: aortic root dilatation, aortic regurgitation and/or coronary ostial lesions 34,35 o Gummatous lesions (gumma) Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 13 of 31 3 Antenatal screening Women (...) · Previous adverse pregnancy outcomes · Identify live births and consider if children may now have late congenital disease o Initiate follow-up as indicated Clinical examination · Syphilis requiring treatment in pregnancy y o Genital examination o Skin examination including torso, eyes, mouth, scalp, palms and soles o If neurological symptoms, conduct a neurological examination · Symptomatic late disease o Skin o Musculoskeletal (congenital) o Cardiovascular system (for signs of aortic regurgitation) o

2019 Queensland Health

4. Asymptomatic Cardiovascular Syphilis With Aortic Regurgitation Requiring Surgical Repair in an HIV-Infected Patient (PubMed)

Asymptomatic Cardiovascular Syphilis With Aortic Regurgitation Requiring Surgical Repair in an HIV-Infected Patient A 47-year-old man with HIV infection presented 10 years after initial secondary syphilis diagnosis and treatment for routine follow-up. His HIV was well controlled on antiretroviral therapy. Rapid plasma reagin was 1:1, and TP-PA was reactive. Physical examination revealed a wide pulse pressure, a systolic murmur, and an early diastolic decrescendo murmur. Echocardiogram revealed (...) moderate to severe aortic regurgitation, and subsequent computed tomography angiogram showed a 6.8-cm fusiform aneurysm of the proximal ascending aorta. Aortic valve and ascending hemiarch replacement were performed. Pathology showed adventitial inflammation with plasma cells, gumma-like amorphous areas surrounded by histiocytes, and giant cells with calcified plaques. Cardiovascular syphilis, while rare, remains a relevant cause of aortic aneurysm, even in previously treated patients. The physical

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2017 Open forum infectious diseases

5. Syphilis

people never develop symptoms and will only be diagnosed by serological tests. • If untreated all people become asymptomatic over a period of 12 to 24 months after initial infection. • After 24 months people are no longer infectious to sexual contacts but women may still pass the infection on to the unborn foetus. Tertiary syphilis • Late symptoms/complications may develop months or years later in about one third of cases if not treated. • Complications include skin lesions (gummas), cardiovascular (...) Syphilis Syphilis Management Guidelines page 1 of 4 The Ministry of Health supports the use of these clinical guidelines, developed by clinical experts and professional associations to guide clinical care. Further guideline information – www.nzshs.org/guidelines or phone a sexual health specialist. This STI Management Guideline Summary has been produced by NZSHS. Every effort has been taken to ensure that the information in this guideline is correct at the time of publishing (September 2017

2017 New Zealand Sexual Health Society

6. Cardiovascular Syphilis

Cardiovascular Syphilis Cardiovascular Syphilis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cardiovascular Syphilis Cardiovascular (...) Syphilis Aka: Cardiovascular Syphilis , Syphilitic Myocarditis , Syphilitic Pericarditis II. Background Manifestation of III. Pathophysiology Arterial wall medial necrosis and loss of elastic fibers Typically affects aorta but may affect any part of the IV. Course Begins 5 to 10 years after initial infection Clinically seen 20-30 years after infection V. Signs Obliterative endarteritis of vasa vasorum Ascending aorta develops Aortic aneurysm VI. Labs See VII. Management See See VIII. Complications

2018 FP Notebook

7. A case of acute myocardial infarction due to cardiovascular syphilis with aortic regurgitation and bilateral coronary ostial stenosis (PubMed)

A case of acute myocardial infarction due to cardiovascular syphilis with aortic regurgitation and bilateral coronary ostial stenosis We report an interesting case of a 66-year-old man with acute myocardial infarction (AMI) with bilateral coronary ostial stenosis cardiovascular syphilis complicated by aortic regurgitation (AR). A 12-lead electrocardiogram and blood tests on arrival suggested AMI, and echocardiography showed moderate AR. Emergency coronary angiography showed bilateral coronary (...) ostial stenosis. The patient underwent emergency surgical treatment, coronary artery bypass grafting, and aortic valve replacement with a bioprosthetic valve. On arrival, rapid plasma reagin and Treponema pallidum hemagglutination tests were 172.2- and 1187.5-fold, respectively. These results suggested cardiovascular syphilis, which was confirmed by pathological findings. The postoperative course was uneventful and the patient was transferred to another hospital on postoperative day 25. This patient

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2016 Surgical Case Reports

8. WHO guidelines for the treatment of Treponema pallidum (syphilis)

% will develop the late clinical sequelae of tertiary syphilis (4), which can affect any organ system up to 30 years or more after infection. The main manifestations of tertiary syphilis are neurological disease (neurosyphilis), cardiovascular disease (cardiosyphilis) and gummatous lesions (gumma). Neurosyphilis can occur at any stage of syphilis infection, even in the first few months. Early neurological manifestations include acute changes in mental status, meningitis, stroke, cranial nerve dysfunction (...) WHO guidelines for the treatment of Treponema pallidum (syphilis) WHO GUIDELINES FOR THE Treatment of T reponema pallidum (syphilis)WHO GUIDELINES FOR THE Treatment of T reponema pallidum (syphilis) WHO Library Cataloguing-in-Publication Data WHO guidelines for the treatment of Treponema pallidum (syphilis). Contents: Web annex D: Evidence profiles and evidence-to-decision frameworks - Web annex E: Systematic reviews for syphilis guidelines - Web annex F: Summary of conflicts of interest 1

2016 World Health Organisation Guidelines

9. Syphilis. (PubMed)

and lead to irreversible neurological or cardiovascular complications. Although syphilis is an ancient disease and the principles of recommended management have been established for decades, diagnosis and management are often challenging because of its varied manifestations and difficulty in interpretation of serological tests used to confirm diagnosis and evaluate response to therapy. In North America and western Europe, incidence of syphilis has increased dramatically in the past decade among men who (...) Syphilis. Syphilis is a chronic bacterial infection caused by Treponema pallidum that is endemic in low-income countries and and occurs at lower rates in middle-income and high-income countries. The disease is of both individual and public health importance and, in addition to its direct morbidity, increases risk of HIV infection and can cause lifelong morbidity in children born to infected mothers. Without treatment the disease can progress over years through a series of clinical stages

2016 Lancet

10. Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. (PubMed)

Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. In 2014, 19,999 cases of syphilis were reported in the United States. Left untreated, syphilis can progress to late-stage disease in about 15% of persons who are infected. Late-stage syphilis can lead to development of inflammatory lesions throughout the body, which can lead to cardiovascular or organ dysfunction. Syphilis infection also increases the risk (...) for acquiring or transmitting HIV infection.To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for syphilis infection in nonpregnant adults. Screening for syphilis in pregnant women was updated in a separate recommendation statement in 2009 (A recommendation).The USPSTF reviewed the evidence on screening for syphilis infection in asymptomatic, nonpregnant adults and adolescents, including patients coinfected with other sexually transmitted infections (such as HIV

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2016 JAMA

11. Syphilis

Syphilis Syphilis - NICE CKS Share Syphilis: Summary Syphilis is a sexually transmitted infection (STI) caused by the spirochete bacterium, Treponema pallidum . Untreated syphilis may progress through 5 stages: primary, secondary, early latent, late latent, and rarely tertiary syphilis. Syphilis can be cured if treated early. Untreated, approximately a third of people will progress to tertiary syphilis with its associated complications of neurovascular, cardiovascular, and gummatous syphilis (...) of infection, in the absence of any current clinical features of the condition. Late syphilis may progress through two stages [ ; ; ] : Late latent stage is defined as syphilis, confirmed by positive syphilis serology, 2 years after infection has occurred, in the absence of any current clinical features of the condition. Tertiary syphilis is rare because of the widespread use of antibiotics, and it is divided into neurosyphilis, cardiovascular, and gummatous syphilis. Primary and secondary syphilis

2016 NICE Clinical Knowledge Summaries

12. Cardiovascular syphilis with coronary stenosis and aneurysm (PubMed)

Cardiovascular syphilis with coronary stenosis and aneurysm Cardiovascular manifestations of tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation, and coronary ostial stenosis. Coronary ostial lesions have been detected in as many as 26% of patients with syphilitic aortitis. However nonostial coronary stenosis and coronary aneurysms in same patient is rarely described in cardiovascular syphilis. Copyright © 2014 Cardiological Society of India

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2014 Indian heart journal

13. Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association (PubMed)

Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses (...) cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association , PhD, FAHA, Chair , PhD , DrPH, FAHA , MD, MPH, FAHA , PhD, FAHA , MD, MPH, FAHA , PhD , MD, MS, FAHA , MD, FAHA , and MD, PhD, FAHA MD, FAHAOn behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Cardiovascular Disease

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2017 American Heart Association

14. Coronary ostial stenosis and aortic aneurysm caused by syphilis (PubMed)

, The University of British Columbia, Vancouver, BC. eng Case Reports Journal Article Canada CMAJ 9711805 0820-3946 AIM IM Aortic Aneurysm, Thoracic diagnostic imaging etiology surgery Computed Tomography Angiography Coronary Artery Bypass Coronary Stenosis diagnostic imaging etiology surgery Humans Male Middle Aged Shock, Cardiogenic etiology Syphilis, Cardiovascular complications diagnostic imaging 2017 3 11 6 0 2017 3 11 6 0 2017 10 17 6 0 ppublish 28280066 189/9/E369 10.1503/cmaj.151133 PMC5334009 J (...) Coronary ostial stenosis and aortic aneurysm caused by syphilis 28280066 2017 10 16 2018 11 13 1488-2329 189 9 2017 03 06 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Coronary ostial stenosis and aortic aneurysm caused by syphilis. E369 10.1503/cmaj.151133 To Fergus F Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC fergusto@alumni.ubc.ca. Kiamanesh Omid O Department of Medicine, Faculty of Medicine

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2017 CMAJ : Canadian Medical Association Journal

15. Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia (PubMed)

Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia The tertiary stage of syphilis is nowadays extremely rare, showing predilection for the cardiovascular and nervous systems. A 57-year-old Caucasian man sought medical assistance due to back pain that evolved to paraplegia of the lower limbs. A thoracic CT scan demonstrated an important aneurysmatic lesion of the descending thoracic aorta causing erosion of the vertebral bodies and VDRL and FTA-abs positivity. Although (...) rare, syphilitic aortitis, the hallmark of cardiovascular syphilis, should be considered in the differential diagnosis in patients with thoracic aneurysm when in the absence of classic risk factors for atherosclerosis, especially in cases that progress with erosion of vertebral bodies.

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2017 Reumatologia

16. Syphilis Antibody

Syphilis Antibody Syphilis Antibody Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Syphilis Antibody Syphilis Antibody Aka: Syphilis (...) Antibody , Syphilis Serology , Syphilis Screening , Syphilis False Positive , Syphilis Testing , Syphilis Diagnosis , Treponema test II. Indication ( ) detection Syphilis Screening annually for all Skin lesions or other clinical findings suggestive of Confirmation of positive III. Background Antigen Extracts from beef heart (cardiolipin) Non-specific antibodies bind cardiolipin IV. Labs: Tests for detection of Treponemal Pallidum Antibody Non- l Derived Substance precipitates (false negatives in first

2018 FP Notebook

17. Syphilis

Syphilis Syphilis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Syphilis Syphilis Aka: Syphilis , Treponema pallidum From Related (...) Chapters II. Epidemiology Resurgence of Syphilis since HIV epidemic onset in 1980s Syphilis in U.S. (primary and secondary) is increasing 2000: 2.1 cases per 100,000 persons (5979 new cases in U.S.) 2005: 2.9 cases per 100,000 persons (8724 new cases in U.S.) 2010: 4.5 cases per 100,000 persons (13,774 new cases in U.S.) 2014: 6.3 cases per 100,000 persons (19,999 new cases in U.S.) Men account for 91% of cases (of whom 83% are ) 2015: 8.0 cases per 100,000 persons (23,872 new cases in U.S.) III

2018 FP Notebook

18. Tertiary Syphilis

Tertiary Syphilis Tertiary Syphilis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tertiary Syphilis Tertiary Syphilis Aka: Tertiary (...) Syphilis , Syphylitic Gumma , Gumma From Related Chapters II. Pathophysiology Low-level infection with strong immune response III. Types Late benign (50% of Tertiary Syphilis cases) Presents with gumma, granulomas and -like s May form 1 to 10 years after initial infection Destructive granulomatous lesions (fungating masses) affect any area Responds rapidly to treatment Typically involves s (especially ascending aortitis) Thoracic aneurysm (Occurs in 10% of untreated ) l penetration of the blood brain

2018 FP Notebook

19. Latent Syphilis

Latent Syphilis Latent Syphilis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Latent Syphilis Latent Syphilis Aka: Latent Syphilis (...) sampling from a Bing search on the term "Latent Syphilis." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Syphilis, Latent (C0039133) Definition (NCI) A stage of syphilis characterized by the serologic evidence of infection by Treponema pallidum without evidence of accompanying signs or symptoms related to the disease. Concepts Disease or Syndrome ( T047 ) MSH ICD9 097.1 ICD10 SnomedCT 444150000 , 186906003 English

2018 FP Notebook

20. Primary Syphilis

Primary Syphilis Primary Syphilis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Primary Syphilis Primary Syphilis Aka: Primary (...) Syphilis , Primary Genital Syphilis , Chancre From Related Chapters II. Signs Solitary Chancre (hallmark of Primary Syphilis) Painless ulcerates Indurated lesion with smooth base and firm border Chancre distribution Forms a in nearly all cases (may form on or perianally) May be difficult to visualize Men and women Carefully examine the perianal area Women Use a speculum and examine the vaginal mucosa Examine the introitus and between the labia Extragenital involvement (fingers, , nipples) in up to 5-7

2018 FP Notebook

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