Eighteen-year-old S is seen in the clinic today with concerns that she may be pr

Question

Eighteen-year-old S is seen in the clinic today with concerns that she may be pregnant. She reports having only one sex partner in the last 6 weeks, so she knows who the father is should she be pregnant. She also casually mentions that she has this annoying place at the entrance of her privates that she has noticed for about 2 months.

How should you approach this situation?

As you talk with S a little longer, she admits that she knows she is not pregnant, but she is afraid she might have a sexually transmitted infection like HPV, since she has that “place” on her private. You order a pregnancy test and perform a gynecological exam, which reveals a 3-cm round ulcerated lesion. There is also bilateral inguinal lymphadenopathy. A tentative diagnosis of syphilis is made.

How will the diagnosis be confirmed?

After a diagnosis is confirmed, how will S be treated?

What are possible consequences of untreated syphilis?

Explanation / Answer

Syphilis diagnosis by doing some tests like1) Blood examination: these tests are done two types a)treponemal and b)nontreponemal because nontreponemal test like VDRL and RPR, Treponemal test like TPHA and FTA-Abs it is for confirmation. 2)Direct testing: dark ground microscopy of serous fluid from a chancer,3)Direct fluorscent antibody,4)nucleic acid amplification test. Treatment: by the signs and symptoms seen in the patient S it shows it is in early stage sotreatment regime a single dose of penicillin, if patient is alergic to penicillin then Doxycycline and tetracycline are alternatives, and advised not to have sex till the sores are healed. --Consequences of untreated syphilis: it may eventually leads to damage to the brain nerves eyes heart blood vessels,etc if the patient is not treated in early stages it may leads skin rashes on the mouth or other private places it is the secondary stage, if untreated now then leads to tertiary stage which can affect the multiple organs systems like brain nerves, blood vesselsetc and it can be fatal.

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