Question

A pregnant 18-year-old woman came to the Ford County urgent-care clinic with a low-grade fever, malaise, and headache. She was sent home with a diagnosis of influenza. She again sought treatment 7 days later with a macular rash on her trunk, arms, hands, and feet. Further questioning of the patient when serology results were known revealed that one month previously, she had a painless ulcer on her vagina that healed spontaneously.

The same day, patient #2 sought medical treatment for a penile ulcer.

In a routine examination, patient #3, a pregnant female, had positive serologic tests for this disease but was asymptomatic.

Patient #4 was tested because of her sexual contact with patient #2. She had no symptoms and a positive serologic test.

Patient #5, a contact of patients #3 and #6, was also serologically positive. He frequently traveled to a neighboring county, which reported a 290% increase in this disease over the preceding year.

Patient #6, a female, had a rash and also tested positive. Patients 1 and 2 were in drug-abuse rehabilitation; these two were the only two who reported use of crack cocaine.

Answer 1

The diagnosis in the given case is, Syphilis, which is a sexually transmitted infection.

Syphilis is a sexually transmitted infection caused by Treponema Pallidum. The first sign of infection is a chancre sore that are painless ulcers. Syphilis is characterized by primary, secondary, latent and tertiary stages of the disease.

The stages of untreated syphilis is given below:

Stage 1: Presence of a painless, contagious lesion (chancre) that heals within 1 or 2 moths, while the causative pathogen spread throughout the body, multiply, and produce lesions. The chancre disappears in 3-6 weeks in both men and women.

Stage 2: The infection remain contagious and systemic manifestation is present. Symptoms include, fever, headache, joint pains, mouth ulcers, and rashes on palms and soles.

Stage 3 or latent period: The period ranges between 1 to 40 years, the infection remain subclinical or asymptomatic. The lesions occurring during this stage are called, “gummas,” which invade the several body systems and can make a person disabled or it can be life threatening.