性传播性疾病

nullnull Syphilis by Dr. Wang li Department of dermatology First affiliated hospital Shantou University Medical College nullWhat is syphilis? “the great imitator ”Syphilis is a complex and variable sexually transmitted infectionnull How can the spread be prevented? A B C null1. Etiology Syphilis is caused by the delicate spirochaetal micro-organism:Treponema-pallidum nullnull2. How is syphilis spread? three ways null in adults through sexual intercourse when contact is made with infectious lesion. null2) Other subjects :indirect accidentally – infectious lesion or laboratorians handing infected animals. Transmission following transfusion of blood from a syphilitic donornull3) an infant --infected in uterus --also occur in infants from contact with an infectious lesionnull3. Stage acquired syphilis:2)congenital syphilis:??nullacquired syphilis: -- early stage: primary(first) < 2 years secondary --tertiary (late)stage: > 2 years --latent phase: detected only by the presence of a reactive serologic test. null2)congenital syphilis: T.pallidum into the fetal circulation. Which stage the child absents? --Primary <2 years --late >2years null4.clinical features (manifestation): 1)primary: The characteristic lesion in first stage syphilis is thechancre or sore. nullnull What is chancre? -- Incubation: about three weeks. the typical incipient --a small red papule or a crusted superficial erosion -- often occur on the penis, on labium, perianal, tongue.(inoculation) null--round or oval ,edge is not undermined --sloughy & markedly indurate base -- erosion, variable size (0.5-3cm in diameter) -- red -- without pain and itch. null --the regional lymph nodes on one or both sides are enlarge, firm, nontender and do not suppurate -- untreated, it disappears after three to eight weeksnullchancrenullnullnullnull2) secondary syphilis There are signs of systemic upset with mild fever, headache, mild arthralgia, generalized lymphadenopathy and skin manifestations. null--incubation: 7- 9 weeks. --skin manifestation: syphlids, 80% (1)macular eruption:early widespread macular rush, including on the palms (2)papular eruption: later papular or lichenoid eruption. nullmacular eruptionnullmacular eruptionnullmacular eruptionnullnullpapular eruptionnullnullnullThickened warty areas ( condyloma lata) appear perianally and in other moist flexural sites. Ulcer appears on the oral mucosa.nullcondyloma lata nullnullalopecianullnull3) Tertiary stage After the secondary stage there is latent period without signs or symptoms lasting for 5-50 years. . nullThe most dangerous scathe --cardiovascular disease with aneurysm formation,central nervous disorder , general paralysis of the insane ulcer active or gummatous lesions that may occur on the skin or on mucosal surfaces. nullnullgummatousnullgummatousnullCongenital Syphilis primary: <2 years tertiary: >2 yeas skin, eye, skeleton, nerver, and marked damage such as Hutchinson teeth, keratitis, neural deaf, nullHutchinson teethnullkeratitisnull5. Diagnosis experience of sexual contact, clinical features,and tests. nullTest: --identification of the spirochaete from wet preparations of the chancre or moist secondary stage lesion --serological tests: VDRL test which is a “flocculation test”null--react specifically tests : FTA-ABS (fluorescent treponemal antibody absorption test) MHA-TP ( T. pallidium microhemagglutination test)null-- a western immunoblot has been developed for detection of fetal IgM antibody against T. Pallidium antigens This test may help to improve serodiagnosis of congental syphilis. null6. Treatment penicillin for all stages of acquired syphilis. Benzathine penicillin G null http://www.cdc.gov/nchstp/ http://www.i-std.com/