Syphilis

Syphilis




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■ Introduction:

Spirochaete (spirochete) Treponema pallidum is argued that by spreading mainly by seongjeopchoke may involve any organ systemic disease. Very different clinical phases and, AIDS and the increased use of antibiotics gradually with mild or atypical syphilis patients are increasingly taking over.





■ Symptoms:



Clinically, many stages, incubation (incubation period), 1 syphilis (primary syphilis), 2 syphilis (secondary syphilis), latent syphilis (latent syphilis), late syphilis (late syphilis) is. 3 syphilis, late syphilis (tertiary syphilis), also known as syphilis (neurosyphilis), cardiovascular syphilis (cardiovasculr syphilis), gomujong (gumma) to appear.





1 syphilis

The incubation period after infection, a lesion of syphilis (hard chancre), the average period of three weeks to appear (3-90 days), and the number of bacteria per 1 gm tissue should be more than 107 divisions and once in the time it takes 30-33 hours therefore depends on the amount initially inoculated. Appearing in all patients but they do not show up, even if the patient has.









Typical of a syphilis lesion is a papule without pain. Papules and ulcers are just the base and a clear boundary with the characteristic bumps hard as cartilage. Unless there is secondary infection, ulcers, there is a clear fluid. There is no pain, is pressing a little tenderness. Lesion for darkfield microscopy, which meant the floor when there is little pain or bleeding. May result in multiple ulcers and skin lesions, atypical lesions appear or if there is also common. Hard chancre congenital syphilis except for the blisters do not appear to be. The location is determined according to the inoculated area, the most common location is the extrinsic period, in women, cervical, oral, anal, anal, gay men around the anus, anal, oral and often appears even. Oral and anal ulceration is common that the two secondary infections. Regional lymphadenopathy secondary connector roads, and solid, without a remedy, there is no pain, lesions are accompanied by a period.





Hard chancre is 3-6 weeks (1-12 weeks) and hard chancre spontaneously to areas had little or no signs of leaving atrophic scars. Lymphadenopathy is usually longer lasting.





2 of syphilis vaccine 6 weeks (2-12 weeks), then, or hard chancre occurring 2-8 weeks after two causes. Therefore, a period in some patients even if the lesion is still. Number in the body in the presence of other H. Spiro, especially in the blood, it appears. With systemic symptoms and skin and mucous membrane lesions appear, all the organs of the body can be seen from the above. The host is immune to the bacteria by creating a spread of other H. Spiro continued until prevented, and lesions due to immune complexes may be seen. After 3-12 weeks are naturally aggressive.





Two clinical phases of syphilis is very diverse and the most common skin lesions. Half (MACULE), papules (papule), pustules (pustule), nodules (nodule) if they appear to vary there is no smoke comes out. Start the trunk and extremities proximal to 3 ~ 10 mm red color of pink appeared banjinyi bilateral lasts from several days to 8 weeks. In some areas of the skin can appear on the palms and soles, especially when 's movement to the rash of syphilis. When the invasion of hair follicles (follicular syphilids) temporary hair loss occurred, eyebrows and beard are thin or missing. Banjineseo rarely papules pustules (pustular syphilids) also is ongoing. Perivascular lymphocytic infiltration of arteries endocarditis and also proceed at the same rate.





Warm and humid skin overlap area (around the anus, the girl's vulva, scrotum, thigh, inside the breast, under the shins, aekwabuna forearms and fingers or between the toes), the papules growing, each combined pain free, a large pink in Are you this edition of the formation of a gray flat condyloma (condyloma lata) is called, is very contagious strong. MUCOUS patch include the other contagious disease called mucosal lesions can occur. Lips, mouth, pharynx, tonsil, women vulva, vagina, penis, penis inside of the epidermis, erosions of the anus to the silvery gray and redness around it is typical. There is no pain.

2nd case of recurrent skin lesions of syphilis, rather than the initial asymmetric distribution not clear, and no enemy invasion. Perhaps the host's immune response is thought to be strong due. Flat condyloma is very common.





Systemic symptoms include fever, general malaise, sore throat, laryngitis, loss of appetite, weight loss, arthritis, systemic lymphadenopathy and minds.

Involvement of the central nervous system and headaches, sumakjageukjeung (meningismus) protein in cerebrospinal fluid is usually shown the rise in lymphocytes and 8-33% of patients can be seen. Acute aseptic meningitis also occurs in 1-2% of the patients. In this group, there was more than it was cured with antibiotic therapy for AIDS patients are not cured neurosyphilis shows. Phase 3 occurs when different from the early neurosyphilis syphilis (early neurosyphilis) should use the term.









Latent syphilis

Latent syphilis, syphilis has no clinical findings of normal CSF and normal chest X-ray phase and treponema test is positive if it represents. Is the state of progress continues. Early latent syphilis can cause a recurrence can be infectious. Recurrence within 1 year if the first is 75-90%, and 95 percent within two years, is 100% within 5 years. As the clinical phase is more vulnerable to relapse. The most common mucosal recurrence. Recurrence of latent syphilis, late period does not (late latent syphilis) is called. Only pregnant women can spread to the fetus through the placenta and may spread to others by blood transfusion can be. Early and late are artificially dividing time 1-4 years. Established by the U.S. CDC currently uses a lot of years. Recurrence of a period other than to pathology or treatment, but the difference, according to animal experiments, the longer treatment period required for infection, increasing the amount of penicillin that is likely to vary because the amount of antibiotics.



Late syphilis (late syphilis) or 3-stage syphilis (tertiary syphilis)

Patients with late latent period 1 / 4 ~ 1 / 3 of the findings appears 3rd VDRL titer syphilis are diverse. The main lesions of secondary syphilis 3 aorta (approximately 10% of the rate), or central nervous system (the rate of about 8%) and other clinical types gomujong (gumma) occurs in approximately 15% of the patients. Granulomatous lesions, skin, soft tissue, bone, liver and testicular tissue, such as occurs in real.



Syphilis positive reviews (BENIGN tertiary syphilis)

Gomujong (gumma) nonspecific chronic granulomatous inflammation mainly in the skin (70%), bone (10%), mucous membranes occur in a certain tissue can occur. Occurs when treatment is incomplete. VDRL is always positive.





Can occur, one or more, the size varying from microscopic lesions such as tumors can be large. It grows very slowly, the main clinical findings on the long-term destruction of the local airspace. Nodular skin lesions on the skin varies from deep granulomatous lesions and necrotic ulcers are formed as the surroundings clean. The course remains a thin atrophic scar. Kinds of rubber bone fractures or joint can lead to the destruction of the respiratory kinds of rubber gives rise to the nose and palate perforation. Trauma can occur in the receiving area. Spiro H. lesions are very difficult to find other, to differentiate from other diseases may not have experienced a dramatic improvement when the penicillin is used.



Cardiovascular syphilis

Cardiovascular disease is the default, or obstructive arterial endocarditis. Vasculature of the aortic wall, blood vessels (vasa vasorum) by involving the destruction of elastic fibers to result in necrosis of the aorta jungpiui. As a result, formation of aneurysms and aortic insufficiency and coronary artery stenosis leads to.





Symptoms of untreated syphilis in the aorta, salt occurs in 10% of patients, one pathological abnormalities have been observed in up to 35%. Chest X-ray phase when the aortic wall calcification in the same line of asymptomatic aortic Syphilis salt should be suspicious. If the hardening of the arteries due to calcification is rare. Syphilis is aortic dissection are rare salts. Central nervous system disorders in patients with cardiovascular syphilis is a common finding.



Neurosyphilis

Whether the symptoms of syphilis are divided into two companion. In recent years, an increasing number of syphilis and substantial mujeunghu syphilis was very rare.

Mujeunghu neurosyphilis (asymptomatic neurosyphilis) the clinical diagnosis of the clinical findings of neurosyphilis CSF examination, while no increase in the cells, increased protein, reduced sugar, VDRL positive, even if any one of the findings is available. Untreated patients with syphilis mujeunghu from 8-33%, indicating mujeunghu Neurosyphilis Neurosyphilis in patients with symptoms may progress with the frequency.



Symptoms of syphilis are two major clinical categories of syphilis so meningeal vascular (meningovascular neurosyphilis)) and real neurosyphilis (parenchymatous neurosyphilis) is. Meningeal vascular occlusive naehyeolgwanyeomyi the meningeal neurosyphilis, brain, spine, involvement of the tiny blood vessels that will be real, syphilis and nerve cells, nerve cells of the cerebral cortex caused the destruction of the means. Thus, the inflammatory meningeal vessels compared with neurosyphilis neurosyphilis real is a degenerative disease. In fact, much of which are overlapping each other, with pathological lesions in two cases jeokeurodo common.





Meningeal blood vessels in neurosyphilis bancheukmabieseo progressive nerve damage that represent a wide range of clinical manifestations. If you are experiencing cramps are also common.

Substantial progress in the attack neurosyphilis (general PARESIS) and spinal cord (tabes dorsalis) has a broad range of real destruction airspace. Progression of paralysis or paralysis (paresis), depending on each letter so convenient to remember - p (personality: personality), a (affect: emotions), r (reflexes: Reflection), e (EYE: eye - Argyll Robertson pupils) , s (sensorium: sensory - delusions, hallucinations), i (intellect: intelligent), s (speech: language) is.





Fracture of the spine (tabes dorsalis), mainly posterior column, dorsal root, dorsal root ganglia of the second as dehydration, ataxia, foot suddenly exit (footslap), sensory disturbances, "was an electric shock when the pain (lightening pain)" (starts suddenly spreading the pain disappeared), bladder disorders, erectile dysfunction, loss of position sense and vibration sense, deep sense of loss of copper through the temperature displayed. Romberg characteristic signs appear. Proliferative degenerative joint disease (Charcot's joints) and hajina traumatic foot ulcers occur.





■ Cause / pathogenesis:



Four trails spiral bacteria called nematic



■ Diagnostics:



Most cases of syphilis depends on clinical and serological methods and clinical findings in latent syphilis serology can not even rely on the diagnosis will be.



As with other serological tests in early infection, antibodies do not appear, false positive is possible, in patients with immune or it can be difficult to interpret.



Facilities or personnel, if possible darkfield immunofluorescence tests or other proof of the H. Spiro is a definite.



■ progress / outcome:



Quite naturally cured cases, but



■ medical treatment:



Sarin was used in a penny is still valid.



Course of illness varies depending on the amount or duration, usually 1-3 times the initial treatment, the intramuscular injection and older are treated with intravenous injection of syphilis.



■ Prevention:



Do not have sex with strangers, and if it can not keep using a condom is



■ belts to your doctor:



1. These days, more blood tests if the symptoms are diagnosed in many cases, were found to test positive if I told you, should consult with your doctor.



2. After sexual intercourse when you look like an ulcer in the genital area