Syphilis - 梅毒
Chancres ― Treponema pallidum による一次梅毒感染症
relevance score : -100.0%
References梅毒は、梅毒トレポネーマという細菌が原因の性感染症です。この研究では、18～68歳の続発性梅毒患者57人を対象としています。
Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp). Herein we describe a cohort of 57 patients (age 18-68 years) with secondary syphilis (SS) identified through a network of public sector primary health care providers in Cali, Colombia.
Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp). Herein we describe a cohort of 57 patients (age 18-68 years) with secondary syphilis (SS) identified through a network of public sector primary health care providers in Cali, Colombia.
梅毒は、梅毒トレポネーマによって引き起こされる細菌感染症です。さまざまな病気に擬態することができるため、great imitatorというニックネームが付けられています。梅毒は依然として世界中で数百万人が罹患しており、ペニシリンで効果的に治療できます。
Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Due to its many protean clinical manifestations, it has been named the “great imitator and mimicker.” Syphilis remains a contemporary plague that continues to afflict millions of people worldwide. Luckily, the causative organism is still sensitive to penicillin.
Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Due to its many protean clinical manifestations, it has been named the “great imitator and mimicker.” Syphilis remains a contemporary plague that continues to afflict millions of people worldwide. Luckily, the causative organism is still sensitive to penicillin.
Treponema pallidum は、妊娠中の性的接触や母子感染により梅毒を引き起こします。梅毒は簡便な検査で診断でき、長時間作用型ペニシリンを1回注射する治療が有効であるにもかかわらず、世界的に再び大きな課題となっています。これは特に高所得・中所得国における男性とセックスする男性（MSM）で顕著です。一部の低所得国では、WHOの母子感染阻止目標が達成されていますが、HIV 陽性 MSM における梅毒の増加は憂慮すべき事態です。
Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase in the prevalence of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen.
Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase in the prevalence of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen.
(1) 肝臓の肥大: これはよく見られ、脾臓の肥大と同時に起こることもあります。暗視野顕微鏡下で肝生検を行うと、スピロヘータの存在が明らかになる場合があります。肝機能検査で異常が見つかることがあります。 (2) 皮膚の黄色化(黄疸): 黄疸の有無は、肝臓がどの程度影響を受けているかによって決まります。 (3) 鼻水: 多くの場合、最初の兆候の一つで、通常は生後1週間以内に現れます。 (4) リンパ節の腫れ: 全身のリンパ節が腫れることもよく見られますが、通常は痛みを伴いません。 (5) 皮膚の発疹: 発疹は通常、鼻水が出てから1〜2週間後に現れます。背中・お尻・太もも・足の裏に小さな赤やピンク色の斑点が見られることがあります。この発疹は、皮むけやかさぶたへと進行する可能性があります。
(1) Hepatomegaly: This is the most common finding and may occur with splenomegaly. Biopsy of the liver followed by darkfield microscopy may reveal the spirochete. Liver function tests may be abnormal. (2) Jaundice: Jaundice may or may not be present depending on the extent of liver injury. (3) Rhinitis: One of the first clinical presentations, usually in the first week of life. Copious, persistent white discharge is noted, which contains spirochetes that can be visualized under darkfield microscopy. (4) Generalized Lymphadenopathy: Generalized, non-tender lymphadenopathy is also a common finding. (5) Rash: Rash usually appears one to two weeks after rhinitis. Small red or pink colored maculopapular lesions may be commonly seen on the back, buttocks, posterior thigh and soles of the feet. The rash progresses to desquamation and crusting.
(1) Hepatomegaly: This is the most common finding and may occur with splenomegaly. Biopsy of the liver followed by darkfield microscopy may reveal the spirochete. Liver function tests may be abnormal. (2) Jaundice: Jaundice may or may not be present depending on the extent of liver injury. (3) Rhinitis: One of the first clinical presentations, usually in the first week of life. Copious, persistent white discharge is noted, which contains spirochetes that can be visualized under darkfield microscopy. (4) Generalized Lymphadenopathy: Generalized, non-tender lymphadenopathy is also a common finding. (5) Rash: Rash usually appears one to two weeks after rhinitis. Small red or pink colored maculopapular lesions may be commonly seen on the back, buttocks, posterior thigh and soles of the feet. The rash progresses to desquamation and crusting.
○ 診断と治療
VDRL と RPR は、最近の感染を確認し梅毒をスクリーニングする際に使用できます。FTA‑ABS テストはより特異的で、過去の感染歴の確認に有用です。ペニシリンは梅毒の治療に用いられます。