Syphilis - 梅毒
Chancres ― Treponema pallidum による一次梅毒感染症
References
梅毒は、梅毒トレポネーマという細菌によって引き起こされる性感染症です。この研究では、18～68歳の続発性梅毒患者57人に焦点を当てます。
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いますが、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、妊娠中の性的接触または母親から赤ちゃんへの感染を通じて梅毒を引き起こします。梅毒を診断するための簡単な検査があり、長時間作用型ペニシリン注射1回による治療が効果的であるにもかかわらず、梅毒は世界中で再び大きな問題になりつつあります。これは、高所得および中所得の国で男性とセックスする男性（MSM）に特に当てはまります。一部の低所得国は母子感染を阻止するというWHOの目標を達成しているが、HIV陽性MSMにおける梅毒の増加は憂慮すべきことである。
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検査すると、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場合があります。 (2) 皮膚の黄色化 (黄疸) : 黄疸が見られるかどうかは、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 1 つで、通常は生後 1 週間以内に起こります。 (4) リンパ節の腫れ: リンパ節の全身的な腫れもよく見られますが、通常は痛みはありません。 (5) 皮膚の発疹: 発疹は通常、鼻水の 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、皮むけやかさぶた化に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ために使用できます。 FTA-ABS テストはより特異的なテストであり、以前の感染歴を確認するために使用できます。ペニシリンは梅毒の治療に使用されます。