Syphilis - 梅毒
Chancres ― 一期梅毒感染（Treponema pallidum）
relevance score : -100.0%
References梅毒是一種由梅毒螺旋體細菌引起的性傳染病。在本研究中，我們將重點放在 57 名年齡介於 18 至 68 歲的第二期梅毒患者。
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.
梅毒是由梅毒螺旋體引起的細菌感染。它可模仿多種疾病，因而獲得「great imitator」的綽號。梅毒仍影響全球數百萬人，但可使用青黴素有效治療。
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 透過性接觸或懷孕期間由母親傳給嬰兒，導致梅毒。儘管有簡便的檢測可以診斷梅毒，且一次注射長效青黴素即可取得良好治療效果，但梅毒仍再次成為全球性的大問題，尤其在高收入與中等收入國家的男男性行為者 (MSM) 中更為顯著。雖然部分低收入國家已達成世衛組織阻止梅毒母嬰傳播的目標，但在 HIV 陽性的 MSM 中，梅毒的增加仍令人擔憂。
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) 肝臟腫大：此情況常見，且常與脾臟腫大同時出現。於暗視野顯微鏡檢查肝臟切片時，可能可見螺旋體。肝功能檢查亦可能呈異常。 (2) 皮膚發黃（黃疸）：是否出現黃疸取決於肝臟受損的程度。 (3) 流鼻水：常為最早的症狀之一，通常在出生後第一週內出現。 (4) 淋巴結腫大：淋巴結普遍腫大，多為無痛，亦相當常見。 (5) 皮疹：皮疹通常在流鼻水後一至兩週出現，常見於背部、臀部、大腿及腳底，呈紅色或粉紅色小斑點，後可演變為脫皮與結痂。
(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.
○ 診斷與治療
VDRL 與 RPR 可用於確認近期感染及篩檢梅毒；FTA-ABS 測試則較具特異性，適合檢查過去感染史。治療上以 Penicillin (青黴素) 為首選藥物。