Syphilis - 梅毒
Chancres ― 一期梅毒感染 Treponema pallidum
References
梅毒是一種由梅毒螺旋體細菌引起的性傳染病。在這項研究中，我們將重點放在 57 名 18-68 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。它可以模仿多種疾病，因此獲得了“ great imitator ”的綽號。梅毒仍影響全球數百萬人，但可以用青黴素有效治療。
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母親傳給嬰兒導致梅毒。儘管有簡單的測試可以診斷梅毒，並且注射一劑長效青黴素治療效果很好，但梅毒再次成為世界範圍內的一個大問題。對於高收入和中等收入國家的男男性行為者 (MSM) 來說尤其如此。儘管一些低收入國家已經實現了世衛組織阻止梅毒從母親傳染給嬰兒的目標，但愛滋病毒呈陽性的男男性接觸者中梅毒的增加令人擔憂。
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：這種情況很常見，並且可能與脾臟腫大同時發生。在暗視野顯微鏡下檢查肝臟切片檢查可能會發現螺旋體的存在。肝功能檢查可能顯示異常。 (2) 皮膚發黃（黃疸）：是否出現黃疸取決於肝臟受影響的程度。 (3) 流鼻水：通常是最初的症狀之一，通常發生在出生後的第一週內。 (4) 淋巴結腫大：淋巴結普遍腫大，通常無痛，也很常見。 (5) 皮疹：皮疹通常在流鼻水後一到兩週出現。您可能會在背部、臀部、大腿和腳底看到紅色或粉紅色的小斑點。這種皮疹可能會發展為脫皮和結痂。
(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 和 RPR 可用於確認近期感染和篩檢梅毒。 FTA-ABS測試是一種更具體的測試，可用於檢查先前的感染史。青黴素用於治療梅毒。