Formerly Myrica sore. "Caused by the Treponema pallidum chronic infectious venereal diseases. Mainly transmitted through sexual relations. Congenital syphilis is passed to the fetus caused by maternal syphilis. Syphilis generally 3-4 weeks after infection, external genital chancre occurs ( 1 syphilis); infection about 2-3 months, there may be rash, papules and axillary, neck, groin superficial lymph nodes (secondary syphilis); 1, 2 syphilis as early syphilis should be treated as soon as possible ; or may invade the heart and other organs was formed late syphilis, and even life-threatening.
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méi dú
A chronic infectious disease, acquired 95% of patients caused by the sexual intercourse, those from the pregnant woman to fetus congenital, pathogens as syphilis, the clinical course of three phases, for years, against a number of organs and tissues can be
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No. 3
梅毒
梅毒
A sexually transmitted diseases. Pathogen is Treponema pallidum. Symptoms: early stage of the hard chancre, lymph node swollen; second, the emergence of various skin rashes, lesions occur in individual organs; the third period, the skin, mucous membrane malignant tumor formation Mei, circulatory or central nervous system lesions occur. The disease can lie dormant for years without any symptoms, or by the pregnant woman to fetus. Called red bayberry sore in some areas.
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No. 4
梅毒
梅毒
梅毒
梅毒
梅毒
(English name: syphilis)
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About diseases
Caused by pale disease spirochetes. Mainly transmitted through sexual intercourse, sexually transmitted diseases. 3 phases: ① a syphilis. The chancre, the incubation period 2 to 4 weeks, external genitalia dark red hard lumps occur, shallow ulcers, with cartilage-like hardness, the surrounding lymph nodes. ② secondary syphilis. Syphilis in a 1 to 2 months later, the body skin, mucous membranes occurred symmetric generalized rash, rash, pimples, impetigo and so on. Mucous membrane mucous plaque can occur, flat condyloma, contagious. ③ three syphilis. Occurs in 2 to 3 years after infection or 10 years, the skin is kind of swollen gums, but also involves bones, joints, heart, blood vessels, showed aortitis, aortic insufficiency and aortic aneurysm, and neural invasion as tabes, general paralysis (GPI). Early congenital syphilis congenital syphilis are equivalent to the day after tomorrow two, but heavier. Late congenital syphilis and acquired similar, but rarely the heart, blood vessels and nerve lesions. Main substantive keratitis, nerve deafness, Hutchinson's teeth (central incisors cut marks, the next small big, generous equal), saber-shaped tibia and so on. Between each period may have latent syphilis, asymptomatic, only seropositive. Treatment with penicillin or erythromycin, tetracycline, and so on. Syphilis is a systemic chronic diseases, syphilis, tuberculosis, leprosy, chronic infectious disease listed as the top three. Syphilis (syphilis) in the origin and spread, many say, according to Western scholars that in Europe before the 15th century without syphilis. 1492 Columbus first voyage to the Americas, a number of sailors and the American women had had sex with, when the sailors returned to Europe, the disease spread to Italy, Spain. 1494 King Charles VIII of France to raise the world more than thirty thousand soldiers in all countries, expedition Italy, syphilis is spreading in Italy and China, when the siege of Naples, the military barracks of the syphilis epidemic. 1495 of these soldiers returned home suffering from syphilis, resulting in the European syphilis epidemic. Some people think that in 1488, the Portuguese fleet to India to syphilis. Some scholars believe that Columbus's fleet of 1498 Cape of Good Hope to reach India. Since the arrival of the crew of syphilis infection, syphilis can be brought to India. Through business contacts, syphilis has also entered China, in Guangdong Province in 1505 and describes the first discovery of syphilis cases, then, did give syphilis to the mainland coastal areas in China spread far and wide, the incidence rate remains high, ranking first in sexually transmitted diseases. After the liberation, the Party and the government effectively banned brothels prohibit prostitution, sexually transmitted diseases, a broad survey of the general rule has been largely eliminated syphilis in 1959. Since the 70s, with the development of society, sexually transmitted diseases but also in our country back from the dead, especially the number of syphilis increased significantly, the sharp rise in incidence.
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Syphilis causes
梅毒病因
梅毒病因
梅毒病因
梅毒病因
The causative agent of syphilis is a spirochete, Treponema pallidum is a spiral of small and delicate micro-organisms, a length of 5-20nm, diameter <0.2nm. It has a 6-12 helix, the naked eye can not see, in the dark field microscope, people only see the refractive index of Treponema pallidum, and its activity is strong. In its front-end with 4-6 flagella-like fine fibers, the end was curled shape. The impact of external factors in the unaffected, the spiral is the rule. Transparency is not easy because of their coloring, also known as the white spiral. Treponema pallidum is the anaerobic bacteria, in vivo long-term survival and reproduction, as long as conditions are suitable, then the horizontal fracture modes into two for breeding. Not easy to survive in vitro, boiling, drying, soap and general disinfectant (such as mercuric chloride, phenol, alcohol, etc.) it is easy to kill it.
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Infection case
Syphilis of the skin, mucous membrane containing Treponema pallidum, not sick patients in sexual contact with syphilis, the skin or mucous membranes can be damaged if slightly ill. Very few can be transmitted through blood transfusion or other means. Acquired syphilis (acquired) is the source of infection of patients with early syphilis, 95% were infected through sexual intercourse dirty, a few through kissing, shaking hands, blood transfusion, contact with contaminated underwear wet towels, cups, pipe, breastfeeding, diapers and other infections. Fetal syphilis (congenital): pregnant women spirochetes, usually in March-April of pregnancy by the placenta and infect the baby.
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Clinical manifestations
梅毒 临床表现
梅毒 临床表现
梅毒 临床表现
梅毒 临床表现
One, acquired syphilis Points of early syphilis and late syphilis. Of early syphilis patients within two years after infection, including a syphilis and secondary syphilis, late syphilis, the disease of more than two years after infection, the tertiary syphilis. Primary syphilis: 3 weeks after infection occurs (between 10-30 days). Infection occurring at a hard, painless nodules round. Start flushing, wet, gradually rupture, erosion, formation of ulcers, syphilis is a chancre. The main damage is a hard chancre, is the initial invasion of Treponema pallidum place, and due to this breed. A typical chancre is a painless erythematous induration, touch as hard as cartilage, basement cleaning, surface erosion covered with little exudate or thin crust, edges neatly. Most damage to a single number, but also for the many. Well occur in the external genitalia. Men occurred in the penis foreskin, Coronal, or Department of the glans belt. Gay men often occurred in the Department of anus and rectum. Occurred in the size of the labia of women inside a good location, etc. can also occur in the cervix. Inguinal lymph nodes at the same time, but not pain. Infected person through kissing, hard chancre may occur in the lips, lower jaw and tongue and other parts may also occur in the eyelids, fingers and breasts, etc., and sometimes not healed chancre may also associated with other sexually transmitted diseases, such as gonococcal dermatitis. A chancre of syphilis spirochete in a lot of plum, often accompanied by local lymph nodes. Highly infectious. Continued 2-6 weeks after chancre subsides spontaneously without leaving a scar. But because women chancre occurs more hidden parts, but also asymptomatic, is often overlooked opportunity to increase the spread. A syphilis if not treated or not treated properly, spiral lines, and lymph node spread blood to the body, a few weeks after the development of secondary syphilis. Secondary syphilis: Untreated patients, usually after infection, 6 weeks to 6 months can occur secondary syphilis. Is due to a syphilis chancre of syphilis within the reach lymph nodes via lymphatic vessels, the body due to spread through the blood. Early may have fever, fatigue, headache, sore throat, muscle pain, joint pain, anorexia and other symptoms. More than half of patients with lymphadenopathy, occasionally hepatosplenomegaly. Blood, as may have leukocytosis, anemia and elevated ESR and so on. Performance of about 70% of patients had skin rash, called syphilis. Syphilis can have many different manifestations, generally symmetrical distribution of a wide range, no itching. (1) type of syphilis rash (rose spots). This is the first emergence of syphilis rash, red, brown or rose rash pigmentation, multiple first began in the trunk. The subsequent development of the limbs, hands and foot and so on. Erythema were round, the basic symmetrical distribution in the palms and soles. This is the syphilis commonly known as "big sore red bayberry" reasons. (2) papular type of syphilis. This is because the course of development, some rash may be thickening developed into pimples. Occur in the trunk, buttocks, legs, hands, foot and face, etc.. Can be manifestations of rash, papules, scaly papules of, ring, like psoriasis and other damage. (3) flat condyloma. This happened in the Ministry of the external genitalia, and other skin folds around the anus and humid parts of the papules. Damage manifested as smooth, thick, flat, level surface covered with gray film, containing a large number of Treponema pallidum. Flat condyloma of infectious syphilis more than the other two. (4) about 30% of the patients had oral mucosal damage, called mucosal plaques. Damage to the surface covered with gray film, containing a large number of Treponema pallidum. Course of secondary syphilis can occur in the sheet or a diffuse hair loss. General hair loss can be self-healing. Secondary syphilis can sometimes compromise the nervous system, bones, or eyes and other organs. Signs and symptoms of secondary syphilis are: General last several weeks, will be self-limiting, if not treated, l - 2 years can often relapse. Secondary syphilis manifested as generalized rash. Characterized by objective findings, which may provide a low-grade fever, headache, sore throat, joint dull pain and other flu-like symptoms. At this point highly contagious, can also better for the natural latent syphilis. Tertiary syphilis: Appeared in more than two years after infection. Have the following main categories: (2) cardiovascular syphilis. May have aortitis, aortic insufficiency, aortic aneurysm. (3) neural syphilis. May have spinal tuberculosis, dementia, paralysis, optic nerve atrophy. Second, congenital syphilis Congenital syphilis is passed from mother to fetus through the placenta, often caused by premature birth and stillbirth. 1. Early congenital syphilis. Symptoms within the age of two who. Mainly with rhinitis, but can also manifestations of pharyngitis, weight loss, insomnia, lymph nodes and hepatosplenomegaly, osteochondritis, pseudo paralysis. Damage to skin and mucous manifestations of papular scaly rash scars or large, flat warts, spots and other mucous membranes. 2. Late congenital syphilis. Symptoms occurred in more than two years old. Substantial performance keratitis, saddle nose, saber shin, syphilis teeth (hutchinson), nerve deafness and so on. Acquired syphilis with three other general similar. 3. Latent syphilis (latent syphilis). Secondary syphilis are not treated, the symptoms and signs of spontaneous regression and enter often asymptomatic period, known as the incubation period. If untreated, patients may relapse, most people relapse within two years. Patients within two years as early latent syphilis. Patients over two years as late latent syphilis. Little late recurrence of latent syphilis, but pregnant women can pass fetus. In addition to seropositive latent syphilis, but without any symptoms.
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Diagnosis of syphilis
In secondary syphilis, mucosal plaques, papules, and flat condyloma and other wetlands are also easy to find lesions of Treponema pallidum. Many test methods syphilis, the spirochetes with the antigen of non-antigen (antigen heart to be fat) and two types of Treponema pallidum antigens. It used to be fat, crude bovine hearts do precipitate antigen test (Kahn's test, was translated Kahn test, etc.) and complement fixation test (Wase Man's test, etc.). The current application of the STD Research (vdrl) Zeyi slide test for antigens of pure heart to be fat, its pure components, test results are stable. Treponema pallidum as antigen to test, commonly used internationally spiral fluorescent antibody absorption test (fta-abs), pale spirochete hemagglutination test (tpha), with its high specificity, high sensitivity. The serum test for syphilis, the diagnosis of syphilis is very important, often a strong positive reaction in early syphilis. Latent syphilis and neurosyphilis symptom-free activities for the clinical symptoms, mainly by the serum test for the diagnosis of syphilis, but the serum test for syphilis should be noted that false positive reactions, some non-syphilis diseases such as malaria, systemic lupus erythematosus, etc., there may be positive reaction, known as biological false positive reaction. Early in the chancre, syphilis sero often negative in late syphilis can also be negative, especially in the late neurosyphilis in patients with spinal tuberculosis negative rate of up to 30 to 50%.
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Prevention
Different with other sexually transmitted diseases, only reconnaissance difficult to detect with the eye, but at least the spread of syphilis, the make us aware of its existence. If you are aware of physical injury, temporarily stop the behavior. With 50-75% of men and women have no symptoms, and some damage can not be aware of what? Use of condoms is the best protection methods.
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Syphilis treatment
梅毒治疗
梅毒治疗
梅毒治疗
梅毒治疗
The treatment of syphilis is based mainly on Western medicine, since the wonders of penicillin for the treatment of syphilis, the Chinese medical treatment as the main base is not only play a supporting role, and that following a brief introduction to the different stages of syphilis in Western medicine approach: (A) early syphilis (including one, secondary syphilis and early latent syphilis) 1, penicillin therapy (1) benzathine penicillin G (long-acting amoxicillin) 2400000 u, points on both sides of the buttocks intramuscular injection, 1 week, 2 or 3 times. (2) procaine penicillin G80 million u / day, intramuscular injection for 10 to 15 days, total 800 million u ~ 1200 万 u. 2, those who are allergic to penicillin (1), tetracycline hydrochloride 500mg, 4 times / day, oral, and even served 15 days. (2), doxycycline 100mg, 2 times / day, and even served 15 days. (B) Late syphilis (including three skin, mucous membranes, bone syphilis, late latent syphilis), and two recurrent syphilis. 1, penicillin (1), penicillin G240 million u, 1 times / week, intramuscular injection, a total of 3 times. (2) procaine penicillin G80 million u / day, intramuscular injection, for 20 days. 2, those who are allergic to penicillin (1), tetracycline hydrochloride 500mg, 4 times / day, oral, and even served 30 days. (2), doxycycline 100mg, 2 times / day, and even served 30 days. (C) cardiovascular syphilis Should be hospitalized and, if heart failure, the first treatment of heart failure, cardiac function to be compensatory time, start small dose penicillin, such as aqueous penicillin G, the first day of 100,000 u, 1 times / day, intramuscularly. Second day of the 10 million u, 2 times / day, intramuscular injection, and the third at 20 million u, 2 times / day, intramuscularly. 4 Since the date of the treatment as follows (in order to avoid Jihai Shi reaction penicillin injection in the day before the oral prednisone 20mg / time, 1 time / day for 3 days). 1, procaine penicillin G80u / day, intramuscular injection for 15 days for treatment, a total of two course of treatment between the off-drug for 2 weeks. 2, tetracycline 500mg, 4 times / day, and even served 30 days. (D) neurosyphilis Should be hospitalized, in order to avoid generating Jihai Shi treatment response, the day before the injection of penicillin oral prednisone, each 20mg, 1 times / day for 3 days. 1, aqueous penicillin G, 12 million a day u, intravenous drip (200 million every 4 hours u), for 14 days. 2, procaine penicillin G, 120 million a day u, intramuscular injection, while oral administration of probenecid per 0.5g, 4 times / day, a total of 10 to 14 days. When necessary, and then benzathine penicillin G, 240 万 u, 1 times / week, intramuscularly for 3 weeks. (E) pregnancy syphilis 1, procaine penicillin G, 80 万 u / day, intramuscular injection for 10 days. Within the first 3 months of pregnancy, a course of injections, injection of 3 months of pregnancy at the end of a course of treatment. 2, allergy to penicillin, erythromycin therapy, each 500mg, 4 times / day, early drug and even served 15 days of regret and second recurrence and late syphilis and even served 30 days. Early pregnancy, late pregnancy, 3 months and 3 months each for a course of treatment (disabled tetracycline). However, application of penicillin baby born to make governance. (F) child transmission of syphilis (congenital syphilis) 1, early congenital syphilis (less than 2 years old) with abnormal cerebrospinal fluid: (1) aqueous penicillin G, 5 万 u / kg body weight, 2 times a day intravenously for 10 to 14 days. (2) procaine penicillin G, day 50 000 u / kg body weight, intramuscular injection for 10 days to 14 days. Normal cerebrospinal fluid: Benzathine penicillin G, 5 万 u / kg body weight, one injection (points on both sides of gluteal muscle). Check the cerebrospinal fluid, such as those who unconditionally, according to the treatment of cerebrospinal fluid abnormalities. 2, late congenital syphilis (2 years) Procaine penicillin G, day 50 000 u / kg body weight, intramuscular injection for 10 days for treatment (not to exceed adult dose). Disabled children under 8 years old tetracycline. Congenital syphilis who are allergic to penicillin can be used erythromycin, 7.5 ~ 12.5mg/kg body weight per day, divided into 4 sub-services, and even served 30 days. Should be noted that the treatment of syphilis, syphilis diagnosis must be clear, the sooner the better treatment, the dose must be sufficient, treatment must be rules to follow observed after treatment. Source of infection and response to sexual contact or sexual companion simultaneous examination and treatment of syphilis treatment. 【How to determine whether the full treatment of syphilis】 Syphilis after treatment, how to determine whether recovered it? Now is usually the detection of syphilis to be judged, now more commonly used in major hospitals is rpr (rapid plasma reagin circle card test) and tpha (Treponema pallidum hemagglutination test). Nonspecific syphilis serological tests, commonly used in the early diagnosis of syphilis, but the latent syphilis, neurosyphilis is not sensitive. tpha serum specific Treponema pallidum antibodies, have high sensitivity and specificity. Once the positive detection of this Law, regardless of whether the activities or disease treatment or not, usually remain life-long positive change, and its titer is unrelated to changes and syphilis, it can not be determined for evaluating the effectiveness of treatment or recurrence of the index and re-infection can only be used as syphilis confirmation test. Syphilis patients after treatment in the anti-mei, the serum response to changes in general There are 3 possibilities: (1) serum overcast. (2) lower serum titers are not overcast, or serum resistance. (3) serum response showed recurrence. If the syphilis patients received less than the amount of anti-Mei treatment, serum response shortly after the negative conversion in the moment they became positive, or 4-fold increase in titer (eg, rose by a 1:2 1:8), namely that "Serum recurrence" can be seen that the formal treatment of anti-plum or not enough and there is a close relationship between serum recurrence. In summary, early syphilis treatment should be formal enough, rpr titer can be observed before and after the therapeutic effect of anti-plum.
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Notes
Pale spirochetes of syphilis is Treponema pallidum that is caused by a chronic sexually transmitted diseases. Can affects the skin, mucous membranes and a variety of other tissues and organs, can have a variety of clinical manifestations, course of the disease was asymptomatic and sometimes latent state. Pathogens can be transmitted to the fetus through the placenta and fetal transmission of syphilis occurs. According to the different mode of transmission of syphilis can be divided into acquired and congenital syphilis (child transmission) syphilis; according to their stage of disease can be divided into early syphilis and late syphilis. Early congenital syphilis congenital syphilis are equivalent to the day after tomorrow two, but heavier. Late congenital syphilis and acquired similar, but rarely the heart, blood vessels and nerve lesions. Main substantive keratitis, nerve deafness, Hutchinson's teeth (central incisors cut marks, the next small big, generous equal), saber-shaped tibia and so on. Between each period may have latent syphilis, asymptomatic, only seropositive. Treatment with penicillin or erythromycin, tetracycline, and so on. Syphilis Note: To adhere to the treatment of syphilis early, adequate treatment principle. Penicillin on a role in the killing of Treponema pallidum, side effects and small, as long as adherence to treatment with the physician, will receive a reduction of complications, cure disease, restore health effect as soon as possible. During treatment, the spouse needs to be checked, if necessary, treatment. Require periodic review, after cure, there is recurrence of symptoms, the antibiotic dosage should be increased. Secondary syphilis occurs when the body reaction occurs, this time to stay in bed. Pay attention to nutrition during illness, and enhance immunity. Duration of illness was not pregnant. If patients with pregnancy, treatment should be started as soon as possible. Whether to keep the fetus, pregnant women should be based on the wishes of the Executive.
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No. 13
梅毒
梅毒
梅毒
Syphilis (A) 【】 Liver syndrome hot and humid place. 【Method】 Liver dampness, liver stagnation line. 【Name】 Jiuwei side Chai Hu Tang. 【Composition】 Bupleurum 3 grams, fried skullcap 3 grams, 1.5 grams of ginseng, fried Gardenia 1.5 g, 1.5 g Pinellia, gentian (Chaojiao) 1.5 grams, 1.5 grams angelica, peony 1.5 grams, 1.5 grams licorice. 【Usage】 Shuijianbi day one, served on the 2nd. 【Source】 "School Notes woman recipe" Volume XIV. (B) 【】 Exogenous toxin syndrome, steeped skin. 【Method】 Qudu, nourishing, active. Party Name】 【Big decoction. Smilax glabra】 【9 grams of the composition, Chuanxiong 3 grams, 4.5 grams of Akebia, Yinhua 9 grams, Poria 6 grams, 4.5 grams of rhubarb, wind 6 grams. 【Usage】 Shuijianbi day one, served on the 2nd. 【Source】 Lin Duanchang side.
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Overview
梅毒 概述
Syphilis is a pale (syphilis) spirochetes caused by chronic, systemic sexually transmitted diseases (VD, STD). Mostly through sexual transmission, clinically manifested as a syphilis, secondary syphilis, tertiary syphilis and latent syphilis. Is the "People's Republic of Infectious Diseases Prevention Law" as a B prevention and management of the disease. Second, the pathogen 1. Treponema pallidum Also known as the pale spirochetes (Treponemiapallidum, TP), 1905, was discovered. In the taxonomy of spirochetes body is present (Spirochaetales), Treponema Branch (Treponemataceae), genus Treponema (Genus Treponema). Cell slender, with evenly arranged 6 to 12 helix, a long 5 ~ 20μm, the average length of 6 ~ 10μ m, diameter of 0.15μm and down, slow and regular exercise, easy coloring dye commonly used in laboratories can be used darkfield microscopy or phase contrast microscope observation of bacteria. Artificial culture in vitro is difficult, get vaccinated rabbit testis spiral. 2. Immunological Produce infectious immunity after infection, 2 weeks after infection to produce specific IgM antibodies, the antibodies can not pass through the placenta; 4 weeks after infection showed specific IgG antibodies through the placenta. Early Syphilis can be cured completely re-infection. In addition, TP destroy human tissue, so that the release of an antigen of heart tissue lipase, stimulate the body to produce reagin, using RPR, USR, VDRL and other methods could be detected in infected TP 5 to 7 weeks after the chancre appears after 2 or 3 flow positive. 3. Resistance Low activity of human external memory, 40 ℃ when the loss of infectivity, 56 ℃ 3 ~ 5 minutes, boiled immediate death; wet necessities of life can survive for several hours, intolerance dry. Of soapy water and common disinfectants (70% ethanol, 0.1% phenol, 0,1% mercuric chloride, etc.) sensitive to low temperature. Third, the epidemiology 1. Pop Briefing Syphilis prevalence in the world, according to WHO estimates that each year about 12 million worldwide new cases, mainly in South Asia, Southeast Asia and sub-Saharan Africa. Introduced by India in 1505 I Guangdong, has been nearly 500 years. Before the liberation of four sexually transmitted diseases is the first in the early 60s basically wiped out, and the popular 80's happen again. The number of reported cases in 1991 to 1,870 cases in 1995, 11,336 cases, 33,668 cases in 1997. Since 1997, accounting for 8 the proportion of sexually transmitted diseases more than 6%, was significantly increased trend, often see a clinical, secondary syphilis, have also been found in tertiary syphilis and congenital syphilis. Obligations found in blood donors in the recessive syphilis. 2. Source of infection and transmission 2.1 The source of infection: Syphilis is a disease unique to humans, dominant and recessive syphilis is the source of infection in patients infected with the human TP skin lesions secretions, blood contains a lot of TP. The first 2 years after infection, the most infectious, 2 years after the base is not sexually transmitted. TP can be passed to the fetus through the placenta, and 2 years after infection is still the risk of infection to the fetus. 2.2 The route of transmission: sexual contact is the main mode of transmission of syphilis, accounting for about 95% or more. Early infection is most contagious TP. If the dominant syphilis, can occur on any part of sexual contact with a hard chancre, such as the genitals, anus, rectum, nipple, tongue, throat, fingers and other parts of the hard chancre. With the extension of the infectious disease getting smaller and smaller, is generally believed that more than 2 years after infection, sexual contact is no longer infectious. Pregnant women with syphilis can be transmitted to the fetus through the placenta, causing fetal infection occurred after 4 months of pregnancy, causing miscarriage, premature birth, stillbirth or birth child child transmission of syphilis. Pregnant women, syphilis is generally believed that the shorter, the greater the chance of infection to the fetus. 2 years after infection, the fetus can pass through the placenta. Treponema pallidum can also be indirect contact, such as through kissing, breast-feeding and to be patient secretions contaminated clothes, bedding and other daily necessities caused by transmission. Fourth, disease process and the staging and classification 1. Syphilis natural history and staging (see below) 7 ~ 60 days 4 to 6 weeks the second latent ─ TP of primary syphilis infection ─ ─ ─ ─ → ─ ─ ─ → chancre dissipated ─ ─ ─ ─ ─ ┬ → Secondary syphilis │ │ 2 ~ 4 weeks │ │ 1 ~ 2 周 │ │ ├ ─ ─ ─ → ─ ┘ proximal lymph nodes │ │ ├ 2 ~ 3 周 ┐ │ └ ─ ─ ─ ─ ─ 5 ~ 7 周 ─ ─ ─ ─ ─ ┴ → RPR (+) │ ↓ 6 weeks to 6 months (3 months) ─ TP secondary syphilis infection ─ ─ ─ ─ ─ ─ ─ ─ → syphilis and changes in skin appendages │ chancre consumption 3 to 4 weeks after flat condyloma specific rash, swollen lymph nodes → Advanced │ ↓ 2 years and above Late syphilis - TP infection ─ ─ ─ ─ ─ ─ → Late syphilis rash and multiple organ and tissue damage (chronic granulomatous). 2. Classification 2.1 Infection Time: according to time of infection can be divided into congenital syphilis and acquired syphilis. The former refers to the spread of infection to the fetus TP suffer from syphilis, acquired syphilis refers to breast milk, blood or sexual contact of a child or adult syphilis. 2.2 Clinical features: Depending on the clinical characteristics, can be divided into overt syphilis and latent syphilis. The former clinical manifestations of syphilis, latent syphilis without clinical manifestations, serological testing confirmed only TP. 2.3 course: According to the disease process, divided into early syphilis and late syphilis. Early syphilis is divided into phase I and II syphilis. TP within 3 months after infection for a period of syphilis; infection TP after 3 months to 2 years for the second phase of syphilis. Late syphilis, also known as tertiary syphilis, the infection is currently defined as more than 2 years after TP with advanced syphilis. In clinical practice, based on time of infection, clinical features, serological testing and course of disease, for diagnosis. Such as congenital syphilis in early overt, acquired two recessive syphilis, acquired syphilis Late dominance. Fifth, clinical manifestations 1. Acquired syphilis dominant 1.1 a syphilis: clinical features of the landmark is a hard chancre (Chancre). Predilection sites are: the penis, the glans, coronary sulcus, foreskin, urethra; size of the labia, clitoris, cervix; anus, anal canal and so on. Also found in the lips, tongue, breasts, etc.. Chancre features are: TP infection appeared after 7 to 60 days, most patients chancre was single, painless non-itchy, round or oval, clear ulcer border, above the leather, wound cleaner, there are much secretion of secondary infection. Touch of cartilage-like hardness. Duration of 4 to 6 weeks, can be self-healing. Chancre and secondary syphilis can coexist, to be with chancroid, genital herpes, fixed drug eruption of ulcerative lesions such as differentiated from the local. Wang Xuan syphilis: a hard chancre 1 ~ 2 weeks, some patients had groin or Sentinel lymph nodes can be single or multiple, enlarged lymph nodes vary in size, hard, non-adhesive, non-ulcerated, painless . Wang Xuan called syphilis. 1.2 Secondary syphilis: rash in secondary syphilis is characterized by a systemic symptoms, occurring after the chancre fade or overlap occurs. TP spread with the blood circulation, causing multi-site damage and multiple lesions. Affects the skin, mucous membranes, bones, internal handling stolen goods, cardiovascular, nervous system. Syphilis into the second phase, all were positive laboratory diagnosis of syphilis. Symptoms occurred before the on_set_ of the rash, fever, headache, joint pain, hepatosplenomegaly, lymphadenopathy. Incidence of about 25% of men; women about 50%. 3 to 5 days better. Then came syphilis, and recurring features. 1.2.1 Skin syphilis: 80 to 95% of the patients. Rash type is characterized by diverse and repeated, extensive and symmetric, superficial, and more without leaving scars after healing, drive quickly faded plum treatment, rash rich in TP. Have spotted the main type of rash-like, papule-like, pustular rash and flat warts of syphilis, syphilis and other palms and soles. 1.2.2 recurrent syphilis: spontaneous regression of primary syphilis, about 20% of secondary syphilis patients relapse within a year, symptoms of secondary syphilis can be any re-emergence of a circular rash is most prevalent. 1.2.3 mucosal damage: about 50% of the patients had mucosal damage. Occurred in the lip, oral cavity of each part, tonsils and throat, the mucous plaque or mucositis, there is leakage or gray membrane, mucous membrane irritation. 1.2.4 syphilitic alopecia: about 10% of patients. Mostly sparse, ill-defined, such as worm-eaten like; a small number of diffuse samples. 1.2.5 bone and joint damage: periostitis, osteitis, osteomyelitis and arthritis. With pain. 1.2.6 two eyes syphilis: syphilitic iritis, iridocyclitis, choroiditis, retinitis and so on. Often bilateral. 1.2.7 Phase II neurosyphilis: No obvious symptoms, abnormal CSF, cerebrospinal fluid RPR positive. May have meningitis symptoms. 1.2.8 Phase II recurrent syphilis: syphilis, herpes and recurrent common mucosal damage, may have other damage. Mild symptoms. 1.2.9 superficial body lymph nodes 1.3 tertiary syphilis: 1 / 3 of the dominant TP tertiary syphilis infection. Of these, 15% for benign late syphilis, 15 to 20% for malignant late syphilis. 1.3.1 damage to skin and mucous membranes: nodular syphilis occur in the scalp, shoulders, back and limbs stretched side. Gum-like swelling often occurs in small legs, as deep ulceration, scar-like atrophy; occur in the upper forehead, the tissue necrosis, perforation; occurred in the nasal septum by the destruction of bone, the formation of saddle nose; tongue, who is Farfetched ulcer; vaginal damage as ulcers, can form the bladder or rectum vaginal leakage vaginal leakage and so on. 1.3.2 recent joint nodules: a syphilitic slowly growing subcutaneous fibroma fibrous nodules, symmetry, size, range, quality hardware, not active, no ulceration, skin normal, no inflammation, pain can be from the consumer. 1.3.3 Cardiovascular syphilis: the main parts of violations of the aortic arch, the occurrence of aortic insufficiency, that is, syphilitic heart disease. 1.3.4 neurosyphilis: occurrence rate of about 10% of the TP occurred in 10 years after infection to 20 years. May be asymptomatic, may also occur syphilitic meningitis, cerebrovascular syphilis, meningitis-like swollen gums, paralytic dementia. Meninges swollen gums like the side of cerebral hemisphere for the involvement of subcortical lesions, the occurrence of increased intracranial pressure, headache and symptoms of cerebral compression. Department of substantive neurosyphilis substantial brain or spinal cord lesions, the former the formation of GPI, which showed root and spinal cord degeneration of posterior cord, paresthesia, ataxia and other symptoms, that tabes. 2. Acquired latent syphilis Acquired infection, not formation of dominant TP syphilis or dominant active syphilis by certain symptoms temporarily subside, syphilis test was positive in serum, cerebrospinal fluid examination was normal, acquired implicit (latent) syphilis. 2 years after infection as early latent syphilis; more than 2 years after infection, known as late latent syphilis. 3. Pregnant syphilis Occurrence of dominant or recessive syphilis during pregnancy pregnancy, commonly known as syphilis. Pregnancy, syphilis, TP can pass through the placenta or umbilical vein of fetal, infant born after the formation of congenital syphilis. Pregnant women occurred because of the small artery inflammation cause the placenta tissue necrosis, resulting in miscarriage, premature birth, stillbirth, but nearly 1 / 6 of the disease, pregnant women healthy children can be students. 4. Dominant congenital syphilis 4.1 Early congenital syphilis: thin children at birth, 3 weeks after birth symptoms, lymphadenopathy, no adhesion, painless, hard. More than a syphilitic rhinitis. About 6 weeks after birth, skin lesions appear, showing blister - bullous-type lesions (syphilitic pemphigus) or rash, papular scaly lesions. Can occur osteochondritis, periostitis. More than a liver and spleen. Thrombocytopenia and anemia. Neurosyphilis rare. No chancre congenital syphilis performance is one of the characteristics. 4.2 Late congenital syphilis: occurred in the 2 years of age. One is the early pathological changes caused by bone, teeth, eyes, nerves and skin of the permanent damage, such as saddle nose, Haoqin Sen's teeth and so on, no activity. The other is caused by damage to remain active clinical manifestations, such as keratitis, nerve deafness, nervous system abnormalities, CSF changes, hepatosplenomegaly, nose or jaw gum swelling, joint effusion, periostitis, refers to the inflammation and damage to skin and mucous membranes. 5. Congenital syphilis latent Without treatment, without clinical manifestations, but seropositive, age less than 2 years of age for early congenital syphilis latent, more than 2 years of age as late latent congenital syphilis. VI, diagnosis and differential diagnosis 1. Epidemiological data History of sexual contact; pregnancy, maternal history of syphilis infection; some indirect contact with history; history of blood transfusion. 2. Clinical manifestations The clinical observation alone for diagnosis of the disease, serological testing should be done in time and attention with other clinical lesions and ulcerative STD's lymphadenitis phase identification. Syphilis chancre chancroid 2.1 Identification with the following table: ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Project chancre chancroid ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Average incubation period of 2-5 days 2 to 4 weeks The number of lots of fat single chancre Border clearance Farfetched sneak Smooth, deep moss-like shallow basement rough granular Serous purulent pus less quantity autoinoculation Cartilage-like hardness and softness No itching feeling pain The surrounding lymph nodes enlargement is not hard not hard purulent purulent No scar scar after healing Duke Lai pale spirochete pathogen Haemophilus Negative-positive syphilis serology ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ 2.2 Syphilis with chancroid, lymphogranuloma venereal identification of lymph node inflammation, the following table: ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Project lymphadenitis chancroid venereal syphilis ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ 2 to 4 weeks incubation period January 2 to 5 days Unilateral or bilateral distribution of both sides of the unilateral or bilateral Size of the thumb, large or larger eggs for large eggs large or larger More than a few number of multiple or single There are no flush septic No sign or without groove No sinus formation a few There are no pain Impermanence are sometimes fever Six weeks after the infection of syphilis test (+) negative negative ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ 2.3 chancre with the identification of fixed drug eruption: fixed drug eruption and more are taking sulfa drugs such as history, history of ulcers may have a history of limitations of the genital area. Ulcers due to the limitations of clear boundaries, nearby tissue edema, exudation, itching, and anti-allergy drug withdrawal can be Suyu. 2.4 chancre complicated by local infection with genital herpes differentiated: the basic clinical course of genital herpes is local erythema, accompanied by paresthesia, followed by the formation of blisters, a few days after the ulceration, ulcer complicated by bacterial infection with purulent discharge, and more a previous history of such disease. 2.5 lesions of syphilis lesions identify with other diseases: syphilis of all types of skin rash, should be marked with pityriasis rosea, erythema multiforme, tinea versicolor, psoriasis, ringworm and other identification of the body. Syphilis should be with ulcerative oral mucosal ulcers spot identification. Condyloma flat condyloma with syphilis should be identified. 3. Laboratory Relevant laboratory tests positive for syphilis should be found, such as microscopic examination found that Treponema pallidum, serology test was positive. Seven, treatment 1. Treatment principles Emphasizes diagnosis and early treatment course rules, the dose is adequate; treatment after the regular clinical and laboratory follow-up, with the investigation of sexual partners chih. Treatment of early syphilis may be all the more thoroughly and remove infectious, the majority of regular treatment of patients 6 months after the USR, RPR or VDRL test converted to negative or significantly lower titer, such as antibody titers, and then increase the serum should be of recurrence. Late syphilis treatment can remove tissue inflammation, but has not naturally repair damaged tissue, the after-effects. Penicillin, such as aqueous penicillin, procaine penicillin, benzathine penicillin as the drug of choice. Optional for those who are allergic to penicillin, tetracycline, erythromycin and so on. Some patients may occur Jihai early penicillin treatment response (Jarish-Herxheimer Reaction, J-HR), began to be prevented by small doses. Syphilis during the first year after treatment should be reviewed every 3 months the serum once every 6 months after a total of 3 years, the last review, including examination of cerebrospinal fluid. Neurosyphilis and cardiovascular syphilis should be followed for life. 2. Treatment of the main proposal 2.1 early syphilis: a, secondary syphilis and early latent syphilis refer to the following programs: ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Non-penicillin allergy - Benzathine penicillin G (long-acting amoxicillin) 2,400,000 u / sub 1 times / week 3 weeks or intramuscular injection points on both sides of the hip Procaine penicillin G 80 ~ 120 万 u / day of a ten-day IM Penicillin allergy - Tetracycline 500mg / times 4 times / day orally or 15 to 30 days Doxycycline 100mg / sub 2 / day orally for 15 days ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Cephalosporins such as ceftriaxone or tetracycline, etc., and a new generation of macrolides, such as the plum role of azithromycin and other anti-obvious, can also be used or combined with. 2.2 Late syphilis: ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Non-penicillin allergy - Benzathine penicillin G 240 万 u / sub 1 times / week 3 weeks or Procaine penicillin G 80 ~ 120 万 u / day intramuscularly for 20 days Penicillin allergy - Tetracycline 500mg / times 4 times / day orally for 30 days or Doxycycline 100mg / sub 2 / day orally for 30 days ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ 2.3 neurosyphilis (Neurosyphilis): ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Non-penicillin allergy - Aqueous penicillin G 1200 ~ 2400 万 u / day intravenous (200 to 400 million u / per 4 hours) 10 to 14 consecutive days or Procaine penicillin G 120 万 u / day of intramuscular 4 times / day for 14 days C Huang Shu add services (probenecid) 500mg 2 ~ 4 times / day After the course, continue to use benzathine 2.4 million young enzyme u, 1 / week 1 to 2 weeks intramuscular injection Penicillin allergy - Tetracycline 500mg 4 times / day orally for 30 days or Doxycycline 200mg 2 times / day orally for 30 days ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ 2.4 Cardiovascular syphilis: need hospital treatment to correct heart function after the application of compensatory anti-Mei drugs, special care should be taken J-HR ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Non-penicillin allergy - Aqueous penicillin G 10 million the first day u 1 time / day day 10 million u 2 times / day On the third day 200 000 u 2 times / day use the fourth day of penicillin G procaine Procaine penicillin G 80 万 U / day IM for 15 days / course of treatment stop a course of treatment plus 2 weeks Penicillin allergy - Tetracycline 500mg / times 4 times / day orally for 30 days ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Pregnant women, syphilis 2.5: Non-penicillin allergy, penicillin treatment of patients with non-pregnant women; penicillin allergy of early syphilis and early latent syphilis with erythromycin 500mg, 4 times / day for 15 days; late syphilis (late latent syphilis, late benign syphilis, neurosyphilis, cardiovascular syphilis, etc.), erythromycin 500mg / 4 times / day for 30 days. 2.6 congenital syphilis: ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ Non-penicillin allergy - Early congenital syphilis (less than 2 years old) - abnormal cerebrospinal fluid Aqueous penicillin G 5 万 u / kg / talent 2 intramuscular injection or intravenous drip for 10 days or Procaine penicillin G 5 万 u / kg / day intramuscularly for 10 days - Normal cerebrospinal fluid Benzathine penicillin G 5 万 u / kg / day intramuscularly for 10 days Late syphilis (more than 2 years old) - Procaine penicillin G 20 万 u / kg / talent 2 intravenously for 10 days Penicillin allergy - Erythromycin 7.5 ~ 12.5mg/kg / 4 oral talent for 30 days ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─ ─
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Syphilis causes
梅毒病因
Syphilis invades the human body after 2-3 weeks of incubation, the occurrence of skin lesions (typical damage to the hard chancre) This is a syphilis. Skin damage occurs after the body to produce antibodies, from rabbit experimental studies have shown that syphilis, syphilis is characterized by the early histological invasion of monocytes in the first six days of infection, that is, infiltration of lymphocytes seen at this time of Treponema pallidum in the chancre gap in the epithelial cells, and invagination of epithelial cells in the body or swallowed, or fibroblast plasma cells and small capillary endothelial cells and lymphatic vessels and local lymph nodes. The role that the immune Treponema pallidum from the lesions rapidly eliminated in the first 24 days after infection, immunofluorescence did not find the presence of Treponema pallidum spirochete most were killed, enter the asymptomatic incubation period namely a latent syphilis. Application of genetic diagnosis can now quickly and accurately detected.
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Transmission
梅毒 传播途径
梅毒 传播途径
Syphilis (syphilis) in the origin and spread of many disputes, according to Western scholars that in Europe before the 15th century without syphilis. 1492, first voyage of Columbus to the Americas, a number of sailors and the American women had had sex with, when the sailors returned to Europe, the disease spread to Italy, Spain. 1494 King Charles VIII of France to raise the world more than thirty thousand soldiers in all countries, expedition Italy, syphilis is spreading in Italy and China, when the siege of Naples, the military barracks of the syphilis epidemic. 1495 of these soldiers returned home suffering from syphilis, resulting in the European syphilis epidemic. Some people think that in 1488, the Portuguese fleet to India to syphilis. Some scholars believe that Columbus's fleet of 1498 Cape of Good Hope to reach India. Since the arrival of the crew of syphilis infection, syphilis can be brought to India. Through business contacts, syphilis has also entered China, in Guangdong Province in 1505 and describes the first discovery of syphilis cases, then, did give syphilis to the mainland coastal areas in China spread far and wide, the incidence rate remains high, ranking first in sexually transmitted diseases. After the liberation, the Party and the government effectively banned brothels prohibit prostitution, sexually transmitted diseases, a broad survey of the general rule, after a decade of efforts, has been largely eliminated syphilis in 1959, 1964 announced to the world of basic elimination of sexually transmitted diseases, a move that shocked the world, a sensation across the country. Since the 70s, with the social development, sexually transmitted diseases but also in our country back from the dead, especially the number of syphilis increased significantly, the sharp rise in incidence. The causative agent of syphilis is a spirochete, which can be present in patients with mucocutaneous syphilis chancre, rash, body fluids. When sexual intercourse with healthy people, the spiral to get into a healthy human body with the secretions of the skin and mucous membrane damage (even very subtle invisible injury), leaving the contacts were infected. Very small number of blood transfusion or through contact with contaminated items of Treponema pallidum infection. Syphilis can be mother to fetus. Medicine called Treponema pallidum (Tre-ponema palidum), 1905 by Schaudinn and Hoffmanu French scientists discovered and reported. Treponema pallidum is a spiral of small and delicate micro-organisms, a length of 5-20nm, diameter <0.2nm. It has a 6-12 helix, the naked eye can not see, in the dark field microscope, people only see the refractive index of Treponema pallidum, and its activity is strong. In its front-end with 4-6 flagella-like fine fibers, the end was curled shape. The impact of external factors in the unaffected, the spiral is the rule. Transparency is not easy because of their coloring, also known as the white spiral. Treponema pallidum is the anaerobic bacteria, in vivo long-term survival and reproduction, as long as conditions are suitable, then the horizontal fracture modes into two for breeding. Not easy to survive in vitro, boiling, drying, soap and general disinfectant (such as mercuric chloride, phenol, alcohol, etc.) it is easy to kill it. Infectious syphilis of the extension with the disease decreases. Phase I, Phase II patients are infectious syphilis, their skin and mucosa damage at a large number of the existence of Treponema pallidum; early latent syphilis can be contagious. The course more than 2 years, the infectious syphilis will gradually weaken, even with treatment duration has not been more than 2 years of syphilis in sexual contact with women in general will not be infected. The longer the duration, the less infectious, disease duration more than 8 years, its infectivity is very small. Early symptoms of syphilis in the male 【】 start inside in the foreskin, or Coronal, frenulum, penis size of a grain of rice appeared round, oval, induration or rash, mostly single, around the hard, fast surface erosion, ulcer , but no pus or discomfort. If not cure, there may occur a month later, more serious secondary syphilis, weight loss, general malaise, chronic diarrhea, lymphadenopathy, oral mucosal ulcers. Opportunistic infections and can cause lung cancer or multiple serious diseases such as bleeding. Sexually transmitted infection is suspected, please seek medical treatment as soon as possible, so as not to delay increase.
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A simple self-test method for syphilis
Syphilis infection, the average incubation period of three weeks, and then progression to Phases I and II (about one to two years), if not adequately treated or not treated can turn into the third period (late), so that renewable years, and even death. Syphilis After a slow, mild symptoms, the early clinical signs can often spontaneous regression, leading to early treatment of patients would be negligence. Syphilis patients can be asymptomatic for many years was a latent state, as disseminators of syphilis. Pregnant women may be suffering from syphilis through the placenta to the next generation, great harm. Currently there is a self-testing can be at home, and the simple and efficient sample of syphilis, called "drop was clearly TM", has been on sale in Hong Kong, not by a doctor's referral to the laboratory for testing, can the protection of personal privacy. "Get out drops TM" syphilis test piece is very simple to use, simply drop into a drop of fresh blood samples for testing chip pads location, fifteen minutes to display the test result is positive or negative, if the test contains the blood of syphilis antibodies, will show positive results, and the presentation of the results can last for hours. Accuracy of test results as high as 99.9%. If the test showed positive results, please seek medical diagnosis and early treatment of withdrawal at the end.
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Syphilis treatment
梅毒治疗
梅毒治疗
梅毒治疗
The treatment of syphilis is based mainly on Western medicine, since the wonders of penicillin for the treatment of syphilis, the Chinese medical treatment as the main base is not only play a supporting role, and that following a brief introduction to the different stages of syphilis in Western medicine approach: (A) early syphilis (including one, secondary syphilis and early latent syphilis) 1, penicillin therapy (1) benzathine penicillin G (long-acting amoxicillin) 2400000 u, points on both sides of the buttocks intramuscular injection, 1 week, 2 or 3 times. (2) procaine penicillin G80 million u / day, intramuscular injection for 10 to 15 days, total 800 million u ~ 1200 万 u. 2, those who are allergic to penicillin (1), tetracycline hydrochloride 500mg, 4 times / day, oral, and even served 15 days. (2), doxycycline 100mg, 2 times / day, and even served 15 days. (B) Late syphilis (including three skin, mucous membranes, bone syphilis, late latent syphilis), and two recurrent syphilis. 1, penicillin (1), penicillin G240 million u, 1 times / week, intramuscular injection, a total of 3 times. (2) procaine penicillin G80 million u / day, intramuscular injection, for 20 days. 2, those who are allergic to penicillin (1), tetracycline hydrochloride 500mg, 4 times / day, oral, and even served 30 days. (2), doxycycline 100mg, 2 times / day, and even served 30 days. (C) cardiovascular syphilis Should be hospitalized and, if heart failure, the first treatment of heart failure, cardiac function to be compensatory time, start small dose penicillin, such as aqueous penicillin G, the first day of 100,000 u, 1 times / day, intramuscularly. Second day of the 10 million u, 2 times / day, intramuscular injection, and the third at 20 million u, 2 times / day, intramuscularly. 4 Since the date of the treatment as follows (in order to avoid Jihai Shi reaction penicillin injection in the day before the oral prednisone 20mg / time, 1 time / day for 3 days). 1, procaine penicillin G80u / day, intramuscular injection for 15 days for treatment, a total of two course of treatment between the off-drug for 2 weeks. 2, tetracycline 500mg, 4 times / day, and even served 30 days. (D) neurosyphilis Should be hospitalized, in order to avoid generating Jihai Shi treatment response, the day before the injection of penicillin oral prednisone, each 20mg, 1 times / day for 3 days. 1, aqueous penicillin G, 12 million a day u, intravenous drip (200 million every 4 hours u), for 14 days. 2, procaine penicillin G, 120 million a day u, intramuscular injection, while oral administration of probenecid per 0.5g, 4 times / day, a total of 10 to 14 days. When necessary, and then benzathine penicillin G, 240 万 u, 1 times / week, intramuscularly for 3 weeks. (E) pregnancy syphilis 1, procaine penicillin G, 80 万 u / day, intramuscular injection for 10 days. Within the first 3 months of pregnancy, a course of injections, injection of 3 months of pregnancy at the end of a course of treatment. 2, allergy to penicillin, erythromycin therapy, each 500mg, 4 times / day, early drug and even served 15 days of regret and second recurrence and late syphilis and even served 30 days. Early pregnancy, late pregnancy, 3 months and 3 months each for a course of treatment (disabled tetracycline). However, application of penicillin baby born to make governance. (F) child transmission of syphilis (congenital syphilis) 1, early congenital syphilis (less than 2 years old) with abnormal cerebrospinal fluid: (1) aqueous penicillin G, 5 万 u / kg body weight, 2 times a day intravenously for 10 to 14 days. (2) procaine penicillin G, day 50 000 u / kg body weight, intramuscular injection for 10 days to 14 days. Normal cerebrospinal fluid: Benzathine penicillin G, 5 万 u / kg body weight, one injection (points on both sides of gluteal muscle). Check the cerebrospinal fluid, such as those who unconditionally, according to the treatment of cerebrospinal fluid abnormalities. 2, late congenital syphilis (2 years) Procaine penicillin G, day 50 000 u / kg body weight, intramuscular injection for 10 days for treatment (not to exceed adult dose). Disabled children under 8 years old tetracycline. Congenital syphilis who are allergic to penicillin can be used erythromycin, 7.5 ~ 12.5mg/kg body weight per day, divided into 4 sub-services, and even served 30 days. Should be noted that the treatment of syphilis, syphilis diagnosis must be clear, the sooner the better treatment, the dose must be sufficient, treatment must be rules to follow observed after treatment. Source of infection and response to sexual contact or sexual companion simultaneous examination and treatment of syphilis treatment. (F) the treatment of syphilis in pregnant women issues 1, married women with a history of syphilis in the pre-pregnancy syphilis must conduct a comprehensive inspection Have had or have dirty sex life of women infected with syphilis in the plan to become pregnant, the best round to the regular hospital for syphilis testing, for those who completed the treatment of syphilis, syphilis of married women have obvious symptoms of syphilis in determining the post-cure to pregnancy. The project should include syphilis syphilis screening tests (such as the VSR or RPR test), syphilis testing and FTAABS or TPHA test, a result of any of them were positive for both the need to use other drugs Qing Lin Mei Mei drive continued treatment. If syphilis pregnant 3 months of pregnancy test results are still negative, you need to re-treatment time; the end of 3 months if the pregnancy test was positive serology, even need a full treatment of syphilis. 2, the health of pregnant women infected with syphilis during pregnancy treatment of matters If the health of pregnant women infected with syphilis during pregnancy, when the serum test results may be negative, in the last 3 months of pregnancy must be timely given to drive Mei treatment. 【How to determine whether the full treatment of syphilis】 Syphilis after treatment, how to determine whether recovered it? Now is usually the detection of syphilis to be judged, the current is commonly used in major hospitals RPR (rapid plasma reagin circle card test) and TPHA (Treponema pallidum hemagglutination test). Nonspecific syphilis serological tests, commonly used in the early diagnosis of syphilis, but the latent syphilis, neurosyphilis is not sensitive. Specificity of serum TPHA Treponema pallidum antibodies, have high sensitivity and specificity. Once the positive detection of this Law, regardless of whether the activities or disease treatment or not, usually remain life-long positive change, and its titer is unrelated to changes and syphilis, it can not be determined for evaluating the effectiveness of treatment or recurrence of the index and re-infection can only be used as syphilis confirmation test. Syphilis patients after treatment in the anti-mei, the serum response to changes in general There are 3 possibilities: (1) serum overcast. (2) lower serum titers are not overcast, or serum resistance. (3) serum response showed recurrence. If the syphilis patients received less than the amount of anti-Mei treatment, serum response shortly after the negative conversion in the moment they became positive, or 4-fold increase in titer (eg, rose by a 1:2 1:8), namely that "Serum recurrence" can be seen that the formal treatment of anti-plum or not enough and there is a close relationship between serum recurrence. In summary, early syphilis treatment should be formal enough, RPR titer can be observed before and after the therapeutic effect of anti-plum. Also known as chancre of primary syphilis, genital hurt does not itch in inflammatory shallow ulcers, generally occur one to nail the size of red meat. Ulcer-like memory in wax secretion. Secondary syphilis with damage to the skin and mucous membranes, skin rash over the body. More obvious in the limbs, a symmetrical rash for a variety of glass will form. A rash papules, scaly rash, palms, soles of the feet may also occur, hurt, no itching, two recurrent syphilis often wet in the perianal papules (flat condyloma) 60% of tertiary syphilis was kind of swollen gums, can appear in 全身各器官, common parts of the lower limbs, the formation of the skin, mucous membrane ulceration large area. A large number of gum-like secretion. Finally hardened scar formation, organ tissue is perforated, serious damage to nervous and cardiovascular systems, life-threatening.
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How far away from pregnant syphilis
Pregnant syphilis affect not only the health of pregnant women can give, much more effect on fetal development, leading to miscarriage, premature birth, stillbirth. Even if the pregnancy can be maintained until delivery, infants born with congenital syphilis risk is also high. Great harm pregnant syphilis. Syphilis in pregnancy is called gestational syphilis, pregnant patients can be both formed, it can be caused by maternal infection during pregnancy. Pregnant syphilis affect not only the health of pregnant women can give, much more effect on fetal development, leading to miscarriage, premature birth, stillbirth. Even if the pregnancy can be maintained until delivery, infants born with congenital syphilis risk is also high. Although some of the fetus developed normally, but through the birth canal, there may be contact with infected genital lesions. Data shows that untreated syphilis of women in early pregnancy, fetal survival rate is only about 50%, most of the fetus will be children with congenital syphilis. Early latent syphilis, although the survival rate of women in the fetus at 80%, but more than half of children in early childhood will become a child with congenital syphilis. How to avoid tragedy Women of childbearing age should be with the doctor, seizing several key opportunity to take the following preventive measures: 1. To pre-pregnancy check. Dominant syphilis by history, signs can be diagnosed; latent syphilis before being diagnosed only by laboratory tests. The incubation period of syphilis is the main cause of pregnancy syphilis. Therefore, women of childbearing age before pregnancy should be carried out in the plan syphilis serology. If you find yourself infected with syphilis, pregnancy should be suspended, the first systematic treatment. At the same time, spouses should be checked, and under the guidance of doctors decide the time of pregnancy. 2. Within 3 months of pregnancy screening and drive Mei treatment. Such as pregnant women infected with syphilis was diagnosed, it is best to choose abortion; also be under the guidance of doctors, treatment plum full of drive. 16 weeks ago because of pregnancy, fetal nutrition is supplied by the chorion, chorion consists of two layers of cells, through the Treponema pallidum is not easy. After 16 weeks of pregnancy, due to placenta trophoblast cells gradually shrinking supply of nutrients from the placenta of fetal replaced at this time of Treponema pallidum and can go through the placenta into the fetus. Whether pregnancy is carried out before treatment, in order to ensure that pregnant women is no longer the body of pathogenic Treponema pallidum, the patient again after pregnancy should be adequate treatment. 3. Suspicious positive test results should be reviewed and followed up regularly for treatment. If positive, but relatively low titer, you need to rule out false positives (such as autoimmune diseases, connective tissue disease, viral infection, non-syphilis). In late pregnancy, there are also false Treponema pallidum positive serum test situation. No false positive reaction in the reason, pregnant women should be driving Mei treatment. 4. Pregnant women late in pregnancy was found to syphilis should be treated in a timely manner at the same time, to determine whether the fetus was infected. ① B-ultrasound. If you find that appear characteristic of fetal scalp edema, fetal infection should be suspected syphilis. ② fetal amniotic fluid collected immediately darkfield examination, Treponema pallidum can be found as the basis for the diagnosis of fetal infection. ③ in childbirth, if the check umbilical cord and placenta abnormalities, umbilical cord vein wall can be scraped and the fetal side of placenta were dark-field examination. After birth can be collected for testing blood, such as non-Treponema pallidum antibody (RPR) titers continue to rise at or above the level of the mother can be confirmed. 5. To determine treatment. In order to prevent side effects of antibiotics, the proposed Chinese medical treatment. 6. If no syphilis lesions in patients with breast, breast-feeding can be a healthy baby. 【Notes】 life of patients with syphilis Syphilis disease because the long course, but also to patients in the advanced organizer Palace cause irreversible damage, thus requiring active treatment patients. In addition, one, two strong infectious syphilis in patients with early syphilis, careful not to pathogen infection to others. (1) to adhere to the early treatment, the principle of adequate medication. Penicillin on a role in the killing of Treponema pallidum, side effects and small, as long as adherence to treatment with the physician, will receive a reduction of complications, cure disease, restore health effect as soon as possible. During treatment, the spouse needs to be checked, if necessary, treatment. Require periodic review, after cure, there is recurrence of symptoms, the antibiotic dosage should be increased. (2) Note the details of life, to prevent transmission to others: a strong early infectious syphilis and late syphilis, although the infectivity gradually decreased, but be careful for protection. Their underwear, towels, wash separately in time, boiled disinfection, not with others in the same basin and bath. Chancre occurs or vulva, perianal warts flat, you can use heat detoxification, herbal insecticide dehumidification Jianshui Fumigation Bath. (3) to ban sexual activity in patients with early syphilis, the sick more than two years should also avoid sexual life, sexual contact must use condoms. If the patient is unmarried, then to be allowed to marry the rear cure syphilis. (4) Secondary syphilis occurs systemic reactions occur at this time to stay in bed. Pay attention to nutrition during illness, and enhance immunity. (5) duration of illness was not pregnant. If patients with pregnancy, treatment should be started as soon as possible. Whether to keep the fetus, pregnant women should be based on the wishes of the Executive.
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Syphilis can cause hair loss do
The incidence of syphilitic alopecia and about 3% to 4%, alopecia as a transient, anti-syphilis treatment, the rapid regeneration of hair. Syphilitic alopecia occurred may be due to violations of the head hair of Treponema pallidum microvessel area, so that the lesions occur in the blocked blood vessel wall, caused by poor blood supply, hair follicle temporary obstacles occur, affecting the development of hair, which appears as a great big or as small irregular hair loss area. Hair loss boundary is not clear, as the mouse macrophage-like or worm-eaten, occur in the occipital, occipital, and lateral head. Hair loss occurs in the head area larger, uneven hair length, which is due to the capillary region in varying degrees of hair loss the result of violations. Syphilitic alopecia or scarring alopecia is not permanent, it can be recycled, such as anti-syphilis treatment in time, hair can be regenerated in the 6 to 8 weeks, or even no treatment can be
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Syphilis and sexual life
As long course of syphilis, so the patient to active treatment. In particular, one, two strong infectious syphilis in patients with early syphilis pathogen careful not to infect others, so no prevention banned sex life. Strong early infectious syphilis and late syphilis, although the infectivity gradually decreased, but be careful for protection. Patients with early syphilis to ban sexual intercourse, the sick more than two years should also avoid sexual life, sexual contact must use condoms. If the patient is unmarried, then to be allowed to marry the rear cure syphilis. If syphilis RPR was negative, the usual six months for having sex out. Adhere to the aggressive treatment, will recover!
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Related to detection of syphilis
1, dark field microscopy Dark field microscopy of Treponema pallidum is a method of checking. Dark field, that is, by definition there is no bright light under the microscope, it is easy to check the pale spirochetes. It is a pathogen inspection, the diagnosis of early syphilis is very important. Early skin and mucous membrane lesions (one, two mold sores) can be found in white spiral. A pale spirochetes of syphilis more than the hard chancre of the induration, ulcers present in secretions and exudates, enlarged lymph nodes biopsy may also be detected. Two pale spirochetes of syphilis in blood and tissues of the body detected, but the highest detection rate of the skin. Early congenital syphilis, can damage the skin or mucous membranes pale at the scraping that syphilis spirochete. Most recently, pregnant women by amniocentesis to obtain amniotic fluid, with its dark field microscope for observation and diagnosis of congenital syphilis have. 2, syphilis serology Serological tests for syphilis diagnosis phase, tertiary syphilis, and syphilis to determine the development and recovery, to determine the effect of drugs are very important. Syphilis serology, including non-treponemal serological tests and treponemal serological tests. The former is commonly used in clinical screening and to determine the effects of treatment, blood 1 hour after the result, the costs are low. The latter is mainly used to determine the test, but it can not determine the treatment effect, once suffering from syphilis, this test will be positive for life. (1) Non-Treponema pallidum antigen serum test of such tests are divided into cardiolipin, lecithin and cholesterol in the suspension, is used to detect anti-cardiolipin antibodies. Since the standardization of these tests have the same antigen, so the sensitivity of similar. There are three commonly used: ① venereal disease research laboratory slide test (VDRL); ② not heated serum reagin slide test (USR); ③ rapid plasma reagin circle card test (RPR). Can be used as clinical screening, and can be quantitative, for the patients. (2) Treponema pallidum serum test include: ① fluorescent Treponema antibody absorption test (FTA-ABS); ② Treponema pallidum hemagglutination (TPHA); ③ dynamic system syphilis test (TPI) and so on. High specificity of these tests, mainly for diagnostic tests. 3, IgM antibody detection of Treponema pallidum 4, molecular biology 5, cerebrospinal fluid Late syphilis, when the neurological symptoms, after flooding plum ineffective treatment of cerebrospinal fluid should be checked. The examination of neurosyphilis diagnosis, treatment and prognosis are helpful. Check the items should include: cell count, total protein determination, VDRL test and colloidal gold test. Related Guidance: The clinical manifestations of syphilis what is? Clinically divided into syphilis syphilis acquired (or acquired syphilis) and fetal transmission of syphilis (congenital syphilis). Acquired syphilis, the duration of their infection, clinical characteristics and infectious, can be divided into one, two, three and latent syphilis. It put one together again as early syphilis II and III are called late syphilis. Strong early infectious syphilis, but later the general non-infectious syphilis. Primary syphilis Second, secondary syphilis (2) two recurrent syphilis. Rash and two early-on_set_ form of syphilis are similar, but smaller number of distribution is also small, focus on the face and limbs. In addition, the anus and vulva, etc. can be seen flat condyloma. Oral, genital mucosa can be seen at the white spots around the congestion of the mucous membrane. These organizations and the injury of a large number of Treponema pallidum, is highly infectious. A variety of secondary syphilis can damage self-healing and into two latent syphilis, but there are still a lot of body to kill the spirochete is not a case of opportunity will be trouble. Phase II is limited to 4 years, more than 4 years are referred to as late syphilis. Third, the tertiary syphilis Tertiary syphilis is not limited to the skin and mucous membrane damage can also be violations of any visceral organs and tissues, characterized by a gum-like swelling, syphilis, tertiary syphilis of the skin and mucous membranes, including: (1) nodular syphilis. In the groups of intradermal or subcutaneous nodules, soya bean or grape large, beginning not with the surrounding tissue adhesion, and then gradually fixed, the face and limbs more common, asymmetric distribution, uniform distribution can also be presented such as the distribution ring. Slow course of the disease, lesions can be completely absorbed, but also rupture to form part or all of the ulcers, superficial, and finally atrophic scar healing. Predilection in the calf on the 1 / 3. (2) Mei cancer (gum-like swelling.) Since the beginning of the subcutaneous induration, may be active, progressive and skin adhesion, rupture, ulceration into sharp chisel-like edge, a sticky gum like discharge can be extended side edge healing. Occur in the scalp, forehead, legs and other places. May also occur in the palate and nose, often leads to hard palate, nasal septum perforation, saddle nose, so that the patient disfigured. Mucosal involvement can occur when the tongue irregular ulceration, inflammation, formation of scar contracture after absorption, tongue hard, to speak clearly. Tips: Shanghai, Kowloon Hospital, specialists point out that men, syphilis is a very serious sexually transmitted diseases, can cause infection and popular, endangering themselves and their families. Syphilis should go to regular hospital diagnosis and treatment of sexually transmitted diseases therapy department, if not completely treatment of syphilis can cause recurrent or latent. Therefore, after treatment is completed to be serious and strict follow-up 1-3 years, and reviewed under the guidance of male physicians, followed up by the doctors decide when to terminate, there is recurrence or retreatment should be so into late syphilis, causing damage to body organs . Some symptoms of syphilis Child transmission of syphilis, also known as congenital syphilis. Department of Treponema pallidum by the mother's blood into the fetus through the placenta and fetus caused by a variety of diseases, syphilis is therefore not an injury occurred. Patient's mother to be syphilis. Under the age of on_set_ were divided into early and late congenital syphilis congenital syphilis. Pregnancy, syphilis during pregnancy fat found in beef or active syphilis or latent syphilis. The impact of pregnancy on syphilis: syphilis less damage, the occurrence of late syphilis and less chance of a relapse. Affected by estrogen may be relevant. Syphilis on pregnancy: miscarriage (4 months), prematurity, congenital syphilis, stillbirth or birth children, only 1 / 6 chance to birth healthy children. But there is a special phenomenon, that is, untreated syphilis of pregnant women in their multiple pregnancy, the baby has become more normal trend. This is only general trends only, we can not relax on the treatment of syphilis in pregnant women. Latent syphilis, syphilis infection after a certain amount of activity after the period of immunity because the body is the impact of increased or irregular treatment, the symptoms subsided temporarily, but not completely cured, syphilis serum reaction is still positive, CSF examination was normal, this stage is called latent syphilis. Within two years, said those infected early latent syphilis, because there are about 20% of patients may occur; two possible recurrence of syphilis, it should be regarded as still contagious. Infected more than two years, said late latent syphilis, the infectious smaller, but 15% to 20% of cardiovascular or neurological syphilis, 15% can occur three skin, mucous membranes or bone syphilis. Pregnant women suffering from latent syphilis, there are still children with congenital syphilis may occur. . Diagnosed as a clear diagnosis, should be asked whether the history of dirty sex, and whether there were one, two, three syphilitic rash history, whether women with miscarriage, premature birth, stillbirth and birth history of congenital syphilis child, spouse or without a history of syphilis and previous treatment history and so on. Suspected congenital syphilis should be asked whether their mother a history of syphilis. To be done to the body system checks and laboratory tests. Application of early syphilis pale dark field microscopy of spirochetes; syphilis serum test for diagnosis of syphilis should be a routine examination, if necessary, cerebrospinal fluid and pathological examination. According to a comprehensive analysis of the above aspects, carefully make a diagnosis.
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Against syphilis
1, structural variation of Treponema pallidum, resulting in drug resistance. Each has a variation of the characteristics of pathogenic microorganisms, spiral is no exception. Variation of spiral like the upgraded computer operating system, function more perfect, more toxic, more difficult to cure. Clinical antibiotics at the same time accelerated the spiral of abuse drug of drug resistance, to conventional treatment difficult. 2, increase the degree of harm, maiming and killing rate. Variation of the spiral after the toxicity increased the degree of damage to body organs increased. And the rapid progression of the disease mutation, combined with conventional treatment is poor, causing syphilis on the body to increase morbidity and mortality. Not treated in time will result in loss of function of organs, or even life-threatening. 3, violations of the central nervous system of Treponema pallidum. Can lead to spinal tuberculosis, dementia, paralysis, optic nerve atrophy. 4, spiral harm the cardiovascular system. Can lead to aortitis, aortic insufficiency, aortic aneurysm. 5, spiral damage the skeletal system. Cause tissue and organ damage, loss of function, resulting in disability or death. The hazards of early syphilis: secondary syphilis, and a syphilis belong to the early syphilis. The main manifestations of secondary syphilis can be summed up in three characteristics: type of flu symptoms, syphilis and systemic lymphadenopathy. When suffering from syphilis because no significant pain, patients often easily ignored. Seen clinically, such as widely distributed, symmetric, and mild symptoms of rash, the detailed history is necessary in order to avoid misdiagnosis. Rash of secondary syphilis Treponema pallidum surface lot, so infectious is also the strongest.
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Syphilis Prevention
As with other infectious diseases prevention, health education should be strengthened first, against the illicit sex, followed by the following preventive measures should be taken. (1) to track the patient's sexual partners, including patients and medical staff self-reported visit to find all sexual contacts of patients, prevention inspections to observe and follow the necessary treatment, not cure the absolute prohibition of sexual life of a former spouse; (2) prevention of suspected patients should be checked, so syphilis serum test for early detection and timely treatment of new patients; (3) found that patients with syphilis treatment must be enforced isolation; (4) suspicious of pregnant women suffering from syphilis, it is timely to give prophylactic treatment to prevent the syphilis infection to the fetus; unmarried men and women patients, without a cure can not get married before; (5) of the patients had received treatment should be given regular follow-up treatment.
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Daquan disease
Disease Name: Syphilis Disease code: 97.901 Attribution system: Infectious diseases Medication program: ⒈ to early treatment; ⒉ dose must be adequate, regular, planned to complete the therapy; ⒊ to penicillin-based; Treatment of late syphilis ⒋ prepared to do to prevent Jihai reaction; ⒌ strict regular follow-up observation after treatment; ⒍ source of infection and the sexual partners must be treated; ⒎ prohibit sex life during treatment.
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Encyclopedia
meidu Syphilis syphilis Caused by the venereal Treponema pallidum. Usually about 3 weeks after infection, external genital chancre occurs, known as primary syphilis; about 2 months after the body skin rash, for secondary syphilis. First, collectively referred to as early syphilis secondary syphilis. At this point a large infectious, should speed with penicillin treatment. If you can not cure may occur after cardiovascular syphilis, neurosyphilis or syphilis of other tissues and organs. The disease may also be the mother to fetus through the placenta, as congenital syphilis.
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English Expression
: syphilis (lues)
n.: lues, measles, pox, syphilis, infectious disease passed from one person to another by sexual contact
