1、Syphilis,by Dr. Wang li Department of dermatology First affiliated hospital Shantou University Medical College,What is syphilis?,“the great imitator ”,Syphilis is a complex and variable sexually transmitted infection,How can the spread be prevented?,A B C,1. Etiology Syphilis is caused by the delica
2、te spirochaetal micro-organism:,Treponema-pallidum,2. How is syphilis spread? three ways,in adults through sexual intercourse when contact is made with infectious lesion.,2) Other subjects :indirectaccidentally infectious lesionor laboratorians handing infected animals.Transmission following transfu
3、sion of blood from a syphilitic donor,3) an infant -infected in uterus -also occur in infants from contact with an infectious lesion,3. Stageacquired syphilis:,2)congenital syphilis:,?,?,acquired syphilis: - early stage: primary(first) 2 years-latent phase: detected only by the presence of a reactiv
4、e serologic test.,2)congenital syphilis:T.pallidum into the fetal circulation.Which stage the child absents?-Primary 2years,4.clinical features (manifestation):1)primary: The characteristic lesion in first stage syphilis is the,chancre or sore.,What is chancre?- Incubation: about three weeks.the typ
5、ical incipient -a small red papule or a crusted superficial erosion- often occur on the penis, on labium, perianal,tongue.(inoculation),-round or oval ,edge is not undermined-sloughy & markedly indurate base- erosion, variable size (0.5-3cm in diameter)- red- without pain and itch.,-the regional lym
6、ph nodes on one or both sides are enlarge, firm, nontender and do not suppurate - untreated, it disappears after three to eight weeks,2) secondary syphilisThere are signs of systemic upset with mild fever, headache, mild arthralgia, generalized lymphadenopathy and skin manifestations.,-incubation: 7
7、- 9 weeks.-skin manifestation: syphlids, 80% (1)macular eruption:early widespread macular rush, including on the palms (2)papular eruption: later papular or lichenoid eruption.,Thickened warty areas ( condyloma lata) appear perianally and in other moist flexural sites. Ulcer appears on the oral muco
8、sa.,3) Tertiary stageAfter the secondary stage there is latent period without signs or symptoms lasting for 5-50 years.,The most dangerous scathe-cardiovascular disease with aneurysm formation,central nervous disorder , general paralysis of the insaneulcer active or gummatous lesions that may occur
9、on the skin or on mucosal surfaces.,Congenital Syphilisprimary: 2 yeasskin, eye, skeleton, nerver, and marked damage such as Hutchinson teeth, keratitis, neural deaf,5. Diagnosisexperience of sexual contact, clinical features,and tests.,Test: -identification of the spirochaete from wet preparations
10、of the chancre or moist secondary stage lesion -serological tests: VDRL test which is a “flocculation test”,-react specifically tests : FTA-ABS (fluorescent treponemal antibody absorption test) MHA-TP ( T. pallidium microhemagglutination test),- a western immunoblot has been developed for detection of fetal IgM antibody against T. Pallidium antigens This test may help to improve serodiagnosis of congental syphilis.,6. Treatment penicillin for all stages of acquired syphilis.Benzathine penicillin G,http:/www.cdc.gov/nchstp/ http:/www.i-
