性传播性疾病.ppt

Syphilis byDr WangliDepartmentofdermatologyFirstaffiliatedhospitalShantouUniversityMedicalCollege Whatissyphilis thegreatimitator Syphilisisacomplexandvariablesexuallytransmittedinfection Howcanthespreadbeprevented ABC 1 EtiologySyphilisiscausedbythedelicatespirochaetalmicro organism Treponema pallidum 2 Howissyphilisspread threeways inadultsthroughsexualintercoursewhencontactismadewithinfectiouslesion 2 Othersubjects indirectaccidentally infectiouslesionorlaboratorianshandinginfectedanimals Transmissionfollowingtransfusionofbloodfromasyphiliticdonor 3 aninfant infectedinuterus alsooccurininfantsfromcontactwithaninfectiouslesion 3 Stageacquiredsyphilis 2 congenitalsyphilis acquiredsyphilis earlystage primary first 2years latentphase detectedonlybythepresenceofareactiveserologictest 2 congenitalsyphilis T pallidumintothefetalcirculation Whichstagethechildabsents Primary2years 4 clinicalfeatures manifestation 1 primary Thecharacteristiclesioninfirststagesyphilisisthe chancreorsore Whatischancre Incubation aboutthreeweeks thetypicalincipient asmallredpapuleoracrustedsuperficialerosion oftenoccuronthepenis onlabium perianal tongue inoculation roundoroval edgeisnotundermined sloughy markedlyinduratebase erosion variablesize 0 5 3cmindiameter red withoutpainanditch theregionallymphnodesononeorbothsidesareenlarge firm nontenderanddonotsuppurate untreated itdisappearsafterthreetoeightweeks chancre 2 secondarysyphilisTherearesignsofsystemicupsetwithmildfever headache mildarthralgia generalizedlymphadenopathyandskinmanifestations incubation 7 9weeks skinmanifestation syphlids 80 1 maculareruption earlywidespreadmacularrush includingonthepalms 2 papulareruption laterpapularorlichenoideruption maculareruption maculareruption maculareruption papulareruption Thickenedwartyareas condylomalata appearperianallyandinothermoistflexuralsites Ulcerappearsontheoralmucosa condylomalata alopecia 3 TertiarystageAfterthesecondarystagethereislatentperiodwithoutsignsorsymptomslastingfor5 50years Themostdangerousscathe cardiovasculardiseasewithaneurysmformation centralnervousdisorder generalparalysisoftheinsaneulceractiveorgummatouslesionsthatmayoccurontheskinoronmucosalsurfaces gummatous gummatous CongenitalSyphilisprimary 2yeasskin eye skeleton nerver andmarkeddamagesuchasHutchinsonteeth keratitis neuraldeaf Hutchinsonteeth keratitis 5 Diagnosisexperienceofsexualcontact clinicalfeatures andtests Test identificationofthespirochaetefromwetpreparationsofthechancreormoistsecondarystagelesion serologicaltests VDRLtestwhichisa flocculationtest reactspecificallytests FTA ABS fluorescenttreponemalantibodyabsorptiontest MHA TP T pallidiummicrohemagglutinationtest awesternimmunoblothasbeendevelopedfordetectionoffetalIgMantibodyagainstT PallidiumantigensThistestmayhelptoim