Secondary syphilis
Introduction
Introduction to secondary syphilis Secondary syphilis is a chronic systemic sexually transmitted disease caused by Treponemapallidum (TP) infection, which is mainly transmitted through sexual intercourse. The disease is extremely complex and can almost invade all organs of the body, causing damage to multiple organs. Secondary syphilis causes skin and mucous membrane damage and lymphadenopathy. Syphilis can also be transmitted to the next generation through the placenta, causing neonatal congenital syphilis, which is extremely harmful. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of transmission: sexual transmission, blood transmission, vertical transmission Complications: pityriasis rosea
Cause
Secondary syphilis
Sexual life is messy and does not focus on personal hygiene. Sexual contact is the main route of transmission of syphilis, accounting for more than 95%. The early contagious infection of syphilis is the strongest. As the period of infection increases, the contagiousness becomes smaller and smaller. It is generally considered that the sexual contact with sexual contact for 4 years or more after infection is very weak.
Pregnant women with syphilis can be transmitted to the fetus through the placenta, causing intrauterine infections, which can lead to miscarriage, premature birth, stillbirth or childbirth. It is generally believed that the earlier the syphilis period in pregnant women, the greater the chance of infection with the fetus. Pregnant women are contagious even with asymptomatic recessive syphilis.
The second-stage syphilis is transmitted through the bloodstream of the syphilis spirochete, causing most small lesions in various organs, often involving the skin, mucous membranes, bones, internal organs, sensory organs and nervous system. The earliest symptoms of secondary syphilis can appear in the hard sputum. Weeks come one after another, and can only appear several months after the healing of the lower jaw. The second stage of syphilis is the general stage of syphilis, the skin and mucous membrane damage, contains a large number of spirochetes, and is highly contagious, although the damaged organ or tissue damage is light. However, if it is not treated, it will often become the basis for the development of viscera, nerves, bones, joints and other syphilis in the future, so timely and adequate treatment should be applied to avoid the development of advanced syphilis.
Prevention
Secondary syphilis prevention
As with other infectious diseases, we should first strengthen health publicity and education, and oppose unfair sexual behavior. Secondly, the following preventive measures should be taken:
(1) All suspected patients should be examined and tested for syphilis serum in order to detect new patients early and treat them promptly.
(2) Patients with syphilis must be forced to undergo isolation treatment. The patient's clothing and supplies, such as towels, clothes, razors, tableware, bedding, etc., should be strictly disinfected under the guidance of medical personnel to eliminate the source of infection.
Complication
Secondary syphilis complications Complications
Damaged organs or tissue damage is light, but if not treated, it often becomes the basis for the development of viscera, nerves, bones, joints and other syphilis.
Symptom
Symptoms of secondary syphilis Common symptoms Syphilitic liver dysplasia lymph node enlargement Pustular immunity Reduces syphilitic hair loss Intercostal neuralgia Bone pain
1) Prodromal symptoms: Before the skin rash, patients with secondary syphilis sometimes have prodromal symptoms such as fever, headache, bone pain, trigeminal or intercostal neuralgia and total weakness, generally lasting 3 to 5 days due to prodromal symptoms. Slight, so often ignored for patients.
2) Skin damage caused by secondary syphilis in the second stage: common skin damage is rash and wet phlegm.
Rash: characterized by mild symptoms, wide and dense and symmetrical rash, the main types are: a, rash syphilis: the most common, mainly distributed in the trunk and the proximal end of the extremities, varying in size, The diameter is about 0.5~2 cm, often round, the number is less elliptical, even like a ring, the color is like rose red, so it is called rose rash, b, pimples syphilis: more common, many types, generally 2 ~ 5 mm diameter small papules, papules are initially reddish-brown, then turned brown, generally hard matrix, a small amount of scales on the surface, such rash type contained in the amount of Treponema pallidum, highly contagious, c, pus The diagnosis of blister-type syphilis: less common, first spotted rash, named after the small pustule at the top of the bulge, widely distributed, such patients generally poor nutrition, d, pustular syphilis: very rare.
Wet warts: It is a very common and unique second-stage syphilis damage. There are many female patients, which occur in the skin friction and moist parts, such as around the anus, external genitals, etc., wet pimple is wet pimples, and then can be merged with each other. Or the rash is expanding outwards, and it becomes a flat uplift damage of varying sizes. The surface is eroded and has fine-grained mites, which have a gray membrane on it, generally have no symptoms, and the exudate contains a large amount of syphilis. Very contagious.
Hair loss: syphilitic hair loss is also one of the common manifestations of secondary syphilis. It is more common in males. It occurs in two sputum and appears to be worm-like shedding. Hair can be regenerated regardless of treatment or not.
3) Secondary stage syphilis mucosal damage: mucosal damage is pharyngitis and mucosal plaque.
a, pharyngitis: clinical manifestations of mucosal catarrhal inflammation, usually oral, pharynx, sacral arch, etc., often need to be treated 2 to 3 weeks after the full recovery, b, mucosal plaque: mucosal localized erosion, surface by infiltration The film consisting of the film is covered with white, no redness around the mucosal plaque, no pain, different shapes, mostly oval, and also a fusion of the film, the secretion has a large number of syphilis, highly contagious.
4) Phase II recurrent syphilis: After the second stage of syphilis symptoms subsided, due to insufficient treatment or decreased patient immunity, secondary syphilis damage will be re-emerged, called second-stage recurrent syphilis. These recurrent lesions and secondary dysplasia Similar, but the number of damage is less, the number of spirochetes is less, and the damage is slightly more destructive. The recurrence damage is more common in genitals. The most common form is flat condyloma and wet papules. The scrotum can be a ring rash. The surface of the micro-bump is attached with thin debris; the mucosal plaque occurs on the lip mucosa and the buccal mucosa or tongue; when it occurs on the trunk, neck and limbs, it is a ring, a curved papule, occasionally a clam-like rash, and also Syphilitic hair loss occurs.
5) Other damages of secondary syphilis: visible systemic lymphadenopathy, damage to the eyes, bones, nervous system and internal organs, but generally mild.
Examine
Secondary syphilis examination
1. Dark-field microscopy: In the lesion, use a slide to scrape tissue exudate or lymph node puncture, see active syphilis.
2. Immunofluorescence staining: Green syphilis spirochetes were observed under a fluorescence microscope.
3. Biopsy of Treponema pallidum, such as silver staining (Warthin-starry) or (Levoaditis method) or fluorescent antibody staining, can be found in Treponema pallidum, dark brown, with a spiral structure, located around the dermal capillaries.
4. Unheated Serum Reagin USR is also an improvement of VDRL antigen with similar sensitivity and specificity to VDRL.
Diagnosis
Diagnosis and diagnosis of secondary syphilis
diagnosis
Syphilis has a long course and complex symptoms, which can be similar to the performance of many other diseases. Therefore, it is necessary to combine the medical history, physical examination and laboratory results to conduct a comprehensive analysis to make a diagnosis. If necessary, follow-up observation, family investigation and Auxiliary methods such as test treatment.
(1) medical history
1. History of infection has a history of smelting or a history of unclean sexual intercourse.
2. Sexually transmitted diseases have been characterized by hard chancre, secondary or tertiary syphilis or other symptoms of sexually transmitted diseases.
3. The number and time of marriage marriage, the health status of the spouse, whether there is syphilis or other sexually transmitted diseases.
4. Childbirth history of married women should be asked whether there is a history of premature birth and stillbirth, and whether the birth of congenital syphilis.
5. Suspected congenital syphilis should ask their parents about the history of sexually transmitted diseases, the history of their mother's childbirth, whether they are premature, and whether there are symptoms of congenital syphilis and the health of their siblings.
6. Suspected latent syphilis should also ask about the presence or absence of syphilis and diseases that can cause false positive reactions in the syphilis serum test.
7. The medication used in the history of treatment, whether the treatment is regular, whether the dose is sufficient, and whether there is a history of drug allergy.
(2) Physical examination should be a comprehensive examination of each system. Patients with short infection period should pay attention to the examination of skin, mucous membrane, genital area, anus, oral cavity, etc. Patients with longer infection period should pay attention to check the heart, nervous system, skin and mucous membranes. And other parts.
(3) Laboratory inspection
