Pediatric Yaws
Introduction
Introduction to pediatric yaw disease Yaws (paw, framboesia) is a non-sexual contact-transmitted infectious disease caused by the trematode Treponemapertenue. The patients are almost all children. The main clinical manifestations are painful skin papules, ulcers, crusting and a certain degree of whole body. Symptoms, etc. Destructive changes in bone occur in patients with advanced disease. basic knowledge Sickness ratio: 0.0001% Susceptible people: children Mode of infection: contact infection Complications: periostitis osteoporosis
Cause
Causes of pediatric yaw disease
(1) Causes of the disease
The pathogen of the disease is a Treponema pallidum, and its physical properties are similar to those of Treponema pallidum. The average diameter of the spiral is 0.13 to 0.15 m and the length is 10 to 13 m. The spiral can be actively moved under a dark field microscope.
(two) pathogenesis
The source of the disease is patients. In some areas of human yaws and endemic syphilis in Africa, some non-human primate sera have antibodies to spirulina, when damaged skin contacts active yaw lesion exudate When infected, insect bites, abrasions, or damage can promote natural infections from spirulina from infected contacts, most likely by direct or indirect exposure to contaminated fingers from early yaw, new Most cases occur during the rainy season. Most of the primary infections occur before puberty. Shortly after the initial infection, the pathogens can invade the bloodstream, which can cause damage to the bones, lymph nodes and distant skin.
Pediatric susceptibility to yaws, lack of clothing, poor sanitation, and frequent skin damage, easy to promote the occurrence of yaws, direct contact with the lesion is the main way of transmission of the disease, but it may also be transmitted indirectly through insects.
Prevention
Prevention of pediatric yaw disease
There is currently no vaccine, and prevention mainly uses active monitoring of the onset and treatment of patients and close contacts, and does not advocate group therapy.
Complication
Complications of pediatric yaws Complications Periostitis Osteoporosis
Combined with periostitis, polyarthritis, after the skin lesions can leave pigmentation atrophic scar or skin contracture, cleft palate, advanced cases of long bone periosteum or osteoporosis lesions, causing osteoporosis, and even formation Cavity, occasional perforation or nasal bone, pharyngeal damage, can also cause fibroid-like nodules and joint effusion around the joint.
Symptom
Symptoms of pediatric yaw disease common symptoms papular nodules, bone pain, rash, palmar keratosis, excessive contracture scar
The clinical manifestations of yaws are characterized by the initial appearance of one or more skin lesions, followed by recurrence, non-destructive secondary damage to the skin and bone, and destructive changes in the skin, bones and joints at later stages.
The pathogen of the disease was experimentally inoculated into susceptible human volunteers, and the incubation period was confirmed to be 3 to 4 weeks. At the initial invagination, a single pimples appeared on the skin, which gradually expanded into nodules and became papillary. Tumor-like, the surface of which has an erosion-like change, covered with a thin layer of yellow sputum, which consists of serous exudate containing yasprobes, lesions up to 3 to 4 cm in diameter, with itching or pain, called yaw Tumor (Raspberry-like) or maternal tumor, more common in the face and extremities exposed, especially in the lower extremities, small lesions around the mother can appear the same lesion, star-shaped, local lymph nodes, the initial damage usually Self-healing within 3 to 6 months, before or after the original lesion is healed, due to spirochete or autologous inoculation, can cause secondary skin lesions, sometimes accompanied by fever, body aches and other symptoms, rash is diverse, can be presented Desquamative rash, papules or large nodules, covered with gray sputum, sparsely distributed throughout the body, with trunk and limbs; can also develop into a bayberry-shaped nodule, covered with deep yellow or brown thick sputum After the sputum, the surface looks like a bayberry, there is Xu exudate and hemorrhage, there is tenderness, mainly distributed in the head and the outside of the limbs. When it occurs in the ankle, it can cause crab-like gait due to tenderness. Therefore, it is called "crab-like yaw", and the secondary lesion can be used. Several weeks or months subsided without leaving traces or pigmentation. Some patients may have recurrence of skin lesions. Different parts of the body may be seen at the same time. Different localized skin lesions may be seen. The local lymph nodes are enlarged but not purulent; when periostitis is combined May cause nighttime bone pain, but also complicated by polyarthritis.
About 10% of cases can develop advanced yaw disease 5 to 6 years after infection. The lesions are nodular. The ulcer is formed after ulceration. It is more common in the flexor of the extremities. The ulcer healing remains a deficient atrophic scar. Or skin contracture; patients can also be expressed as palm, excessive keratosis of the ankle, and cleft palate, the course of advanced yaw disease is prolonged, and can be cured for many years without treatment.
Examine
Examination of pediatric yaws
1. Pathogen examination: After the early lesions are removed, the exudate smear is taken. The dark-field microscopy reveals the Treponema pallidum, and the shape resembles other spirals such as syphilis.
2. Serological examination: The method of detecting Treponema pallidum can be used, such as VDRL, USR, RPR test or FTA-ABS, FPHA Treponema test, syphilis serological reaction and spirochete brake test are positive after 1 to 2 months of onset. .
X-ray chest X-ray, X-ray bone film, electrocardiogram and B-ultrasound were selected according to clinical needs.
Diagnosis
Diagnosis and diagnosis of pediatric yaws disease
Because the results of laboratory tests are similar to syphilis, the diagnosis needs to be combined with epidemiological and patient contact history and clinical manifestations. The general diagnosis is not difficult.
The disease should be differentiated from syphilis. Parents have a history of illicit sexual behavior when syphilis, skin lesions, etc. are different, can be identified, in addition to leprosy, cutaneous leishmaniasis, tuberculosis.
Syphilis (syphilis) is a common sexually transmitted disease caused by infection with the human body by Treponema pallidum. It has been published for hundreds of years and is distributed all over the world. It is a very important sexually transmitted disease; it can be divided into acquired syphilis and congenital syphilis. And pregnancy syphilis and so on.
