STD-2015-1

Acquireds yphilis
syphilis
Congenital syphilis
Early syphilis (< 2 years)
Late syphilis (>2 years)
Primary syphilis
Secondary syphilis
Early latent syphilis Tertiary cutaneous～
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Syphilis classification
• Mode of transmission
acquired ～ congenital ～
• course of disease early syphilis late syphilis
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Diagram of the stages and course of syphilis
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①Itching →absent ②Fever, malaise→ present ③Generalized lymphadenopathy → present
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With the passage of time, the cutaneous lesions become more papular and scale is more likely to be seen.
⊙vary from 9 days to 90 days (2-4 weeks on the average).
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2 primary syphilis
① Chancre(characteristic lesion) → a solitary and painless ulcer with indurated base
☆ on one or both sides ☆ beginning 1 or 2 weeks after appearance
of the chancre ☆ groin (most common location)
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Laboratory Test
1) Dark field microscopic examination of serous fluid ↓ recognition of Treponema pallidum
RPR(rapid plasma reagin circle card test) TPPA(treponema pallidum passive
particle agglutination test) FTA-ABS test (fluorescent treponema
antibody absorption test)
Tertiary Late mucous syphilis membrane～
Neurosyphilis Late cardiovascular～ Late latent
syphilis
Early congenital syphilis Late congenital syphilis Latent congenital syphilis
Sexually Transmitted Disease
Yunhua Deng
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Definition
The term STD refers to a large group of disease syndromes that can be transmitted sexually irrespective of whether the disease has genital pathologic manifestations.
Prevalance in 2011 ⇒ to 2010 Syphilis 29.47/100 thous. ⇒ 9.71% AIDS 1.53/100 thous. ⇒ 27.37%
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High risk groups
1)homosexual,bisexual,heterosexual contact with infected patient
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3 secondary syphilis
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☆If left untreated, chancre heals in a matter of 3～6 ws
☆an interval of ws/ms before the lesions of sec. syphilis appear
☆During this interval →no clinical evidence of syphilis →not contagious
Human papilloma virus
acuminatum
Genital herpes
HSV-Ⅱ/Ⅰ
AIDS
HIV
Genital candidiasis
Candida
Bacteritic vaginitis
Gartner's bacillus
Anaerobic bacteria
Scabies
Sarcoptes scabiei
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chancre
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Chancre ←2-4w Exposure ①genitalia/ora,recta occasionally ②one ulcer/second/third ③diameter:1 cm at the first seeing ④floor of the ulcer is clean ⑤tissue underneath the ulcer is firm ⑥there’s little undermining of margins
1) Improve legal system 2) Pay attention on educational programmes
to public ➢delaying sexually debut; ➢using condom; ➢reducing number of partners; ➢altering partner selection methods.
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Diagnosis
1) dark field examination--best 2) a positive RPR test
+ a clinically typical lesion. 3)When RPR are negative in a patient with a highly suspicious lesion, an FTA-ABS /TPPA test should be obtained .
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Classic venereal disease
<
Modern venereal disease
↓
• syphilis • gonorrhea • chancroid
(soft chancre) • lymphogranuloma
venereum • granuloma inguinale
↓
•nongonococcal urethritis •condyloma acuminatum (CA) •genital herpes •AIDS •bacteritic vaginitis •hepatitis B
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Principles of effective control
3) Perfect STD reports system 4) Strengthen the behavior interference
to STD patients ➢Accurate diagnosis; ➢Effective treatment; ➢Follow-up; ➢Contact tracing.
clothes) 3)blood transmission 4)perinatal transmission (mother→children) 5)iatrogenic infection 6)organ transplant, artificial impregnation
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Principles of effective control
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Treponema pallidum
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Treponema pallidum
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Laboratory Test
2) Serologic test:
Serologic reactions are negative in 2 weeks after the appearance of chancre.
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Syphilis
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Definition: Syphilis is a chronic systemic and infectious sexually transmitted disease caused by Treponema pallidum.
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1)High risk groups: prostitutes, male homosexuals
……
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Diseases
Pathogens
Syphilis
Treponema pallidum
Gonorrhea
Neisseria gonorrhoeae
Nongonococcal
Chlamydia trachomatis
urethritis
Ureaplasma urealyticum
Condyloma
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Early lesions is discrete, small macules or papules which occur in a generalized pattern over the entire body.
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• Palms/soles
～yellowish red macule, collarette of scales overhanging the border of the lesion.
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chancre
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chancre
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chancre
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chancre
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chancre
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chancre
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② Sclerolymphadenitis syphilitica
☆ enlarged lymph nodes draining the side of the chancre (firm, painless)
2)intravenous drug abusers 3)recipients of contaminated blood
products 4)children from infected mothers
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Modes of transmission
1)sexual intercourse and similar sexual action 2)indirect contact (sharing bed, bath, toilet,
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Acquistinct stages
• incubation • primary stage • secondary stage • latency • late syphilis
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1 Incubation
⊙length of time between infection and formation of primary lesion.
Molluscum contagiosum
M.C virus
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Epidemiology
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1) STDs are widely spread in the world. 2) In our country, the incidence of STDs has increased sharply from 1991 to 2011. For example,
2)The incidence of syphilis increased rapidly throughout the country in the recent twenty years.
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Pathogen
Treponema pallidum
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Treponema pallidum
①A delicate spirochete ②Destroyed by drying, heating (60℃→15 min. , 100℃→0 sec.), various disinfectants ③In a moist discharge, treponema lives for up to 12 hours or longer.