Tertiary syphilis

Introduction to the third phase of syphilis Syphilis is a chronic systemic sexually transmitted disease caused by infection with Treponema pallidum, 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. Such as the first stage syphilis infection ulcer or hard sputum; secondary syphilis skin mucosal damage and lymphadenopathy; third syphilis heart, nerves, stomach, eyes, ear involvement and gum damage, etc., syphilis can also be transmitted through the placenta The next generation, causing congenital syphilis in newborns, is extremely harmful. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of transmission: sexual transmission, spread, mother-to-child transmission Complications: gonorrhea syphilitic scleritis

Third stage syphilis cause

Mainly due to lack of anti-syphilis treatment or treatment time is insufficient, the amount of medication is not enough. There is also a relationship between the internal and external environmental imbalances. Excessive drinking, swallowing, debilitation, and patients with chronic diseases such as tuberculosis have a poor prognosis.

Three-stage syphilis prevention

As with other infectious diseases, we should first strengthen health publicity and education, oppose unfair sexual behavior, and secondly take the following preventive measures.

(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;

(3) Tracking the patient's sexual partners, including patient self-reports and medical personnel visits, finding all sexual contact persons, conducting preventive examinations, tracking observations and performing necessary treatments. The spouse is absolutely forbidden to have sex before the cure;

(4) For pregnant women with suspected syphilis, preventive treatment should be given in time to prevent the infection of syphilis to the fetus; unmarried men and women patients can not get married without being cured.

Three-stage syphilis complications Complications gonorrhea syphilitic scleritis

It is more destructive to the organization, can be life-threatening in severe cases, can invade the central nervous system, cardiovascular system and skeletal system, cause damage to tissues and organs, loss of function, leading to disability or death.

Symptoms of third-stage syphilis common symptoms nodular genital ulcer vaginal ulcer

The time of occurrence is generally 2 years after the onset of the disease, but it can also be longer for 3-5 years, which occurs between 40-50 years old, mainly due to insufficient treatment of anti-syphilis or insufficient treatment time.

The characteristics of the third stage syphilis are as follows:

1 The time of occurrence is late (2-15 years after infection), the course of disease is long, if not treated, it can be as long as 10-20-30 years, even for life;

2 complex symptoms, can involve any tissue and organ, including skin, mucous membranes, bones, joints and internal organs, more easily invade the nervous system, easy to be confused with other diseases, difficult to diagnose;

3 In vivo and skin lesions have less syphilis, weaker infective power, but destroy tissue strength, often cause tissue defects, organ damage, can cause disability, and even life-threatening;

4 anti-mei treatment, although effective, but can not repair damaged tissues and organs,

5 syphilis serum reaction is unstable, the negative rate can reach more than 30%, cerebrospinal fluid often changes.

The third-stage syphilis skin and mucous membrane damage accounted for 28.4% of the incidence of advanced benign syphilis, most of which occurred within 3-10 years after infection. Clinically, it can be divided into nodular syphilis, gum swelling, near joint nodules, and skin damage with the following characteristics;

1 small number, isolated or clustered rather than symmetrical, often occurs in vulnerable parts;

2 systemic symptoms are mild, lack of self-consciousness of skin lesions, such as invasion of periosteum and bone, it is painful, at night;

3 There is a tree infiltrating induration, and the ulcer formed after the ulceration still has a hard solid infiltration at the bottom, which is very slow, often for several months or more;

4 ulcers have a specific kidney shape or horseshoe shape;

5 ulcers can be cured at the center, while the edges often continue to expand;

6 damage surface syphilis spirochetes, dark field microscopic examination is difficult to find, but vaccination can be positive;

7 Destruction of tissue strength, healing can form scars.

Third-stage syphilis examination

First, syphilis spiral 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 Treponema pallidum was observed under a fluorescence microscope.

Second, syphilis serum test

The syphilis serum test is divided into the following two categories depending on the antigen used:

(1) Non-treponema pallidum antigen serum test, using cardiolipin as an antigen, to determine anti-cardiolipin antibodies in serum, also known as responsiveness.

1. Rapid plasma responsiveness test: It is an improvement of VDRL antigen, and its sensitivity and specificity are similar to those of VDRL. The advantage is that the result can be read by the naked eye;

2. The unheated serotonin slide test is also an improvement of the VDRL antigen with similar sensitivity and specificity to VDRL.

(2) Serum test for Treponema pallidum antigen

1. Fluorescent syphilis spiral antibody absorption test: this method is a more sensitive and specific spirochete test;

2. Treponema pallidum hemagglutination test: high sensitivity and specificity, easy to operate, but not sensitive to primary syphilis as FTA-ABS test.

Diagnosis and diagnosis of third-stage syphilis

(1) Diseases differentiated from advanced skin syphilis

1 disease identified with nodular syphilis

A. Lupus vulgaris: small nodules, often trapped in the skin, brownish red, lighter infiltration, soft in nature, often formed after the ulceration to form a large ulcer, which occurs in the face and mouth and nose, destroying the tissue To the disfigurement.

B. Rheumatic nodules: should be differentiated from the near joint nodules. The joint nodules are small, there are signs of inflammation such as redness and swelling, and they are short-lived, with other symptoms of acute RF.

C. Others: There are also tumor-type leprosy.

2 diseases identified with skin gum

A. Spastic skin tuberculosis: occurs in the subcutaneous tissue, easy to invade the lymph nodes, more common in the cervical lymph nodes, but also in the limbs, after slow, not easy to self-heal. The edge of the ulcer formed after the rupture is thin and irregular, such as the rat bite-like chiseling, often forming a sinus, the secretion is thin, mixed with particles, and after the formation of a cord-like scar, anti-tuberculosis treatment is effective.

B. sporotrichosis: arranged along the lymphatic vessel path, the initial hair may be painless, hard, movable nodules, softening and ulceration after the formation of ulcers, but no syphilis infiltration around the ulcer, secretions can be found spores Filamentous bacteria.

C. Chronic calf ulcer: more with calf varicose veins, no nodules at first, no pus on the surface of the ulcer, no damage to the bone.

D. Others: There are also necrotic skin tumors.

(2) Diseases identified with advanced mucosal syphilis: tumor-type leprosy, SLE, Behcet syndrome, and nasopharyngeal carcinoma.

(3) Diseases identified with late genital syphilis: LGV, inguinal granuloma, prostate cancer, uterine fibroids and ovarian cysts.

(4) Diseases differentiated from late exercise syphilis: suppurative periostitis, osteomyelitis, osteitis, various bone tumors, rheumatoid arthritis, bone and joint tuberculosis, senile arthritis and subcutaneous fibroids.

(5) Diseases differentiated from late-eye syphilis: combined with ocular lesions such as tuberculosis or leprosy interstitial keratitis and brain tumors.

(6) Diseases identified with cardiovascular syphilis: hypertension, aortic sclerosis, coronary heart disease, rheumatic aortic regurgitation, and mediastinal tumors.

(7) Diseases differentiated from advanced neurosyphilis: tuberculous meningitis, meningeal tumor, cerebral thrombosis, cerebral hemorrhage, cerebral embolism, neurasthenia, schizophrenia and brain tumors.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.