Syphilis, how to reduce the chance of infection?

Doctor, I want to screen for hepatitis B, by the way, check all other infectious diseases
.

The patient's face was very light and breezy, just like an ordinary medical examiner
.

After careful medical history by the doctor, the patient said after several hesitations that his family had found syphilis and was very worried, and wanted to know more about the origin of the disease and the methods of
examination and prevention.

In the face of syphilis, some patients think that they can determine whether the diagnosis is confirmed by just taking a blood test, but this is not the case
.

Routes of transmission of syphilis

Patients with syphilis are the only source of infection, and treponemal infection can occur through sexual contact (primary cause), fetal transmission, blood transfusion (very rare), especially exposure to open lesions in the presence of microorganisms, contact with infectious secretions (eg, kissing), which may cause primary lesions
at the site of contact.
Clinical manifestations of syphilis

The clinical manifestations of syphilis are diverse and can harm all systems
.
Especially in patients with early syphilis within 2 years of the course of the disease, it is particularly contagious
.

Issue I

After the incubation period of 10~90 days, there can be primary syphilis manifestations in the contact site, such as the "chancre" of the male external genitalia, which is a shallow ulcer with clear edges and slightly higher than the surrounding skin, which lasts for 3~4 weeks and then subsides on its own, often causing patients to have the illusion that "the disease has healed" and delay medical treatment
.
Ulcers caused by syphilis can also occur in hard-to-see areas, such as around the anus, the back of the pharynx, and the vagina, or rectum
.

Phase II

Primary syphilis without treatment, can enter the secondary syphilis stage after 9~12 weeks, most of them are manifested as a variety of skin and mucous rashes, and there may be similar to influenza-like manifestations
in the early stage.
In addition to the rash, ocular syphilis, gastrointestinal syphilis, syphilitic alopecia, osteoarthritis, kidney damage, liver function abnormalities, etc
.
may also occur.

Phase III

Untreated patients have a 25~40% probability of entering tertiary syphilis, that is, the late syphilis stage, which is more destructive and can cause disfiguring skin lesions, cardiovascular damage, nervous system damage (such as paralytic dementia, tabes dorsal), and even life-threatening
.

Tests for syphilis

Commonly used laboratory tests include TPPA (treponemal particle agglutination test) and TRUST (toluidine red non-heating serum test).

It is recommended to leave the interpretation of the results to a professional doctor to avoid mistakes
.

Two test results worth reminding

1TRUST and TPPA are negative≠ healthy and fine
.
In very early syphilis patients, there are not sufficient amounts of antibodies, and a negative blood draw may occur, and if there is a specific history of exposure, it should be repeated 4 weeks after exposure
.

2TRUST positive, TPPA negative→ may be false positives
.
For example, the elderly and pregnant women belong to special groups, and there is a small probability that they may show this result, but they do not suffer from syphilis; This may
occur in patients with autoimmune diseases (e.
g.
, lupus erythematosus, rheumatoid officiosis), acute febrile illness, recent immunization, and HIV infection.

What to do when discovered

For patients who have been diagnosed, the commonly used drug is penicillin, and if penicillin is allergic, drugs such as doxycycline can also be substituted
.
When taking medication, pay attention to a sufficient amount, regular course of treatment, regular review and tracking, should go to the dermatology clinic to receive evaluation guidance, and formulate individualized treatment plans, such as cardiovascular syphilis, neurosyphilis, pregnancy syphilis, congenital syphilis and other treatment plans are different
.

In particular, even those who are asymptomatic but have a history of the following sexual encounters can be treated with "post-exposure treatment" to reduce risk through earlier medication, rather than waiting for a "positive result" trial
.
Include:

● Partner diagnosed primary, secondary, or early latent syphilis within the previous 90 days;

● Sexual partner diagnosed with advanced latent syphilis within the previous 90 days with a high TRUST titer (eg, >1:32);

● When
the sexual partner was diagnosed with syphilis before 90 days, the patient is asymptomatic, has no conditional serological testing, or is uncertain about follow-up.

How to reduce syphilis infection

1.
Use latex condoms
every time you have sex.

2 Avoid sex
when you or your sexual partner have symptoms that may be caused by infection.

3.
Routine screening for pregnant women to prevent congenital syphilis
in infants.

There is a similar record of syphilis in ancient books, "Liu Gong's father suffered from a vicious disease in his later years, his eyebrows were degenerate, the bridge of his nose was broken, he felt ashamed, and he died of hardship" ("Cangxi Yuyin Cong Tale"), which shows that its harm has been long-standing
.
Syphilis also accounts for a large part of modern medical books, it is difficult to describe it in this small article, only focus on the patient's easy misunderstanding and omission here to remind here, it is recommended that you seek the help
of a doctor in time.
Pay attention to the harm of syphilis, be vigilant against its invisibility, prevent and treat early, and embrace a healthy life
.