Syphilis is a chronic systemic sexually transmitted disease caused by Treponema pallidum. It has caused great harm to humans in the past and still today. Syphilis is widely spread around the world. It is the most harmful disease among the classic sexually transmitted diseases and one of the three major chronic diseases in old China.

Before liberation, the disease was widely prevalent in large and medium-sized cities and minority areas in my country. In 1964, my country announced to the world that syphilis had been basically eliminated. In recent years, due to frequent international exchanges, syphilis has made a resurgence.

The disease has the following characteristics:

①The course of the disease is chronic and progressive. Without anti-syphilis treatment, syphilis lesions can spread from local lesions to the whole body, and after 3 to 5 years of incubation, they can transform into chronic necrotic lesions, destroying all important organs of the body, and even lead to death due to the failure of important organs of the body. .

② It can invade any organ and tissue of the human body during the development process. In addition to the initial sores of syphilis, which is limited to the genitals, secondary syphilis, late syphilis, and fetal-transmitted syphilis all invade various systems and organs throughout the body, causing various symptoms and even life-threatening symptoms.

③A latent disease course may occur. The clinical manifestations of syphilis are diverse, with symptoms appearing and disappearing, and there are recessive stages in the natural course of the disease. Therefore, there may be latent syphilis in which the clinical symptoms disappear but the serum reaction is still positive, and may relapse under certain conditions. Some even show no trace for the rest of their lives and have a tendency to heal on their own, but are prone to relapse.

④ Blood source and placenta infection. Patients with secondary syphilis have Treponema pallidum in their blood. Once they become a blood donor, they can directly cause secondary syphilis in the recipient. Pregnant women suffer from early syphilis, and the spirochetes can be transmitted to the next generation through the placenta.

⑸ Sensitive to drugs. The pathogen is very sensitive to anti-plumb drugs, so early and timely treatment can kill all the spirochetes in the body in a short time and cure it completely.

The causative agent of syphilis is Treponema pallidum. It appears smooth white and transparent under a dark field microscope and is not easy to stain, so it is also called Treponema Pallidum

Syphilis is a classic sexually transmitted disease. According to research by medical historians, syphilis originated in the Americas. After Columbus discovered the New World in the 15th century, syphilis spread rapidly across Europe and Asia through sailors and soldiers. Before the 16th century, there were no records of syphilis in my country. Around 1505, syphilis was introduced from India to the Lingnan area of ??Guangdong, my country. At that time, it was called "Guangdong sore" and "bayberry sore". Since then, syphilis has spread to the mainland. The ancient Chen Sicheng's "Secret Records of Mildew" is my country's first and most perfect monograph on syphilis. The "Compendium of Materia Medica" written by Li Shizhen in the Ming Dynasty recorded the epidemic situation of syphilis in detail. Syphilis was first introduced to my country by the Portuguese in the 16th century. In ancient times, it was known as willow disease, bayberry sore, mildew sore, filthy sore, etc. After the founding of the People's Republic of China, syphilis was once eliminated in our country. In recent years, with the increasing frequency of foreign exchanges, the incidence of syphilis has also been on the rise.

Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum. The clinical manifestations are very complex and can invade almost every organ in the body, with various symptoms and signs. In the early stage, it mainly invades the skin and mucous membranes; in the late stage, in addition to the skin and mucous membranes, it is particularly easy to invade the heart and central nervous system. Syphilis patients are the main source of infection of the disease, and the main route of infection is sexual contact. Especially untreated patients are most contagious within 1 year after infection. Generally, the longer the course of treatment, the less contagious. After 4 years of infection, there is no contagion through general contact. In addition, the fetus can be transmitted during pregnancy or delivery, and can also be transmitted through kissing, towels, tableware, and blood transfusions. After Treponema pallidum enters the body, it is affected by many factors, and the onset time is different sooner or later, but the course of syphilis still has a certain regularity.

Syphilis is a chronic contagious disease. The causative agent of syphilis is Treponema pallidum, a spirochete that is seriously pathogenic to humans and can invade any organ and produce various symptoms. Treponema pallidum only infects humans, so syphilis is the only source of infection. The route of infection is that acquired syphilis is mainly transmitted through sexual intercourse, and a few can be transmitted through kissing. Occasionally, it is transmitted to the fetus through the placenta and causes disease. Syphilis patients who do not receive treatment are most contagious within one year after infection. The longer the disease period, the less contagious. Four years after infection, the disease is generally no longer contagious through sexual contact, but it can still be transmitted from fetus to fetus.

Syphilis is generally believed to have originated in the Americas. Columbus's sailors contracted syphilis in North America in 1493 and brought it back to Spain, where it soon became popular in Europe. Later, it spread to Asia and other parts of the world through exchanges. According to the World Health Organization, the prevalence of syphilis in the world dropped significantly in the late 1940s, increased again in the 1960s, declined slightly in the 1970s, but has increased again in the past 10 years. There are an estimated 3 million new cases each year worldwide, and even more so in the United States, where the annual incidence rate increases by 10% to 15%. Syphilis was introduced to my country around 1500. It was first discovered and recorded in Guangdong in 1505. It was called "Guangsang" at that time and later called syphilis. It spread from south to north and spread throughout the country. Before 1949, the incidence rate was very high, ranking first among the five major sexually transmitted diseases. At that time, the incidence rate for some ethnic minorities was as high as 48%. Some tribes were almost wiped out. After the founding of New China, a series of active prevention and control measures were adopted, and syphilis was basically eliminated in 1959. In recent years, it has resurfaced, and many syphilis patients have been discovered in various places.

There were 50 cases of syphilis in Guangzhou from 1984 to 1988. Before 1993, no more than 40 syphilis cases were reported every year. In 1993, the number of syphilis cases exceeded 40, in 1994, there were 159 cases, and in 1995, it reached 461 cases. In the first half of 1996, the number of syphilis cases was The number of cases reached 352, which was 76.36% of the total number in 1995. According to the report of the STD Control Center, 1,870 syphilis cases were reported nationwide in 1991, 1,997 cases in 1992, 2,016 cases in 1993, 4,591 cases in 1994, and 11,336 cases in 1995. The incidence rate of syphilis was 0.81/100,000 in 1993 and increased in 1994. to 1.72/100,000, and increased to 3.91/100,000 in 1995, with an average increase of 137.13% in the past three years. With the rapid growth in southeastern and southern coastal cities, the number of syphilis cases reported in Fujian Province has exceeded that of Xinjiang, which has ranked first for many years. Syphilis is the most serious sexually transmitted disease that harms individuals, families and society. Therefore, we should be fully aware of it, actively prevent and treat it, and never take it lightly.

Clinical manifestations

1. Acquired syphilis

It is divided into early syphilis and late syphilis. The disease period of early syphilis is within two years after infection, including primary syphilis and secondary syphilis. The disease period of late syphilis is more than two years after infection, that is, tertiary syphilis.

Primary syphilis. Occurs 3 weeks after infection (between 10-30 days). The main damage is the chancre, which is the place where Treponema pallidum first invades and reproduces here. A typical hard chancre is a painless red induration, which is as hard as cartilage when touched, with a clean base, surface erosion covered with a little exudate or thin scab, and neat edges. The number of damages is mostly single, but it can also be multiple. It usually occurs in the external genitalia. In men, it usually occurs on the foreskin, coronal sulcus, glans or frenulum of the penis. It often occurs in the anorectum in homosexual men. In women, it usually occurs in the labia majora, but it can also occur in the cervix and other places. In people infected through kissing, chancre can occur on the lips, mandible, tongue and other parts of the body, as well as on the eyelids, fingers and breasts. Sometimes the chancre can be accompanied by other sexually transmitted diseases, such as gonococcal dermatitis, before it heals. The chancre contains a large number of Treponema pallidum and is often accompanied by local lymphadenopathy. Without treatment, chancre lasts for 2-6 weeks and then disappears without leaving scars.

Secondary syphilis. In untreated patients, secondary syphilis usually develops 6 weeks to 6 months after infection. It is caused by the Treponema pallidum in the chancre of primary syphilis reaching the lymph nodes through lymphatic vessels and spreading throughout the body through blood circulation. In the early stage, there may be systemic symptoms such as fever, fatigue, headache, sore throat, muscle pain, joint pain, and anorexia. More than half of the patients have systemic lymphadenopathy and occasionally hepatosplenomegaly. Blood pictures may include increased leukocytosis, anemia, and elevated erythrocyte sedimentation rate. About 70% of patients have a rash called syphilis. Syphilis rash can have many different manifestations, and is generally symmetrical and widespread, without itching.

(1) Macular syphilis (roseola). This is the first syphilis rash, which is a red, brown or pigmented roseola that usually starts on the trunk. Later it developed to the limbs, palms and soles of the feet. The erythema is round and symmetrically distributed on the palms and soles of the feet. This is why syphilis is commonly known as "bayberry sore".

(2) Papular syphilis rash. This is due to the progression of the disease, and some macules can thicken and evolve into papules. It commonly occurs on the trunk, buttocks, calves, palms, soles and face. May show maculopapular rash, papule, papulosquamous, annular, psoriasis-like and other lesions.

(3) Flat condyloma. This is a papule that occurs in skin folds and moist areas such as the external genitalia and around the anus. The lesions appear smooth, thick, flat, and covered with a gray film containing a large number of Treponema pallidum. Genital warts are more contagious than other secondary syphilis eruptions.

(4) About 30% of patients have oral mucosal damage, called mucosal plaques. The surface of the lesion is covered with a gray film containing a large number of Treponema pallidum.

Patchy or diffuse hair loss may occur during secondary syphilis. Generally, hair loss can heal on its own. Secondary syphilis sometimes affects the nervous system, bones, eyes and other organs.

The symptoms and signs of secondary syphilis are: It usually lasts for a few weeks and then subsides on its own. If not treated, it can often recur within 1 to 2 years.

Tertiary syphilis. Appears more than two years after infection. There are mainly the following types:

(1) Late benign syphilis. The basic damage is gumma, which may be caused by an inflammatory response to Treponema pallidum antigens. Its pathogenesis is still unclear. Microscopically, active lesions are granulomatous lesions and old lesions are extensive fibrosis. Treponema pallidum is generally not found in gumma. This inflammation can affect any organ, but most commonly affects the skin and bones. Skin lesions include dermal or subcutaneous nodules, ulcerative nodules and gumma. Nodules often occur on the face, trunk and limbs, are asymmetrically distributed in clusters, are painless, progress slowly, and gradually become ulcerated. Ulcers generally heal slowly from the center, leaving scars. Skin gumma appears as a single induration, which gradually enlarges into an infiltrative mass and collapses to form an ulcer. During the course of the disease, some areas heal themselves and leave scars. For example, when the oral mucosa and nasal mucosa are involved, it can lead to perforation of the nasal septum and soft and hard palate. Bone damage mainly includes periostitis, gumma, etc.

(2) Cardiovascular syphilis.

There may be aortitis, aortic valve insufficiency, aortic aneurysm, etc.

(3) Neurosyphilis. There may be tuberculosis, paralytic dementia, optic atrophy, etc.

Congenital syphilis

Congenital syphilis is passed from mother to fetus through the placenta, often causing premature birth and stillbirth.

1. Early congenital syphilis. Symptoms occur in children under two years of age. The main manifestations are rhinitis, but also pharyngitis, weight loss, insomnia, lymph node and hepatosplenomegaly, osteochondritis, pseudoparalysis, etc. Skin and mucosal lesions include papulosquamous or large scar rashes, flat condyloma, mucosal plaques, etc.

2. Late congenital syphilis. Symptoms occur in people over two years old. Symptoms include parenchymal keratitis, saddle nose, saber shins, syphilitic teeth (Hutchinson), neurological deafness, etc. Others are generally similar to tertiary acquired syphilis.

3. Latent syphilis (latent syphilis). The symptoms and signs of untreated secondary syphilis often subside naturally and enter the asymptomatic period, which is called the incubation period. If not treated, patients may relapse, usually within two years. Patients within two years of age are called early latent syphilis. Patients more than two years old are called late latent syphilis. Late latent syphilis rarely recurs, but pregnant women can still pass it from fetus to fetus. Latent syphilis has no symptoms except for a positive seropositivity.