Zviratidzo nezviratidzo zvechirwere zvakabatana nechikamu chetachiona. Nharaunda yekutanga inosanganisira kuonekwa kweshungu isina kurwadza pamakumbo edzimba, rectum, kana muromo. Mushure mokunge chirwere ichi chiporesa, danho rechipiri rinowanzoratidzika nekukurumidza. Pakupedzisira, mushure mekunge kwenguva yakareba isina zviratidzo, danho rechitatu rinogona kukurumidza kuitika, zvichikonzera kukanganisa kwakakura kuuropi, mitsipa, maziso, kana mwoyo.
Nemhaka yokuti zviratidzo zvechirwere zvinowanzova zvisingazivikanwi (kana kutevedzera zvimwe zvinhu zvakadai semaporioriasis, hemorrhoids, uye zvironda zvinokonzera ), zvirwere dzimwe nguva zvinoshaya uye zvisiyiwa zvisina kutenderwa. Ndicho chikonzero icho chirwere chinowanzotumidzwa se "mutevedzeri mukuru."
Ipi syphilis inoratidzika uye inonzwa sechishanduko sezvainochinja, uye inogona kusiyanisa pakati pemarudzi akasiyana.
Primary Syphilis
Primary syphilis inowanzotanga nechitarisiko che chancre chero ipi zvayo kubva pamatatu kusvika kune makumi mapfumbamwe nemashure mushure mekutanga kuonekwa (inopera mazuva 21). Donda racho richakurumidza kusvika pamucheto wekubatana, kazhinji pamumuviri wemukati, vagin, penis, anus, rectum, kana muromo.
Ikoko kunogona kunge kune imwe kana zvimwe zvipembenene zviri muhukuru zvichibva pachisere chema inch kusvika inch kana kupfuura. Nemhaka yekuti maronda haasuruvara, anogona kuraswa nyore nyore kana akaiswa mukati. Kupfigira lymph glands kunogonawo kuitika, kazhinji pedyo nenzvimbo yehutachiona.
Pasina kurapwa , chancre ichaporesa chero kupi zvako kubva mavhiki matatu kusvika matanhatu.
Secondary Syphilis
Kana isina kusiyiwa, chirwere chepakutanga chichapfuurira kusvika kuchirwere chechipiri. Zviratidzo zvinowanzoonekwa mukati memavhiki mana kusvika ku10 ekuonekwa kwechancre. Munguva iyi, munhu anogona kunzwa anorwara uye ane hutano, hutonda, kuneta, kuora muviri, uye musoro. Kufuridzira kwemaitiro emakirini nhengo ( generalized lymphadenopathy ) yakajairikawo.
Chimwe chezviratidzo zvechipiri chechirwere ndeyekupararira, kusina-kusvibiswa kwechikwata pamutsipa, maziso, uye (kunyanya zvinotaurira) zvimiti uye zviso zvetsoka . Nezvo izvo zvichitaurirwa, kuonekwa kwehushoni kunogona kusiyanisa zvinoshamisa. Zvironda zvinogona kunge zvakadzika kana kuti zvakasimudza, zvinyoro kana kuti mikoko , uye zvinokwanisa kutaridzika nemabhetera anozadza (pustules). Chero zvingave zvakaita, zvipembenene zvinopararira uye zvinogona kutapura chirwere kune vamwe.
Zvimwe zviratidzo zvinotaura zvinosanganisira kusarudzwa kwebvudzi kusina kutsanangurwa (syphilitic alopecia) uye kuputsika kwezvipembenene pakona yemuromo (fissure cheilitis).
Secondary syphilis inogonawo kuratidza nenzira isingawanzoiti, isiri, uye nzira dzakasiyana-siyana dzinobata chiropa, mafungiro, mapfupa, uye hutachiona hwehutano-nei hunowanzotumidzwa se "mutevedzeri mukuru" kana "guru guru".
Zviratidzo zvechirwere chechipiri zvinowanzogadziriswa pasina kurapwa mukati memavhiki matatu kusvika matanhatu.
Latent Syphilis
Latent syphilis inhanho yechitatu yehutachiona yakaratidzwa nekusavapo kwezviratidzo asi kuongororwa kweutachiona. Inowedzera kugoverwa muzvikamu zviviri:
- Chirwere chepakutanga chenguva yakareba nguva inopfuura pasi kubva pagore rekuongorora ropa. Chikamu chechipiri zviratidzo dzimwe nguva chinodzokazve munguva yekutanga latent phase.
- Late latent syphilis ndiyo nguva yakakura kudarika gore kubva pakupedzisira kuedzwa kweropa. Inogona kugara kwemakore uye kunyange makumi emakore isina zvirwere zvezvirwere.
Kunyange zvazvo hutachiona hunogona kudarika munguva yekutanga yakaderera, hazvikwanisi kuita saizvozvo munguva dzekupedzisira dze latency.
Nguva ye latency yakasiyana zvikuru, uye masayendisiti haasi kunyatsoziva kuti sei. Chimwe chezvinhu zvinozivikanwa kuti kukurumidze kufambira mberi kune HIV mune hutachiona . Kune rumwe rutivi, chirwere chakavhurika chancre chinopa HIV chirwere chiri nyore mumuviri. Kune rimwe, kuva neHIV uye kusangana pamwe kunoita kuti pave nehutano hwekugadzirisa matanho ekupedzisira-kunyange panguva dzekutanga dzehutachiona.
Syphilis yepamusoro
Siriphira yepamusoro ndiyo nharaunda yakakomba yehutachiona uye inoratidzirwa nezvinetso zvitatu zvikuru:
- Gummatous syphilis inokonzera kuumbwa kwezvinyorova, zvipembenene-semakumbo zvinonzi gummas. Izvi zvinenge zvisingava nekenza zvinogona kukonzera maronda makuru ekuonda kwepachivara paganda nemuromo, uye kubvisa maviri emwoyo, chiropa, masimba, mapfupa, uye dzimwe nhengo dzinokosha. Zviratidzo zvinogona kukura kare mushure megore rinotevera kusununguka kana makore akawanda makumi mashanu gare gare.
- Utachiona hwepfungwa hunogona kukonzera kupisa kwakanyanya kweaorta uye kukura kweanorous aneurysm (kubvunda uye kuderera kwetambo we aortic). Zviratidzo zvehutano hwemwoyo zvinowanzoonekwa makore gumi nemakumi matatu mushure mekutanga kwehutachiona.
- Neurosyphilis inokanganisa hutano hwepamusoro yenheyo uye inowanzotanga mukati memakore mana kusvika makumi maviri ehutachiona. Kunyange zvazvo vamwe vanhu vacharamba vasina zviratidzo-vakasununguka, vamwe vangave vane zvirwere zvakakomba zvehupombwe zvinosanganisira meningitis (kuputika kwemuviri wakakomberedza uropi nemutsipa wesimbi) kana tes dorsalis (chirwere chinoratidzirwa nehutano hwepfungwa, kurasikirwa kwemajini, kutadza kuona, kushaya matsi, uye incontinence). Kushushikana, hupenyu hunochinja, kukanganiswa, kuora mwoyo , schizophrenia, uye kurohwa kunogonawo kuitika.
Kunyange zvazvo hutachiona hwechirwere hunogona kucheneswa panguva yechikoro chepamusoro, chero kukanganisa kunokonzerwa pamwoyo, itsvo, nedzimwe nhengo zvingaguma zvichisingaperi uye zvinotungamirira kumagumo ekugumburwa kwechimiro. Mishonga inogadziriswa nemhando uye huwandu hwekukuvara.
Sirifi haina kupararira munguva yepamusoro.
Matambudziko muMucheche
Congenital syphilis chirwere chakakomba umo amai vane pamuviri vane chirwere chinopfuurira T. pallidum kumucheche wavo.
Kusaparadzaniswa kwechirwere munguva yekuzvimba kunogona kuita kuti pave nepamuviri kana kupererwa. Pakati pevana vakaberekerwa nechirwere, vazhinji vezvikamu zviviri kubva muzvitatu havangave nezviratidzo mukati memakore maviri ekutanga ehupenyu. Kana isina kusiyiwa, zviratidzo zvinogona kusanganisira:
- Chiropa nekuwedzera kwepleen
- Petechia (purplish ganda mavara anokonzerwa nemapapuriri akaputsika)
- Inoita kuti pfupa rinokonzerwa (rinonzi syphilitic "snuffles") rakanyanya kupararira mucus discharge
- Neurosyphilis
- Chiremera chekuremera
- Jaundice (kuchena kweganda nemeso)
- Kugumburwa
Nezera rechipiri, mwana wacho angave ane unhu hwemaziso kana hutano uye hutachiona hwekunetseka, kusanganisira:
- Blunted kumusoro kumeno mazino (anozivikanwa semeno maHutchinson)
- Kuwa kwechikamu chebonyamu chemapapiro
- Chirafu chinoputika uye tsvina yakasimudzirwa kumusoro
- Chifukidzo chepakona chepakona (bhokisi riri mberi)
- Dzorera mabvi
- Kupfugama kwemapfupa (saber shins)
- Kuvhiringidza uye kupora kwekromaa (interstitial keratitis)
- Glaucoma
- Matsi
- Kukura kunonoka
Kufananidzwa nerufu muvana ava kanowanzokonzerwa nehuputi hwemapapu.
Nguva Yokuona Chiremba
Nemhaka yokuti zvirwere zvechivipiti zvinorasikirwa nyore nyore kana kuti zvisingazivikanwi, unofanirwa kutora matanho kana iwe uchikanganwira kuti wakatapukirwa. Kana iwe uripo kana wakambove uri panjodzi yekuita zvepabonde- zvichida nekuda kwepabonde risina kudzivirirwa, kuva nevakaroorana vakawanda, kana kuva nehutachiona hweHIV-iwe unofunga kufunga nezvekuwana chirwere cheDDD kana iwe wakanga uine zviratidzo kana kwete.
Uyezve, chisarudzo chezviratidzo hachifaniri kumboonekwa sechiratidzo chokuti utachiona hwave hwakabviswa. Kana usina mubvunzo, ita iwe unofadza uye uongororwe. Miedzo iri nyore uye inowanzodzorera migumisiro mumazuva mashoma ebhizinesi.
Sources:
> Basu, S. uye Kumar, A. "Mharidzo Dzakasiyana-siyana dzeChirangaridzo Chakatanga Kubatana." J Trop Pediatrics. 2013; 59 (3): 250-4. DOI: 10.1093 / tropej / fms076.
> Lee, K .; Nyo-Metzger, Q .; Wolff, T. et al. "Utachiona hwepabonde: Mazano kubva kuUnited States Preventive Services Task Force." Amer Fam Phys. 2016; 94 (11): 907-915.
> Workowski, B. uye Bolan, G. "Zvepabonde Zvirwere Zvirwere Zvokurapa Zvinyorwa, 2015." MMWR . 2015 Aug 28; 64 (33): 924.