Igcushuwa

I-Syphilis yintsholongwane yebhaktiriya ehlala isasazeka ngokuqhagamshelana ngokwesondo.

I-Syphilis sisifo esosulela ngokwabelana ngesondo (STI) esibangelwa yintsholongwane I-Treponema pallidum. Le bhaktiriya ibangela usulelo xa ingena kulusu olaphukileyo okanye inwebu yencindi, ihlala iphambili kwilungu lobufazi. I-Syphilis ihlala isasazwa ngokudibana ngokwesondo, nangona inokudluliselwa nangezinye iindlela.

I-Syphilis yenzeka kwihlabathi liphela, ikakhulu kwiindawo ezisezidolophini. Inani lamatyala likhula ngokukhawuleza emadodeni abelana ngesondo namadoda (MSM). Abantu abadala abancinci abaneminyaka engama-20 ukuya kwengama-35 ngabona bantu basemngciphekweni omkhulu. Kuba abantu banokungazi ukuba bosulelwe yi-syphilis, uninzi lwamazwe ludinga uvavanyo lwe-syphilis ngaphambi komtshato. Bonke abasetyhini abakhulelweyo abafumana ukhathalelo ngaphambi kokubeleka kufuneka bahlolwe igcushuwa ukukhusela usulelo ekubeni ludlulele kwiintsana zabo (i-syphilis yokuzalwa)

I-Syphilis inezigaba ezithathu:

• Igcushuwa yaseprayimari
• Igcushuwa yesibini
• Igcushuwa (inqanaba lokugula)

I-syphilis yesibini, i-syphilis ephakamileyo, kunye ne-syphilis yokuzalwa ayibonakali rhoqo e-United States ngenxa yemfundo, ukuhlolwa kunye nokunyangwa.

Ixesha lokufukama kwegcushuwa lokuqala ziintsuku ezili-14 ukuya kwezi-21. Iimpawu zesyphilis zaseprayimari zezi:

• Isilonda esincinci, esingenabuhlungu okanye isilonda (esibizwa ngokuba yi-chancre) kwizitho zangasese, umlomo, ulusu, okanye i-rectum ephilisa ngokwayo kwiiveki ezi-3 ukuya kwezi-6
• Ukwandiswa kwee-lymph node kwindawo yesifo

Iibhaktheriya ziyaqhubeka nokukhula emzimbeni, kodwa zimbalwa iimpawu ukuya kwinqanaba lesibini.

Iimpawu zesyphilis yesibini ziqala kwiiveki ezi-4 ukuya kwezi-8 emva kwegcushuwa yokuqala. Iimpawu zingabandakanya:

• Irhashalala, ihlala isentendeni yezandla kunye nonyawo
• Izilonda ezibizwa ngokuba zii-mucous patches ngaphakathi okanye macala onke emlonyeni, kwilungu lobufazi, okanye kwilungu lobudoda
• Ubumanzi, amabala aneentsumpa (abizwa ngokuba yi condylomata lata) kwilungu lobufazi okanye kulusu lwesikhumba
• Ifiva
• Imvakalelo yokugula ngokubanzi
• Ukuphelelwa ngumdla wokutya
• Imisipha kunye nentlungu edibeneyo
• I-lymph nodes ezidumbileyo
• Umbono utshintsha
• Ukulahleka kweenwele

Igcushuwa ephezulu ikhula kubantu abangafunyaniswanga. Iimpawu zixhomekeke ekubeni ngawaphi amalungu achaphazelekayo. Ziyahluka ngokubanzi kwaye kunokuba nzima ukufumanisa isifo. Iimpawu zibandakanya:

• Ukonakala kwentliziyo, kubangela i-aneurysms okanye isifo sevalve
• Ukuphazamiseka kwenkqubo ye-nervous system (neurosyphilis)
• Ukudumba kolusu, amathambo, okanye isibindi

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu. Uvavanyo olunokwenziwa lunokubandakanya:

• Ukuhlolwa kolwelo kulusu (kunqabile ukwenziwa)
• I-Echocardiogram, i-aortic angiogram, kunye ne-catheterization yentliziyo ukujonga kwimithambo yegazi kunye nentliziyo
• Impompo yomqolo kunye novavanyo lwe-spinal fluid
• Uvavanyo lwegazi ukukhusela i-syphilis bacteria (RPR, VDRL, okanye TRUST)

Ukuba i-RPR, i-VDRL, okanye iimvavanyo ze-TRUST zilungile, olunye lolu vavanyo luya kufuneka ukuqinisekisa isifo:

• I-FTA-ABS (uvavanyo lwe-anti-anti-treponemal antibody)
• MHA-TP
• I-TP-EIA
• TP-PA

I-Syphilis inokunyangwa nge-antibiotics, njenge:

• IPenicillin G benzathine
• I-Doxycycline (uhlobo lwe-tetracycline olunikwa abantu abaphikisana nepenicillin)

Ubude bonyango buxhomekeke ekubeni inzima kangakanani igcushuwa, kunye nezinto ezinje ngempilo yomntu iyonke.

Ukunyanga igcushuwa ngexesha lokukhulelwa, i-penicillin sisiyobisi esithandwayo. I-Tetracycline ayinakusetyenziselwa unyango kuba iyingozi kusana olungekazalwa. I-Erythromycin ayinako ukuthintela i-syphilis yokuzalwa emntwaneni. Abantu abaphikisayo kwi-penicillin kufuneka babe ne-desensitised kuyo, emva koko baphathwe nge-penicillin.

Kwiiyure ezininzi emva kokufumana unyango kumanqanaba okuqala egcushuwa, abantu banokufumana impendulo yeJarisch-Herxheimer. Le nkqubo ibangelwa kukungaziphathi kakuhle komzimba kwiimveliso ezaphukileyo zosulelo hayi into ebangelwa kukungavumi ukulwa negciwane.

Iimpawu kunye neempawu zempendulo zibandakanya:

• Ukugodola
• Ifiva
• Imvakalelo yokugula ngokubanzi (malaise)
• Intloko ebuhlungu
• Imisipha kunye nentlungu edibeneyo
• Isicaphucaphu
• Irhashalala

Ezi mpawu zihlala zinyamalala kwiiyure ezingama-24.

Uvavanyo lwegazi olulandelayo kufuneka lwenziwe kwiinyanga ezi-3, 6, 12, kunye nama-24 ukuqinisekisa ukuba usulelo alusekho. Kulumkele ukunxibelelana ngokwesondo xa kukho ichancre. Sebenzisa iikhondom kude kube kuvavanywa iimvavanyo ezimbini emva koko kubonise ukuba usulelo lunyangekile, ukunciphisa ithuba lokudlulisela usulelo.

Onke amaqabane esini lomntu onegcushuwa kufuneka nawo anyangwe. I-Syphilis inokusasazeka ngokulula kakhulu kwizigaba eziziiprayimari neziziisekondari.

Igcushuwa yaseprayimari nasesekondari inokunyangeka ukuba ifunyaniswe kwangethuba kwaye inyangwa ngokupheleleyo.

Nangona i-syphilis yesibini ihlala ihamba phakathi kweeveki, kwezinye iimeko inokuhlala ukuya kunyaka omnye. Ngaphandle konyango, ukuya kwisinye kwisithathu sabantu baya kuba neengxaki zegcushuwa.

I-syphilis emva kwexesha inokukhubaza ngokusisigxina, kwaye inokubangela ukufa.

Iingxaki zegcushuwa zingabandakanya:

• Iingxaki zentliziyo (aortitis kunye neaneurysms)
• Izilonda ezonakalisayo zolusu namathambo (gummas)
• Neurosyphilis
• I-Syphilitic myelopathy - ingxaki ebandakanya ubuthathaka bemisipha kunye neemvakalelo ezingaqhelekanga
• I-Syphilitic meningitis

Ukongeza, i-syphilis enganyangekiyo ngexesha lokukhulelwa inokusasaza isifo kumntwana okhulayo. Oku kubizwa ngokuba yi-syphilis yokuzalwa.

Biza ixesha lokubonana nomboneleli wakho wezempilo ukuba uneempawu zegcushuwa.

Nxibelelana nomboneleli wakho, okanye ujongeke kwikliniki ye-STI ukuba:

• Unonxibelelwano olusondeleyo nomntu one-syphilis okanye nayiphi na enye i-STI
• Ukuzibandakanya nakweziphi na izinto ezinobungozi obuphezulu ngokwesondo, kubandakanya ukuba namaqabane amaninzi okanye angaziwayo okanye ukusebenzisa iziyobisi ezifakwa ngaphakathi

Ukuba usabelana ngesondo, ziqhelanise nokwabelana ngesondo okukhuselekileyo kwaye uhlala usebenzisa ikhondom.

Bonke abafazi abakhulelweyo kufuneka bahlolwe igcushuwa.

Igcushuwa yaseprayimari; Igcushuwa yesibini Igcushuwa emva kwexesha; Igcushuwa ephezulu; Treponema - negcushuwa; Iilwimi; Izifo ezosulela ngokwabelana ngesondo - igcushuwa; Ukosuleleka ngesondo - igcushuwa; STD - negcushuwa; STI - negcushuwa

• Igcushuwa yaseprayimari
• Iinkqubo zokuzala zamadoda nabasetyhini
• I-Syphilis - yesibini kwiintendelezo
• Igcushuwa emva kwexesha

IGhanem KG, iHook EW. Igcushuwa. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 303.

URadolf JD, iTramont EC, uSalazar JC. I-Syphilis (I-Treponema pallidum). Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahl 237.

U-Stary G, uStary A. Izifo ezosulela ngokwabelana ngesondo. Ku: I-Bolognia JL, uSchaffer JV, uCerroni L, ii-eds. Dermatology. Ngomhla we-4. IPhiladelphia, PA: Elsevier; I-2018: isahluko 82.