Chindoko

Chindoko ndi matenda omwe amabwera chifukwa cha kugonana.

Chindoko ndi matenda opatsirana pogonana omwe amayambitsidwa ndi bakiteriya Treponema pallidum. Bacteria uyu amayambitsa matenda akafika pakhungu losweka kapena mamina, nthawi zambiri kumaliseche. Chindoko nthawi zambiri chimafalikira kudzera mukugonana, ngakhale chimatha kupatsirana m'njira zina.

Chindoko chimachitika padziko lonse lapansi, makamaka m'matawuni. Chiwerengero cha milandu chikukwera mwachangu kwambiri mwa amuna omwe amagonana ndi amuna (MSM). Achinyamata achikulire azaka 20 mpaka 35 ndiye omwe ali pachiwopsezo chachikulu. Chifukwa anthu samadziwa kuti ali ndi chindoko, mayiko ambiri amafunika kuyesedwa kwa chindoko asanakwatirane. Amayi onse apakati omwe amalandila chithandizo chobereka asanabadwe ayenera kuyang'aniridwa ndi syphilis kuti apewe matendawa kupita kwa mwana wawo wobadwa kumene (congenital syphilis).

Chindoko chili ndi magawo atatu:

• Chindoko chachikulu
• Chindoko sekondale
• Chindoko chapamwamba (kumapeto kwa matendawa)

Chindoko cha sekondale, chindoko chachikulu, ndi chindoko chobadwa nazo sizimawoneka kawirikawiri ku United States chifukwa cha maphunziro, kuwunika, ndi chithandizo.

Nthawi yokwanira ya syphilis yoyamba ndi masiku 14 mpaka 21. Zizindikiro za chindoko chachikulu ndi izi:

• Zilonda zazing'ono, zopanda ululu kapena zotupa (zotchedwa chancre) kumaliseche, pakamwa, pakhungu, kapena pakhosi zomwe zimadzichiritsa zokha m'masabata atatu kapena 6
• Amakulitsa ma lymph lymph m'dera la zilonda

Mabakiteriya akupitilizabe kukula mthupi, koma pali zochepa zochepa mpaka gawo lachiwiri.

Zizindikiro za chindoko chachiwiri zimayamba milungu 4 mpaka 8 pambuyo pa chindoko chachikulu. Zizindikirozi zitha kuphatikiza:

• Kutupa pakhungu, nthawi zambiri kumakhala m'manja ndi pamapazi
• Zilonda zotchedwa zigamba zotsekemera mkamwa kapena mozungulira pakamwa, kumaliseche, kapena mbolo
• Zinyontho, zotsekemera (zotchedwa condylomata lata) kumaliseche kapena m'makola a khungu
• Malungo
• Kumva kudandaula
• Kutaya njala
• Kupweteka kwa minofu ndi molumikizana
• Kutupa ma lymph node
• Masomphenya akusintha
• Kutaya tsitsi

Chindoko chachikulu chimayamba mwa anthu osachiritsidwa. Zizindikiro zimadalira ziwalo zomwe zakhudzidwa. Zimasiyana mosiyanasiyana ndipo zimakhala zovuta kuzizindikira. Zizindikiro zake ndi izi:

• Kuwonongeka kwa mtima, kumayambitsa matenda am'mimba kapena matenda a valavu
• Matenda apakatikati amanjenje (neurosyphilis)
• Zotupa za khungu, mafupa, kapena chiwindi

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro. Mayeso omwe angachitike ndi awa:

• Kuyesa kwamadzimadzi kuchokera pachilonda (osachitidwa kawirikawiri)
• Echocardiogram, aortic angiogram, ndi catheterization yamtima kuti muwone mitsempha yayikulu yamagazi ndi mtima
• Kugwiritsa ntchito msana ndikuwunika msana wam'mimba
• Kuyezetsa magazi kuti muwonetse mabakiteriya a syphilis (RPR, VDRL, kapena TRUST)

Ngati kuyesa kwa RPR, VDRL, kapena TRUST kuli koyenera, chimodzi mwazoyeserera izi chidzafunika kutsimikizira kuti ali ndi matendawa:

• FTA-ABS (kuyesa kwa fluorescent treponemal antibody)
• MHA-TP
• TP-EIA
• TP-PA

Syphilis imatha kuchiritsidwa ndi maantibayotiki, monga:

• Penicillin G benzathine
• Doxycycline (mtundu wa tetracycline woperekedwa kwa anthu omwe matupi awo sagwirizana ndi penicillin)

Kutalika kwa chithandizo kumadalira momwe syphilis ilili, komanso zinthu monga thanzi la munthuyo.

Kuchiza chindoko panthawi yapakati, penicillin ndi mankhwala osankhika. Tetracycline singagwiritsidwe ntchito ngati mankhwala chifukwa ndi owopsa kwa mwana wosabadwa. Erythromycin sangalepheretse chindoko chobadwa mwa mwana. Anthu omwe matupi awo sagwirizana ndi penicillin ayenera kukhala opanda chidwi nawo, kenako amathandizidwa ndi penicillin.

Maola angapo atalandira chithandizo cha matenda oyamba a chindoko, anthu atha kukhala ndi vuto la Jarisch-Herxheimer. Izi zimachitika chifukwa cha chitetezo cha mthupi kuzinthu zowonongeka za matendawa osati chifukwa cha mankhwalawa.

Zizindikiro za izi zimaphatikizapo:

• Kuzizira
• Malungo
• Kumva kudwala (malaise)
• Mutu
• Kupweteka kwa minofu ndi molumikizana
• Nseru
• Kutupa

Zizindikirozi nthawi zambiri zimatha pasanathe maola 24.

Kuyezetsa magazi kwotsatira kumayenera kuchitika miyezi itatu, 6, 12, ndi 24 kuti matenda athe. Pewani kugonana pamene chancre alipo. Gwiritsani ntchito kondomu mpaka kuyezetsa kotsatira kawiri kukuwonetsa kuti matendawa adachiritsidwa, kuti muchepetse mwayi wopatsirana.

Onse ogonana nawo omwe ali ndi chindoko amayeneranso kuthandizidwa. Chindoko chimatha kufalikira mosavuta mu magawo oyambira ndi apamwamba.

Chindoko choyambirira ndi chachiwiri chimatha kuchiritsidwa ngati chingapezeke koyambirira komanso kuchiritsidwa kwathunthu.

Ngakhale kuti syphilis yachiwiri imatha pakatha milungu ingapo, nthawi zina imatha chaka chimodzi. Popanda chithandizo, gawo limodzi mwa magawo atatu a anthu amakhala ndi zovuta za syphilis mochedwa.

Chindoko chakumapeto chimatha kulepheretseratu ndipo chitha kupha.

Zovuta za chindoko zitha kuphatikizira izi:

• Mavuto amtima (aortitis ndi aneurysms)
• Zilonda zowononga za khungu ndi mafupa (gummas)
• Matenda osokoneza bongo
• Syphilitic myelopathy - vuto lomwe limakhudza kufooka kwa minofu ndikumverera kachilendo
• Syphilitic meningitis

Kuphatikiza apo, syphilis yachiwiri yosalandiridwa panthawi yapakati imatha kufalitsa matendawa kwa mwana yemwe akukula. Izi zimatchedwa kobadwa nako chindoko.

Itanani kuti mudzakumane ndi wothandizira zaumoyo wanu ngati muli ndi zizindikiro za chindoko.

Lumikizanani ndi omwe amakupatsani, kapena kuti mukawunikidwe kuchipatala cha matenda opatsirana pogonana ngati muli:

• Anali kulumikizana kwambiri ndi munthu yemwe ali ndi chindoko kapena matenda ena opatsirana pogonana
• Kuchita zogonana zilizonse zowopsa, kuphatikiza kukhala ndi zibwenzi zingapo kapena osadziwika kapena kugwiritsa ntchito mankhwala osokoneza bongo

Ngati mukugonana, yesetsani kugonana motetezeka ndipo nthawi zonse mugwiritse ntchito kondomu.

Azimayi onse ayenera kuyezetsa chindoko.

Chindoko chachikulu; Chindoko Secondary; Chindoko mochedwa; Chindoko apamwamba; Treponema - chindoko; Lues; Matenda opatsirana pogonana - chindoko; Matenda opatsirana pogonana - syphilis; STD - chindoko; Opatsirana pogonana - chindoko

• Chindoko chachikulu
• Ziwalo zoberekera za abambo ndi amai
• Chindoko - yachiwiri pa kanjedza
• Chindoko chakumapeto

Ghanem KG, Hook EW. Chindoko. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 303.

Radolf JD, Tramont EC, Salazar JC. Chindoko (Treponema pallidum). Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 237.

Stary G, Stary A. Matenda opatsirana pogonana. Mu: Bolognia JL, Schaffer JV, Cerroni L, olemba. Matenda Opatsirana. Wolemba 4. Philadelphia, PA: Elsevier; 2018: mutu 82.