Ugcunsula

Ugcunsula ukutheleleka kwamagciwane okuvame ukusabalala ngokuxhumana ngokocansi.

Ugcunsula yisifo esithathelwana ngocansi (STI) esibangelwa yigciwane I-Treponema pallidum. Leli bhaktheriya lidala ukutheleleka uma lingena esikhunjeni esiphukile noma ulwelwesi lwamafinyila, imvamisa izitho zangasese. Ugcunsula uvame ukudluliswa ngokuxhumana ngocansi, yize kungadluliselwa nangezinye izindlela.

Ugcunsula lwenzeka emhlabeni wonke, ikakhulukazi ezindaweni ezisemadolobheni. Inani lamacala likhuphuka ngokushesha kwabesilisa abalala nabesilisa (MSM). Abantu abadala abasebasha abaneminyaka engama-20 kuya kwengama-35 yibona bantu abasengozini enkulu. Ngoba abantu bangahle bangazi ukuthi bane-syphilis, izifundazwe eziningi zidinga ukuhlolwa kwegcunsula ngaphambi komshado. Bonke abesifazane abakhulelwe abathola ukunakekelwa ngaphambi kokubeletha kufanele bahlolwe ugcunsula ukuvimbela ukutheleleka ekudluliseleni ezinganeni zabo ezisanda kuzalwa (i-syphilis yokuzalwa).

Ugcunsula unezigaba ezintathu:

• Ugcunsula oyinhloko
• Ugcunsula wesibili
• I-syphilis ephakeme (isigaba sokugcina sokugula)

Ugcunsula wesibili, ugcunsula osezingeni eliphakeme, nogcunsula wokuzalwa azibonwa kaningi e-United States ngenxa yemfundo, ukuhlolwa nokwelashwa.

Isikhathi sokufukamela ugcunsula oyinhloko izinsuku eziyi-14 kuye kwezingu-21. Izimpawu ze-syphilis eyinhloko yilezi:

• Isilonda esibuhlungu esincane noma esibuhlungu (esibizwa nge-chancre) esithweni sangasese, emlonyeni, esikhunjeni, noma ku-rectum esiziphilisa ngokwaso emavikini amathathu kuya kwayisithupha
• Ama-lymph node akhulisiwe endaweni yesifo

Amagciwane aqhubeka nokukhula emzimbeni, kepha zimbalwa izimpawu kuze kube isigaba sesibili.

Izimpawu zikagcunsula wesibili ziqala emavikini angu-4 kuya kwayi-8 ngemuva kogcunsula oyinhloko. Izimpawu zingafaka:

• Ukuqhuma kwesikhumba, imvamisa ezintendeni zezandla naphansi kwamathe ezinyawo
• Izilonda ezibizwa ngokuthi ama-mucous patches emlonyeni noma ngaphakathi, emlonyeni, esithweni sangasese sowesilisa noma kowesilisa
• Amachashazi aminyene, anezinwele (abizwa ngokuthi ama-condylomata lata) ezithweni zangasese noma emapulangweni esikhumba
• Imfiva
• Ukuzizwa okuvamile
• Ukuphelelwa isifiso sokudla
• Ubuhlungu bemisipha namalunga
• Ama-lymph node avuvukile
• Umbono uyashintsha
• Ukulahleka kwezinwele

Ugcunsula obuphakeme bukhula kubantu abangalashwa. Izimpawu zincike ekutheni yiziphi izitho ezithintekile. Ahlukahluka kakhulu futhi kungaba nzima ukuwathola. Izimpawu zifaka:

• Ukulimala kwenhliziyo, kubangele ama-aneurysms noma isifo se-valve
• Izinkinga zesistimu yezinzwa eziphakathi (i-neurosyphilis)
• Izimila zesikhumba, amathambo, noma isibindi

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu. Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa koketshezi oluvela kwesilonda (akuvamile ukwenziwa)
• I-Echocardiogram, i-aortic angiogram, ne-catheterization yenhliziyo ukubheka imithambo yegazi enkulu nenhliziyo
• Ukuthinta umgogodla nokuhlola uketshezi lomgogodla
• Ukuhlolwa kwegazi ukuvivinya amagciwane kagonyovu (RPR, VDRL, noma i-TRUST)

Uma ukuhlolwa kwe-RPR, i-VDRL, noma i-TRUST kutholakele kahle, okunye kokuhlolwa okulandelayo kuzodingeka ukuqinisekisa ukuxilongwa:

• I-FTA-ABS (isivivinyo se-fluorescent treponemal antibody)
• I-MHA-TP
• I-TP-EIA
• TP-PA

Ugcunsula ungelashwa ngama-antibiotic, njenge:

• IPenicillin G benzathine
• I-Doxycycline (uhlobo lwe-tetracycline olunikezwa abantu abaphikisana ne-penicillin)

Ubude bezokwelapha buxhomeke ekutheni ugcunsula ubucayi kangakanani, nezinto ezifana nempilo yomuntu jikelele.

Ukwelapha ugcunsula ngesikhathi sokukhulelwa, i-penicillin yisidakamizwa ozikhethelayo. I-Tetracycline ayinakusetshenziswa ekwelashweni ngoba iyingozi enganeni engakazalwa. I-Erythromycin kungenzeka ingavimbeli ugcunsula obelethwe enganeni. Abantu abangenwe i-penicillin kufanele bangayizwa, bese belashwa nge-penicillin.

Amahora ambalwa ngemuva kokuthola ukwelashwa ngezigaba zokuqala zikagcunsula, abantu bangathola ukusabela kweJarisch-Herxheimer. Le nqubo idalwa ukuphendula komzimba ekuqhekekeni kwemikhiqizo yokutheleleka hhayi ukusabela okweqile kumagciwane.

Izimpawu nezimpawu zalokhu kusabela zifaka:

• Amakhaza
• Imfiva
• Ukuzizwa okujwayelekile (malaise)
• Ubuhlungu bekhanda
• Ubuhlungu bemisipha namalunga
• Isicanucanu
• I-Rash

Lezi zimpawu zivame ukunyamalala kungakapheli amahora angama-24.

Ukuhlolwa kwegazi okulandelwayo kufanele kwenziwe ezinyangeni ezi-3, 6, 12, nezingama-24 ukuqinisekisa ukuthi ukutheleleka sekuphelile. Gwema ukuxhumana ngokocansi lapho i-chancre ikhona. Sebenzisa amakhondomu kuze kube ukuhlolwa okubili okulandelile okukhombisile ukuthi ukutheleleka kuselaphekile, ukunciphisa amathuba okudlulisa ukutheleleka.

Bonke abalingani bobulili bomuntu one-syphilis kufanele nabo baphathwe. Ugcunsula bungasakazeka kalula ezigabeni zokuqala nezesibili.

Ugcunsula oluyisisekelo nolwesibili lungalapheka uma lutholakale kusenesikhathi lelashwa ngokuphelele.

Yize ugcunsula wesibili uvame ukuhamba kungakapheli amasonto, kwezinye izimo kungahlala unyaka owodwa. Ngaphandle kokwelashwa, kuze kufike kwengxenye eyodwa kwezintathu zabantu bazoba nezinkinga sekwephuzile.

Ugcunsula okwenzeka ngemuva kwesikhathi lungakhubaza unomphela, futhi kungaholela ekufeni.

Izinkinga ze-syphilis zingafaka:

• Izinkinga zenhliziyo (i-aortitis kanye nama-aneurysms)
• Izilonda ezibhubhisayo zesikhumba namathambo (ama-gummas)
• I-Neurosyphilis
• I-Syphilitic myelopathy - inkinga ebandakanya ubuthakathaka bemisipha nemizwa engajwayelekile
• I-syphilitic meningitis

Ngaphezu kwalokho, ugcunsula wesibili ongalashwa ngesikhathi sokukhulelwa ungasabalalisa lesi sifo enganeni ekhulayo. Lokhu kubizwa nge-syphilis yokuzalwa.

Shayela i-aphoyintimenti nomhlinzeki wakho wezokunakekelwa kwezempilo uma unezimpawu ze-syphilis.

Futhi xhumana nomhlinzeki wakho, noma uhlolwe emtholampilo we-STI uma une:

• Ubunobudlelwano obuseduze nomuntu onegcunsula noma enye i-STI
• Ukuzibandakanya kunoma iyiphi imikhuba yezocansi enobungozi obukhulu, kufaka phakathi ukuba nabalingani abaningi noma abangaziwa noma ukusebenzisa izidakamizwa ezifakwa emithanjeni

Uma uya ocansini, zijwayeze ukwenza ucansi oluphephile futhi usebenzise ikhondomu njalo.

Bonke abesifazane abakhulelwe kufanele bahlolwe ugcunsula.

Ugcunsula Primary; Ugcunsula Secondary; Ugcunsula Late; Ugcunsula ephakeme; Treponema - ugcunsula; Ama-Lues; Izifo ezithathelwana ngocansi - ugcunsula; Ukutheleleka ngocansi - ugcunsula; STD - ugcunsula; I-STI - ugcunsula

• Ugcunsula oyinhloko
• Izinhlelo zokuzala zabesilisa nabesifazane
• Ugcunsula - okwesibili ezintendeni zezandla
• Ugcunsula osezingeni eliphezulu

UGhanem KG, Hook EW. Ugcunsula. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 303.

URadolf JD, iTramont EC, uSalazar JC. Ugcunsula (I-Treponema pallidum). Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 237.

I-Stary G, i-Stary A. Izifo ezithathelwana ngocansi. Ku: Bolognia JL, Schaffer JV, Cerroni L, ama-eds. Isikhumba. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2018: isahluko 82.