Differential Diagnosis of Syphilis

A. The differential diagnosis of SI (Syphilis I)
        Basic diagnosis of S I as follows. In history it is known mass of incubation; there is no constitutional symptoms, as well as local symptoms ie no pain. In primary affective important there is erosion / ulceration were clean, Solitar, round / oval, regular, with indolent induration: T. pallidum positive. The disorder can be painful if accompanied by secondary infection. Regional nodes may be enlarged, indolent, no groups, no periadenitis, without suppuration. Serologic test after a few weeks of weak positive reaction.

Syphilis Classification and Clinical Manifestations

According to the WHO, syphilis classification are early and late syphilis, with the time difference between the two is two years, and some even say four years. This classification is based on epidemiological considerations. Early syphilis can transmit the disease due to there is Treponema pallidum in skin disorders. Late Syphilis is no longer contagious because there are no bacteria in the lesion. In pregnant women, Treponema pallidum can enter the body of the fetus.

Pathogenesis of Syphilis


A. Early Stage

         In acquired syphilis T.pallidum get into the skin through a micro-lesions or mucous membranes, usually through sex. The germs multiply, tissue reacts by forming infiltrates consisting of lymphocytes and plasma cells, particularly in the perivascular, small blood vessels proliferate, T.pallidum and surrounded by inflammatory cells. Treponema is located between the capillary endothelium and perivascular tissue around it. Loss of bleeding will cause erosion, on clinical examination appear as SI.

Syphilis and Etiology

Syphilis in Penis Male
Syphilis Ulcer in Male
Syphilis is an infectious disease which caused by Treponema pallidum. its a chronic and systemic diseases which during the course of the disease can affect all organs of the body. There is a latency period without manifestations of lesions in the body. Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex.

Medical Treatment Therapy for Viral Encephalitis

a. General Therapy:
1 Bed rest total.
2 When the estimated infection due to enteroviruses personal hygiene should be observed.
3 Headache and high heat necessary to handle the administration of antipyretics to be given acetaminophen / paracetamol.

Clinical Manifestations of Viral Encephalitis

      Encephalitis can be a part of systemic diseases such as varicella or measles, by itself is the first manifestation of disease symptoms initially. If the encephalitis is not a part of a systemic viral disease, it is likely to be found complaints that precedes neurological syndrome include headache, weakness or malaise, myalgia, complaints of upper respiratory tract disorders and fever.

Pathophysiology of Viral Encephalitis

Pathophysiology of Viral Encephalitis
Viral infection of the central nervous system can be in several ways:
1 Invasion directly through anatomical barrier.
a. Scalp, skull and dura mater forming an effective barrier against infection directly from the surrounding environment. Infection with the direct path is usually due to trauma or surgery wounds.
2. axonal transport by neurons of the peripheral.
a. Neurons can be road traffic from and to the "Cell Body" and antegrade and retrograde transport systems, such as rapid retrograde transport an average of 200-300 mm / day, for example, the herpes simplex virus and varicella zozter are transported of replication in skin and mucosa by sensory fibers to the dorsal nerve roots.
3 The entrance of respiratory tract pass through the olfactory epithelium.
a. How to enter the organism in the olfactory mucosa through the apical process of nerve cell receptors that stand out on the edge of the epithelium as "olfactory rads", so that the particle is placed on the olfactory mucosa can be taken by pinocytic vesicles and transported to the olfactory bulb.
4 Infection through blood vessels pass through the capillary endothelium or epithelial plexus choroideus.

Etiology of Viral Encephalitis

Various Etiology of Viral Encephalitis:
a. Epidemic Viral infection :
1. Group enteroviruses, = poliomyelitis, coxsackie virus, ECHO virus.
2. Group Arbo virus, = equire western encephalitis, St. louis encephalitis, Eastern equireencephalitis, Japanese B encephalitis, Murray valley encephalitis
b. Sporadic Viral infections : rabies, herpes zoster, lymphogranuloma, mumps, limphotic, choriomeningitis and other types that are considered caused by a virus but it is not yet clear.
c. Post-infection encephalitis, post morbili, post-varicella, rubella post, post-vaccinia, pascamononucleosis, infectious and other types of respiratory tract infections that follow are not specific.
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