23.传染病-2Sexually transmitted diseases, STD.ppt

Sexually transmitted diseases, STD Syphilis 梅毒 Gonorrhea 淋病 Condyloma acuminatum 尖锐湿疣 AIDS Gram stain of urethral discharge from a patient with gonorrhea淋病. Many Gram-negative diplococci (Neisseria gonorrhoeae) are present within a neutrophil.  Condyloma acuminatum of the penis Condyloma acuminatum of the penis. Low magnification reveals the papillary (villous) architecture. Condyloma acuminatum of the penis. The epithelium shows vacuolization (koilocytosis), characteristic of human papillomavirus (HPV) infection. Condyloma acuminatum 1 表皮疣状乳头状增生 2 表皮角化不全角质层增厚 3 棘层增厚 4 基底层增生 5 上皮角延长增宽，假上皮瘤样增生 6 挖空细胞形成 7 真皮血管扩张上移 8 慢性炎细胞浸润 Syphilis is divided into three stages, which have distinct clinical and pathologic manifestations.  1. 一期 Chancre下疳/obliterative endoartertis 2-6w 2. 二期 Syphilid梅毒疹/ obliterative endoartertis 8-10w 3. 三期 Gumma 树胶样肿/syphiloma 梅毒瘤 4-5y 心血管 Syphilitic aortitis/aortic aneurysm/cor bovinum 中枢神经 Meningovascular syphilis/paretic dementia/tabes dorsalis 肝 Hepar lobatum 骨 Saddle nose AIDS/HIV 110 Homosexual or bisexual men constitute by far the largest group, accounting for over 50% of the reported cases. This includes ～5% who were intravenous drug abusers as well. Transmission of AIDS in this category is on the decline: currently, about 42% of new cases can be attributed to male homosexual contacts. Intravenous drug abusers with no previous history of homosexuality are the next largest group, representing about 25% of infected individuals. They represent the majority of cases among heterosexuals. Hemophiliacs, especially those who received large amounts of factor VIII or factor IX concentrates before 1985, make up ～0.5% of all cases. Recipients of blood and blood components who are not hemophiliacs but who received transfusions of HIV-infected whole blood or components (e.g., platelets, plasma) account for ～1% of patients. (Organs obtained from HIV-infected donors can also transmit AIDS.) Heterosexual c