系统病理学 (33)系统病理学.pdf

Syphilis and AIDS n Sexually transmitted diseases Ø Syphilis Ø AIDS Ø Gonorrhea Ø Condyloma acuminata Ø ... AIDS Acquired Immunity Deficiency Syndrome n Introduction Ø Venereal (sexually-transmitted) disease Ø Trep onema p allidum (T. p allidum) Ø The name origin of ‘syphilis’ n Etiology T. p allidum n Transmission routes Ø Sexual intercourse → glans penis, vulva, vagina and cervix Ø Intimate person-to-person contact →lips, tongue or fingers Ø Transfusion of infected blood Ø Vertical transmission by placenta n Pathogenesis Host immune response Ø Nontreponemal antibodies - positive in early disease Ø Treponemal antibodies -positive later, but indefinitely Serologic testing (RPR/VDRL tests) -Diagnostic mainstay n Basic pathological changes Proliferative endarterities and periarterities Long arrows: Vascular lesion; Short arrows: Plasma cells n Primary syphilis Ø Chancre Ø Regional lymphadenitis n Secondary syphilis Ø Generalized maculopapular skin rash Ø Generalized lymph nodes enlarged n Tertiary sphilis Ø Syphilitic gumma Ø Diffuse lesions l Cardiovascular syphilis （80% ） l Neurosyphilis （10% ，mainly in HIV positive cases ） n Gumma n Congenital syphilis n Brief overview Ø Sexual transmitted disease Ø Etiology: HIV Ø Injury of the host: immunosuppression n Etiology n Transmission routes Ø Sexual contact Ø Intravenous injection with shared needles Ø Transfusion of blood products Ø Vertical transmission by placenta n Pathogenesis n Immune deficiency n