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"code": "A65",
"name": "Невенерический сифилис",
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"lead": "Нарушение здоровья, относящееся к группе другие болезни, вызываемые спирохетами",
"description": "Невенерический сифилис – инфекционное заболевание, которое характеризуется поражением кожи, слизистых оболочек, костей и суставов, но без патологии внутренних органов и нервной системы.",
"etiology": "<p>Возбудитель невенерического сифилиса – один из подвидов грамотрицательной спирохеты вида Бледная трепонема, а именно – Treponema pallidum endemicum. Спирохеты имеют штопорообразную извитую форму. Спор, капсул, жгутиков не образуют. Спирохеты обладают активной подвижностью вследствие выраженной гибкости их тела.</p>\r\n<p>Источником инфекции является больной человек. Инфицирование происходит при неполовых контактах с больным, а также через бытовые вещи. Распространению болезни способствует низкий санитарно-гигиенический уровень культуры. Чаще болеют дети.</p>",
"pathogenesis": "<p>В месте внедрения возбудителя появляется первичный аффект (беджелоидный шанкр), который проявляется незначительными воспалительными явлениями на едва гиперемированном отечном основании. Воспалительные явления в лимфатических сосудах и узлах при этом отсутствуют. В результате слабой местной тканевой реакции и анергичного состояния регионарных лимфатических узлов происходит более активное проникновение спирохет в кровь (спирохетемия), распространяясь в кожу и слизистые оболочки. В короткие сроки образуются вторичные беджелиды. Они диссеминированные, множественные, симметричные и полиморфные: розеолезно-папулезные, пустулезные и кондиломатозные.</p>",
"diagnostics": "<p>Диагностика беджеля основывается на типичной клинической картине, учете возраста, эпидемиологической обстановки и нахождении Т. pallidum в материале из свежих высыпаний кожи и слизистых оболочек в темном поле зрения. Большое значение для диагностики могут иметь результаты серологических исследований крови. При беджеле реакция Вассермана, осадочные реакции, а также РИБТ, РИФ дают положительный результат. </p>",
"treatment": "<p>Лечение больных эндемическим сифилисом, а также контактировавших с ними лиц проводится препаратами пенициллина пролонгированного действия. При противопоказаниях к применению пенициллина лечение проводится эритромицином или тетрациклином.</p>\r\n<p>Если болезнь перешла в третичную стадию, могут понадобиться восстанавливающие хирургические операции.</p>",
"prevention": "<p>Профилактика эндемического сифилиса включает:</p>\r\n<ul>\r\n<li>Своевременное выявление больных детей, изоляция их от здоровых и проведение соответствующего лечения.</li>\r\n<li>Клинико-серологическое обследование всех членов семей и лиц, находившихся в тесном контакте с больным, для выявления активных и латентных форм заболевания.</li>\r\n<li>Превентивное лечение всех контактировавших лиц с больными беджелем.</li>\r\n<li>Улучшение жилищно-бытовых условий, повышение санитарной культуры населения.</li>\r\n</ul>\r\n<p> </p>",
"clinical_picture": "<p>Течение невенерического сифилиса включает в себя отдельные стадии.</p>\r\n<p>В раннюю стадию входят инкубационный период (от 1-2 недель до 3 месяцев), а также первичные и вторичные высыпания. Поздняя (третичная) стадия включает гуммы (характерные узлы в тканях, где происходит их разрушение; язвы, после которых остаются заметные рубцы).</p>\r\n<p>Сначала в том месте, через которое возбудитель проник в организм, появляется беджелоидный шанкр (язвочка). Затем образуются высыпания на слизистой оболочке рта, а также в районе гениталий и заднего прохода. Они имеют склонность к мацерации (мокнут).</p>\r\n<p>Далее проявления болезни распространяются на кожу туловища и конечностей. Это буро-красные высыпания, которые шелушатся и сильно зудят. Подобные высыпания при отсутствии лечения держатся от полугода до года.</p>\r\n<p>После этого обычно следует третичная стадия: часть высыпаний преобразуется в гуммозные (узловатые или язвенные) высыпания. На этой стадии заражение уже менее вероятно, однако третичные беджелиды очень болезненны и несут опасность для самого больного. На этой стадии болезнь глубоко поражает подкожную основу, кости, суставы, сухожилия. Образуются обширные язвы со свищевыми ходами и гнойными выделениями. При локализации в области конечностей возникают беджелоидные остеомиелиты, разрешающиеся инвалидизирующими рубцами. Часто в связи с провоцирующим травматизирующим действием недоброкачественной пищи гуммозно-язвенные очаги локализуются в области рта, глотки, проникая в ткани неба, носа.</p>",
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"pathogenesis": "<p>Проникают трепанемы через поврежденные участки кожи и слизистые оболочки. Затем они локализуются преимущественно в роговом слое эпидермиса, где развивается гиперпигментация, утолщение кожи, межклеточный отек. Также происходит нарушение пигментной функции, так как наблюдается гибель меланоцитов. Поражаются регионарные лимфатические узлы. В поздней стадии развивается очаговая атрофия эпидермиса. </p>",
"diagnostics": "<p>Диагноз пинты основываются на появлении характерных пятен на коже и стадийности их изменений без нарушения общего состояния, за исключением кожного зуда. Диагноз подтверждается обнаружением в соскобах кожи трепонем; в поздних стадиях болезни становится положительной реакция Вассермана. </p>\r\n<p>Применяются серологические реакции, реакции иммунофлюоресценции - обнаруживаются специфические антитела к трепонеме. </p>",
"treatment": "<p>Лечение проводят дюрантным и препаратами пенициллина, типа бициллина, или новыми препаратами – экстенциллнн, ретарпен и др. Детям и взрослым, контактировавшим с больными, проводят профилактическое лечение бициллином.</p>",
"prevention": "<p> </p>\r\n<p>Профилактические мероприятия сводятся к выявлению и лечению больных и лиц, находящихся с ними в тесном контакте. Специфической профилактики не разработано. </p>",
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}
