Time of manifestation of syphilis. Symptoms of syphilis: a complete overview of the possible manifestations

Syphilism is one of the most common sexually transmitted diseases (STDs). The causative agent of the disease is the bacterium Treponema pallidum. Modern medicine easily copes with this disease, but if the patient is not treated, then he will face a slow and painful death with a wide range of symptoms.

As of 2014, 26 people per 100,000 people in our country have syphilis. The incidence of venereal diseases is decreasing slowly, so the state is engaged in informing the population about STDs. Awareness in the prevention of STDs helps to avoid serious health problems for both young people and adults.

Symptoms of a syphilitic infection

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person does not know about the infection, as he does not have any signs of illness. Even most tests cannot detect the disease at this stage. There is a high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of their actions.
The first signs of the disease appear at the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of a hard chancre, multiple chancre, syphilitic rash, baldness (skin syphilides) and on the mucous membranes - chancres in the mouth, on the genitals, rashes on the mucous membranes (syphilides of the mucous membranes).

Symptoms of a syphilitic infection in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). A hard chancre is formed at the sites of bacteria entry. Its appearance gives a countdown to the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of pale treponema. It is localized in the mouth, in the area of ​​​​the external and internal genital organs, in the anus.

A hard chancre is an inflammatory outgrowth of a rounded shape with a flat base. In the initial stages of its appearance, it practically does not hurt. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre on visible places of the body and on the mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a hard chancre. The ulcer is formed more often on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, in the anus. The symptoms and course of the disease are practically the same in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest itself in women

• The primary stage of sifaka in women begins with the detection of a hard chancre on the skin or mucous membranes. At the initial stage, this does not cause serious discomfort. Then there is a gradual inflammation of the chancre, it takes on a red or cyanotic color, characteristic of a strong inflammatory process.
• During the first week after the onset of the first symptoms in women, inflammation of the lymph nodes and blood vessels begins next to the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of tangles, forming significant edema and swelling around the hard chancre. When the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, which complicates the process of swallowing and breathing. The symptoms cause considerable distress during verbal communication and eating. Scleradenitis in the genital area makes it difficult to walk and defecate.

Photo: Jarun Ontakrai/Shutterstock.com

The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient's body. Modern diagnostic methods make it possible to detect syphilism immediately after the first symptoms appear. The most commonly used enzyme immunoassay (ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist in a clinic or a venereologist in a skin and venereal dispensary. The average cost of the analysis is 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will show nothing but a seronegative reaction, indicating the absence of pale treponema in the body.

Symptoms of secondary syphilis

• The skin around the chancre is covered with spots and ulcers up to 15 mm in diameter. The rash can grow and combine into large areas on the skin and mucous surfaces, causing severe discomfort to the patient. There are three types of syphilitic rash.
  Roseolous rash - pink or red spots with clear or blurry borders 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
  Papular rash - small conical growths of pink color. Can peel off at the top of the cone. It looks like such a raw material is extremely unpleasant.
  Pustular rash - growths with purulent cavities.
• Along with the appearance of a rash, damage to the nervous system can begin. Degradation of the nervous tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, the treatment of the disease will not lead to the restoration of the lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
• There are signs of partial or complete baldness. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, thins, thins. Then the thinning of the hair intensifies, extensive bald patches of skin appear. After treatment for syphilis, the hairline does not regenerate.

Stages of syphilis

In our time, every person infected with pale treponema can quickly and efficiently receive adequate and effective treatment. Only a few pass through all stages of syphilis. Without treatment, a person lives in terrible agony for 10 or even 20 years, after which he dies.
The following is a brief description of the stages of syphilis.
Stage of the incubation period

Stage of primary syphilis

Stage of secondary syphilis. It is divided into four stages of the course of the disease. In the absence of adequate treatment, the order will be something like this:

Stage of tertiary syphilis. It is divided into three stages of the course of the disease. In the absence of adequate treatment, the order will be as follows:

Neurosyphilis begins towards the end of secondary syphilis. It usually manifests itself in the form of the following diagnoses:

• Asymptomatic neurosyphilis - in which there are no painful manifestations yet, but tests already show inflammation and infection of the cerebrospinal fluid. This stage of neurosyphilis usually begins a year and a half after infection.
• Hummous neurosyphilis - accompanied by the formation of gums inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, causes an increase in pressure inside the patient's skull.
• Syphilitic meningitis is a lesion of the meninges of the brain at the base and in the region of the cranial vault. Accompanied by severe symptoms, including impaired attention, thinking, memory, emotional sphere of a person.
• Meningovascular form of neurosyphilis - destroys the vessels of the brain, accompanied by chronic meningitis. In the absence of therapy, it leads to headaches, personality and behavior change, sleep is disturbed, convulsions begin. This eventually leads to strokes.
• Tencus dorsalis - a violation of the nerve fibers of the spinal cord, their thinning and dysfunction. This leads to an irreversible impairment of the ability to move in space: the gait is bent, the patient may fall, losing the feeling of the ground under his feet. When closing the eyes, orientation in space is lost.
• Progressive paralysis - causes a violation of the functions of the central nervous system, accompanied by a violation of the personality, behavior dangerous for society, degrades all higher mental functions. A person turns into a lunatic and can easily end up in a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
• Optic nerve atrophy is the degradation of visual function. At first, the vision of only one eye deteriorates, but gradually the infection approaches the second optic nerve. Leads to total blindness if left untreated. Changes in the visual apparatus are irreversible.
• Late visceral syphilis - degradation of the tissues of internal organs. Basically, the cardiovascular system and the liver suffer. Other organs are rarely affected. Patients complain of a deterioration in well-being at the slightest load, they develop systolic heart murmurs due to aortic dilation. With the localization of late visceral syphilis in the heart, a heart attack can occur.
• Late syphilism of bones and joints - causes local expansion of bones and large joints. Accompanied by the formation of gum on the bones.

Atypical syphilis

In addition to the hard chancre, others can also appear at the stage of primary syphilis, the so-called. atypical chancres. That is why this variant of the development of the disease is called atypical syphilis. Atypical chancres are of the following types:

• Inductive edema.
  It looks like a change in the color of the scrotum in men, the clitoris and labia in women. The color varies from scarlet to bluish in the center, turning pale at the edges of the edema. Women are more susceptible to this symptom than men. Usually, the patient perceives indurated syphilitic edema as an infectious and inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the true cause of the edema. It can be distinguished from another infection by the absence of an inflammatory process in the blood and by the presence of inflammation of the lymph nodes.
• Chancre felon.
  May appear in people caring for patients with syphilis: medical personnel, relatives. The thumb, index and middle fingers are affected. This is a very painful attack. The skin lags behind the fingers, exposing large areas of bleeding, as in second-degree burns. Panaritium is also accompanied by swelling and inflammation of the fingers, which interfere with the normal functioning of a person. Often appears together with a hard chancre of the genital organs.
• Chancre-amygdalite.
  It manifests itself in the form of inflammation of one tonsil, and its surface is not disturbed, it remains smooth. The oral cavity is subjected to severe pain, the process of swallowing is difficult. The patient experiences a fever, as in a sore throat. The difference from angina is that with amygdalitis, only one tonsil becomes inflamed.

congenital syphilis

The transmission of the disease by the mother during pregnancy is highly undesirable. The fetus is exposed to pale treponema, which leads to irreversible morphological consequences, impaired intrauterine development.
Medicine knows three main symptoms:

• • Parenchymal keratitis is a pathology of the external epithelium of the internal organs and the eyeball. It manifests itself in the form of severe redness and inflammation of the organ from the outside. Sometimes inflammation penetrates a little deeper into the surface. After treatment, scars remain, a thorn may remain on the eyes. The most common consequence for the eye is a decrease in visual acuity. Keratitis is accompanied by clouding of visual perception, acute pain, lacrimation.
  • Deafness from birth. The causative agent of syphilis actively destroys the nervous tissue of the fetus during pregnancy. One of the options may be the pathology of the auditory nerve, which leads to irreversible deafness.
  • Congenital anomalies of teeth. Occur due to underdevelopment of tooth tissues during fetal development. This pathology is called Hutchinson's teeth. The teeth grow in the form of a screwdriver with a rounded notch on the cutting edge, rarely planted. Sometimes the teeth are not completely covered with enamel. Which leads to their early destruction and impartial appearance.

A child who has had intrauterine syphilis has poor health even if the mother has successfully completed the course of treatment. If adequate treatment is not followed, then the child will have severe deformities and remain disabled for life. When a mother is infected with syphilis, breastfeeding of the child should be stopped immediately, since syphilis is transmitted through mother's milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for treponema pallidum (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide on pregnancy.

The causative agent of syphilis

Treponema pallidum (Treponema pallidum) is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common sexually transmitted diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to a quick cure for syphilis, and they also opened the way to the invention of methods for early diagnosis of the disease.

Exciter properties

The bacterium was called pale due to the fact that for a long time scientists could not see it through a microscope. The transparent color of treponema is difficult to stain in other colors for further research. For staining, the Romanovsky-Gizma and silver impregnation methods are used, which make it possible to detect a bacterium under a dark-field microscope for further study.
It was found that under favorable conditions (it should only be a human or animal body), pale treponema divides every 30 hours. The weak point of pale treponema is that it lives and reproduces only at a temperature of 37 ° C. This explains the effectiveness of archaic methods of treating syphilis, when, by artificially raising the patient's body temperature to 41 ° C with the help of malaria, some relief of the symptoms of the underlying disease occurred.
The length of the bacterium is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, its body forms curls in the form of a ball. At the same time, he constantly changes the shape and number of curls due to the ability to contract the cells of pale treponema.

Incubation period

Getting into the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Sharing at a rate of about once every 30 hours, it accumulates at the site of infection. There are no visible symptoms. About a month later, a hard chancre is formed on the body, combined with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of immunity in different patients is different, which makes a large variation in the length of the initial period of infection. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases sexually. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. A hard chancre is formed at the site of entry of bacteria.

When caring for the sick, infection is likely through contact with the patient's clothes, his personal belongings, and his body. In this case, a chancre panaritium appears, affecting the fingers and toes. This is one of the most painful symptoms in the primary syphilis stage. Then a hard chancre of the genitals may appear.
Syphilis can also be transmitted through the blood. When transfusing infected blood, when reusing the patient's syringe, his razor, scissors, dishes.

How to treat syphilis

Treatment should begin at the first sign of syphilis. So the recovery process will be as fast as possible. Since the 1950s, antibiotics have been used in the treatment of syphilis. Drugs based on penicillin were used. Nowadays, preparations based on it are also used, since pale treponema does not know how to adapt to this type of antibiotics. Sufficient doses of penicillin effectively fight the disease. For the treatment of syphilis in patients with allergic reactions to penicillin, use erythromycin or tetracycline.
If the course of the disease has reached neurosyphilis, then the treatment becomes more complicated. Add pyrotherapy (artificial increase in body temperature) and intramuscular injection of antibacterial drugs.

In tertiary syphilis, along with antibiotics, highly toxic drugs based on bismuth are used. Treatment takes place strictly in a hospital with multi-level supportive care.

If the patient is diagnosed with primary syphilis, it is necessary to forcibly treat all his sexual partners with whom he had contact during the last trimester.
If secondary syphilis is diagnosed, it is necessary to forcefully treat all his sexual partners with whom he has had contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bed and underwear, clothes, etc.
Hospitalization in the initial stages of syphilis is not required, outpatient treatment is sufficient. Only in severe forms, starting from the secondary stage, the patient is admitted to the hospital. Treatment of syphilis under the CHI policy is free and anonymous.

It is not recommended to cope with the disease with folk remedies. Only a well-designed treatment can defeat pale treponema. Otherwise, there is a high probability of the transition of the disease to more severe stages.

Which doctor treats sifak disease

Since sifak is a disease that is predominantly transmitted sexually, a venereologist is involved in the treatment. The patient can turn to a therapist and get a referral to a venereologist. It is possible to go directly to the venereal clinic.

After examination and obtaining the results of the tests, the patient is treated either by the venereologist himself, who specializes in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

There is a syphilidologist in every major city at skin and venereal dispensaries. He can select the most effective dosages of drugs and develop a treatment program that must be strictly observed. With complications in men (when the head of the penis is infringed), syphilis is treated together with a urologist.
With complications in women (hard chancre in the vagina, on the cervix), you need to go to the gynecologist.

How much to treat syphilis

The duration of treatment of the disease is determined solely by the doctor. Depending on the stage of the disease, complications and the general condition of the body, it may take from two weeks to six months to cure.

It is very important to know that in no case should you interrupt the course of treatment. With incomplete treatment, the patient will soon relapse. Therefore, treatment must be taken very seriously.

Syphilis is also classified as a venereal disease. This disease is characterized by a not very obvious manifestation. But in men and what are its ways of infection?

How is it transmitted?

There are several routes of infection. The disease is transmitted:

1. Sexually. This is best known when infection occurs during sexual contact with a person who has syphilis. Treponema, whose habitat is liquid, can enter the body not only during traditional sex, but also during both oral and anal.
2. Household way. So you can get sick only if the household does not know that one of them has found its refuge treponema. For its further distribution, it is enough to share dishes, towels, lipsticks and even cigarettes. So you should be careful not only in choosing a new partner for sexual relations, but also in using unfamiliar household items. But it is difficult to get infected in this way, since the bacterium itself cannot live for a long time in the wrong environment for itself. But there are cases when people fell ill with syphilis after they washed things that belonged to a sick person in a common container.
3. By blood transfusion. The cause of infection is blood. Basically, this happens during its transfusion - from a sick person to a healthy one. It is also possible to infect when using a disposable syringe by more than one person.
4. In a professional way. Thus, healthcare workers can become infected. For example, gynecologists-obstetricians, dentists, surgeons, pathologists.
5. through the placenta. Newborns are susceptible to this infection. If a mother has treponema in her blood, then it can enter the baby's body through the placenta, as well as through milk during breastfeeding.

Incubation period

How does syphilis manifest itself in men? Before describing the signs of the disease, it is worth talking about It lasts about three weeks. But there are also cases when this period increases from about a couple of months to three. It may also appear after eight days, without showing any special symptoms indicating the severity of the disease.

How long does it take for syphilis to show up in men? Considering the issue, it should be noted that when during the incubation period a person used antibiotics of any kind, the manifestation of symptoms may be delayed for a longer period. This also happens when a man has a venereal ulcer.

The incubation period is no less dangerous for others and sexual partners than a pronounced disease.

stages

But after what time does syphilis appear in men? There are three stages of the onset of the disease:

primary;

secondary;

Tertiary.

The main symptom in the primary stage is the chancre. It can be like an ulcer or an erosion. It is characterized by its appearance in any place, regardless of where the sexual intercourse took place. It appears immediately after the end of the incubation period. At first, this chancre is small and does not cause any particular inconvenience. In addition, there is no feeling of pain.

signs

Initial manifestations occur on the foreskin or head of the penis. Thus, the immune system signals a syphiloma that has entered the body.

Primary syphilis in men manifests itself in such areas of the body as:

Genitals;

Scrotum;

upper limbs;

Oral cavity;

Anal area and others.

At the first remark of the chancre, it is safe to say that the primary stage of syphilis has already begun. Although the symptoms are not so noticeable. They are more pronounced at the secondary stage of the development of the disease, but here one can still note an increase in the lymph nodes.

If you ignore the symptoms of the first two stages, then in the third it will be difficult to do this, since both the epidermis and internal organs, as well as the nervous system, are affected. This is possible only in those cases when the disease proceeds in an invisible form and manifests itself only at the last stage. Basically, the disease is detected during preventive examinations.

It should be noted that the sooner you undergo treatment for this disease, the safer it will be both for your own health and for future offspring.

Conclusion

In our time, a disease such as syphilis is treatable, regardless of the stage at which it was discovered. Naturally, the sooner the better.

So at the slightest suspicion, especially after casual contacts, it is best to contact a venereologist and get tested.

The bacterial causative agent of syphilis - pale treponema - got its name due to the fact that when staining the material with special dyes, it is not visible when viewed with a light microscope. It looks like a thread twisted into a spiral. Outside the body, it quickly dies when dried. Heat and disinfectants are also destructive to bacteria, but it tolerates cold very well.

Infection occurs in a large number of cases during unprotected intercourse, when there are open foci of infection in the area of ​​​​contact. Recently, there has been an increase in cases of infection by the oral route. Also, the microorganism can enter the bloodstream immediately (transfusion from an infected person, repeatedly used syringes from drug addicts). There are frequent cases of infection during pregnancy, when the disease passes from mother to child. The domestic route of infection is unlikely - pale treponema quickly dies outside the human body. However, the transmission of infection is possible with close prolonged contact with the patient, when pale treponemas from the affected areas fall on towels or dishes.

There are also forms of congenital syphilis.

What happens when you get infected?

After 3-4 weeks, a hard chancre appears at the site of the introduction of the pathogen - a painless ulcer of a bright red color with a dense base. It heals after a while, which does not mean the death of the infection. On the contrary, at the same time there is an active reproduction of pale treponema and its movement through the body through the lymphatic vessels. A sick person may feel a headache, fever, general malaise, but most often during this period there are almost no symptoms of the disease.

Later, syphilis manifests itself with small ulcers on the palms, a rash on the skin, mucous membranes and soles. If you let the disease take its course, it can flare up and fade for several years, and rashes can either appear or disappear without a trace. The person feels healthy. With the distance from the onset of the disease, the quiet intervals become longer. People who are not familiar with the features of syphilis even think that they recover completely. However, such well-being is imaginary, since pathogens are already present in all tissues and organs, and begin to affect them.

The reasons

The causative agent of the disease is a bacterial microorganism, Treponemapallidum (pale treponema). It enters the human body through microcracks, abrasions, wounds, ulcerations, from the lymph nodes enters the general bloodstream, affects the mucous surfaces, skin, internal organs, nervous system, skeleton. Bacteria multiply rapidly, division occurs every 33 hours, it is on this time period that the treatment of syphilis is based.

The likelihood of infection depends on the number of bacteria that have entered the body, that is, regular contact with the patient increases the risks.

Classification

The staging of syphilis is based on the method of first contact, i.e. this is the stage of the disease at which the patient first noticed the first symptoms of syphilis and sought medical attention.

Stages of syphilis:

• Primary gray-negative is characterized by the formation of a specific wound - a hard chancre, ulceration is not painful, rounded in shape with certain boundaries and a depression in the middle. It mainly affects the external genital organs, however, it can also be localized in other places on the skin, mucous surfaces, and in the internal organs. Appears after 3-6 weeks from the moment of infection and disappears after the same period of time after the onset.
• Primary sero-positive - positive sero-reactions are detected.
• Primary latent proceeds without a standard clinical picture.
• Secondary fresh appears 4-10 days after the appearance of ulceration, i.e. from the onset of the disease takes from 2 to 4 months. Symptoms of syphilis at this station are characteristic rashes on the skin and mucous membranes. The patient feels weakness, malaise, headaches, fever. Clinical tests reveal positive seroreactions, accelerated ESR, anemia, etc. in human blood. Damage to internal organs is noted: the digestive tract, the cardiovascular system, and the lungs.
• Secondary recurrent. Appears after a period of relative calm. The first symptoms of syphilis at this stage are the reappearance of a rash that merges into continuous foci, the formation of papules. Each relapse can last up to several months. In general, this form of the disease manifests itself for up to three years.
• The secondary latent form, in which there are no symptoms characteristic of syphilis, and it can only be determined using clinical tests. A patient with a latent form of the disease is highly contagious.
• The tertiary active stage is extremely rare today. Appears in people who have not received treatment, or who have not been sufficiently treated. It occurs in a time interval from 3 to 10 years after the onset of the disease (cases of fixation of up to 60 years after the alleged contact infection are described!) It is characterized by severe forms of diseases of the internal organs, the membranes of the brain and nervous system, skeletal bones and articular cartilage. The surface of the epidermis is affected by cicatricial atrophies, peculiar gummas are formed. This stage can be fatal for the patient.
• The tertiary latent stage proceeds latently, without a clinic of typical manifestations.
• The latent form of the disease is asymptomatic, but tests for syphilis are positive. This group also includes patients whose treatment was started with an unidentified form of the disease.
• An early congenital form is transmitted to the fetus in utero, through the blood of a sick mother. Usually such children are not viable, but if the child survives, he has numerous violations of all functional systems. Such children lag behind in development, are weakened and often get sick.
• The late congenital stage practically does not manifest itself until the age of 15-16, followed by symptoms of tertiary syphilis.
• Hidden congenital, which includes all categories of children's ages.

What are the symptoms of syphilis?

The symptomatic picture of syphilis is polyvariant, depending on the nature of the course of the disease, its form. There are three phases of the disease that determine the symptoms and treatment of syphilis:

Primary:

The first symptom of the disease is the appearance of a hard chancre, localized to a greater extent on the genitals or having a different location. A hard chancre is a dense round ulcer with a diameter of up to 20 mm. It does not bleed, has no purulent discharge and is absolutely painless. A week after the appearance of the chancre near the affected area, the patient begins to enlarge the lymph nodes. The complexity of diagnosing syphilis at this stage lies in the absence of pronounced symptoms. In addition, there is a possibility of infection of the ulcer, when swelling and redness appear around the chancre, pus begins to be released. As a result, correct diagnosis can be difficult.

Spontaneous healing of ulceration (hard chancre) in the next 3-6 weeks.

What are the characteristics of the secondary form of the disease:

• Formation at 4-10 weeks after the primary hard chancre of a characteristic pale rash, located symmetrically over the body.
• Deterioration of the patient's well-being - headaches, general malaise, fever.
• Lymph nodes in the area and outside the affected area are enlarged.
• Characteristic hair loss with a ladder or focal alopecia, which involves the eyebrows, eyelashes, scalp.
• Wide condylomas of beige color appear on the skin and mucous membranes of the genital organs, in the anus.
• The repeatability of this picture of symptoms with intervals of bursts and absolute attenuation.

What are the symptoms of tertiary syphilis:

• The brain (both brain and spinal), nervous and cardiovascular systems are affected.
• Bones, joints and internal organs are affected.
• Changed skin with visible scarring.
• Characteristic granulomas, gummas, tubercles and bumps appear.

Diagnostics

Activities for the diagnosis of syphilis include the study of anamnesis, examination and assessment of the overall clinical picture, conducting clinical blood tests. The main goal is to identify what symptoms are observed in the patient and confirm the presence of pathology. All diagnostic measures are divided into two groups: treponemal and non-treponemal.

Non-treponemal tests are performed in mass studies, sometimes they can give a false positive result in the absence of the disease. Upon receipt of such an answer, treponemal tests are additionally prescribed. They are also used to assess the success of ongoing treatment in dynamics.

Treponemal tests for the detection of antibodies that remain in the body of a person who has recovered from syphilis forever cannot be used to evaluate the effectiveness of treatment, but with their help they reveal hidden forms of the disease.

Treatment of syphilis

After carrying out the procedures that revealed the first signs of syphilis and establishing the diagnosis, an adequate treatment protocol is prescribed, which can be quite long - from 2-4 months, and in some cases of advanced disease - more than two years. Depending on the general condition of the patient, treatment is carried out in a hospital, rarely on an outpatient basis. For the whole time, until a complete cure, confirmed by clinical tests, sexual activity is prohibited. In addition, all members of the patient's family undergo examinations and preventive treatment.

Antibiotic therapy is the only effective method in the treatment of syphilis, since pale treponema is highly sensitive to penicillin drugs, which are most effective in combating the microorganism. Water-soluble penicillins are injected into the patient's body for 24 days every three hours in stationary conditions - this is the most effective method.

In the presence of an allergy to penicillin, the patient is prescribed antibiotics from a number of cephalosporins or macrolides - in tablets or intramuscularly. Active forms of the disease are treated in stationary conditions, latent ones - through outpatient therapy. The duration of treatment is determined by the stage of the disease and can reach several years.

It is necessary to treat syphilis with simultaneous support of the body's internal reserves, which is carried out with the help of immunostimulating complexes, vitamins, etc.

It is very important to inform all sexual partners about the presence of the disease and convince them to undergo the necessary studies, even in the absence of symptoms - this course of the pathology does not reduce the risk of complications. In the event that the patient is cured, but his sexual partner is not, re-infection is very likely.

Complications

At different stages, the symptoms and treatment of syphilis can give a multiple picture of complications, which is due to the stage of the disease.

The primary period is characterized by:

• Examination of all pregnant women, passing tests for serological reactions three times to avoid cases of congenital syphilis.
• Mandatory preventive treatment for pregnant women who were previously registered, but were removed from it after the cure.
• Regular examinations for those at risk (drug addicts, prostitutes).
• It is imperative to examine everyone who had close contact with the sick person, necessarily for family members.
• Hospitalization of persons with a positive reaction, after treatment - dispensary observation.

Prevention and prognosis for recovery

It is impossible to reflect syphilis in advance. There is no vaccine or other active prevention against this disease. It is important to follow the rules of safe sex, to refuse casual relationships.

Public prophylaxis should be carried out in accordance with the general rules for combating venereal diseases. The components of such prevention are the mandatory registration of all patients, examination of his family members and persons who were in close contact with him, hospitalization of the infected and monitoring them over the next few months, constant dispensary control monitoring of the treatment of sick patients.

The prognosis for the clinical cure of early stages of syphilis is favorable. The earlier the disease is diagnosed and treated, the more favorable the prognosis.

In the later stages, with the help of treatment, it is possible to significantly improve the patient's condition.

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The question of whether syphilis can be cured is very relevant in our time and worries many people, especially young people. So, under syphilis it is necessary to understand a disease that leads to the formation of a large number of pathological processes in the body. If left untreated, syphilis can lead to a huge number of complications and even death. The main route of transmission is considered to be sexual. We will talk about how syphilis is treated and what features of its course are in the presented article.

Key Aspects

The causative agent of syphilis is pale treponema (Treponema pallidum), it is capable of rapid spread and penetration into various internal organs. Cured individuals do not have immunity, so the risk of re-infection remains quite high.

The first cases of the disease were recorded as early as 1495, among the soldiers of the French army. After that, the pathological condition spread rapidly throughout Europe. Despite the fact that the disease did not have a high mortality rate, it was considered terrible, because it was accompanied by the formation of genital ulcers (chancres), which led to the appearance of pain and had a rather repulsive appearance. Over time, their transformation into abscesses was observed, and ulcerative processes spread over the surface of the entire body.

In the vast majority of cases, chancre is formed on the vulva, anus, vagina or rectum, but its appearance on the mucous membranes of the oral cavity and on the lips is no exception.

Transmission of the pathogen occurs during vaginal, anal or oral intercourse.

Syphilis, as a disease, is also considered dangerous because its clinical manifestations do not appear immediately, but only after a few weeks. In a given period of time, a sick person can infect a large number of people. If you do not diagnose the disease in time and do not get rid of syphilis, it can cause male and female infertility, the formation of pathological processes in the internal organs, and even death.

When a pregnant woman is infected, infection of the fetus is possible in 70% of cases. As a result of this, the child may die or have a congenital form of this disease.

In medical practice, it is customary to divide syphilis:

• Depending on the stage at which the pathological condition is located: into primary, secondary and tertiary.
• Depending on the route of infection - congenital or acquired over time.
• Depending on the period of diagnosing the pathological process, late and early.

Taking into account the above aspects, the choice of a scheme and an effective method of treatment is carried out.

Clinical picture

The causative agent of syphilis, having penetrated into the cavity of the human body, spreads by the hematogenous or lymphogenous route. The incubation period can be up to four months, but the first symptoms may appear as early as 2 weeks after infection. The manifestations of the disease will depend on what stage of the course it is at.

• Primary syphilis is characterized by: the formation of a chancre at the site of the introduction of the pathogen; over time, hyperemic ulcerative processes begin to appear, which have clear boundaries; the absence of pain; swelling of the tissues at the site of the introduction of the pathogen.
• Manifestations of secondary syphilis. In the absence of adequate therapy, the disease passes into the second stage, this happens after about 2-3 months. This pathological condition is characterized by: the appearance of elements of an erythematous, papular or pustular rash; hair loss; violation of the functioning of internal organs.
• Symptoms of tertiary syphilis. This type of disease is formed 3-5 years after infection. It manifests itself: the appearance of tubercles and nodes in the thickness of the skin; the formation of seals in the areas of penetration of treponema.

Signs of syphilis

Quite often, people do not realize that they are sick, because they do not pay much attention to the appearance of a rash. Over time, it disappears, and therefore any worries seem unfounded, but it must be remembered that the disease is gaining momentum at this time. Patients complain about:

• swelling and hardening of the foreskin;
• the formation of ulcerative processes and erosions on the genitals or anus.

Ulcers (chancres) can be localized in other places, they are rounded and painted red.

After a week, there may be an increase in lymph nodes and an increase in temperature. Due to the fact that the symptoms of this period are not expressed too clearly, patients are in no hurry to seek medical help.

The appearance of rash elements on the skin indicates secondary syphilis, this is a kind of evidence that destructive processes have begun. In the absence of treatment, over time, the organs will cease to function normally.

Diagnostics

First of all, it is necessary to focus on the fact that in no case should you diagnose yourself on your own (after analyzing the information provided on the Internet), and even more so carry out self-treatment. This is explained by the fact that syphilis has a large number of symptoms similar to other diseases, and this causes an incorrect diagnosis even by doctors. To make a diagnosis, you need:

• Get checked out by a dermatologist. The doctor conducts a general examination of the patient, collecting an anamnesis and complaints.
• Pass tests for direct immunofluorescence reaction, PCR.
• Undergo serological examinations that allow you to detect the presence of antibodies to treponema in the human body. This may be the Wasserman reaction, VDRL, rapid plasma reagent test.
• In some cases, the doctor directs the patient to instrumental examinations, such as ultrasound, MRI, CT, X-ray. They allow you to identify gummas.

Choice of tactics

Due to the fact that the disease belongs to the group of serious diseases, the doctor who treats syphilis must be very careful. The scheme of therapy, its duration will depend on the stage of the course of the pathological condition, its severity and the general condition of the patient. Therefore, it is customary to use not only antibacterial drugs, but also various treatment regimens for syphilis, depending on each specific case. Used:

• specific treatment. It is an option of choice for those patients who have an accurate diagnosis.
• Perventative or in other words preventive. It is intended for persons who have been in contact with a person with syphilis. In this case, contact will be considered not only sexual intercourse, but also domestic. This method of treatment is also used for those individuals whose lifestyle is considered antisocial. A positive effect of such treatment will be observed if contact with a sick person took place no earlier than two months. Otherwise, you can not hope for a positive result from the therapy. The contact person undergoing treatment must undergo regular check-ups for another six months.
• Preventive. It is carried out during the bearing of a child by a woman. Its implementation is necessary not only to alleviate the condition of the woman, but also to dull the progression of the pathological condition in the fetus. This type of therapy is actually prescribed to all, without exception, pregnant women with a history of syphilis and who have completed a full course of treatment (regardless of the duration of the case). In a situation where a pregnant woman does not have time to be treated completely before childbirth, then therapy is prescribed after that for both the woman and the baby.
• Trial course. It is used to treat those individuals in whom syphilis is at an advanced stage of development. Treatment using this method is carried out even in the case when the presence of the disease is not confirmed by laboratory. This is explained by the fact that syphilis in the third stage is quite difficult to diagnose, and there is no time to lose. This drug therapy got its name due to the fact that the causative agent of the pathological condition is unknown according to the results of the analysis, but all the characteristic symptoms of syphilis are present. During the treatment, the patient's condition and changes in his body are monitored. If there is a positive effect, then in this case, the trial treatment switches to a specific one.
• Epidemiological. This type of therapy is carried out in cases where there are clinical manifestations of the disease, an asocial lifestyle or sexual contacts, as well as positive test results for syphilis. The main difference of this type of treatment is that it is carried out only on the basis of a history of suspicious sexual relations, without laboratory confirmation of the diagnosis.

Types of treatment

As already noted, syphilis is cured with the use of antibacterial drugs, mainly the choice is on Penicillin and its derivatives. With how to cure syphilis with antibacterial drugs, we will now try to understand in more detail.

Drugs with an antibacterial effect are classified depending on the duration of the therapeutic effect on the drugs: long-acting, medium, short.

Long-term and medium-acting antibacterial drugs are endowed with the ability to accumulate in muscle tissue and gradually enter the body. Due to this feature, the interval between the administration of drugs is lengthened. Medicines that belong to this group are used for therapy directed at syphilis of all types, except late.

Short-acting products do not have this ability, but they are more likely to spread throughout the body and are able to easily overcome any natural barriers. That is why drugs of this type can cure late syphilis, because during the course of this pathological condition, the pathogen is localized in hard-to-reach tissues and internal organs. Drugs are administered intravenously or intramuscularly.

Treatment with penicillin

In ancient times, the treatment of syphilis was ineffective, because it was carried out by applying mercury ointment to the affected areas. This method of treatment led to the formation of a large number of adverse reactions, which manifested themselves in the form of: neuropathy, renal failure, ulcerative processes in the oral cavity, loss of teeth.

Such treatment for syphilis caused patients to die not from the disease itself, but from mercury poisoning, which was in the medicinal preparation.

Another attempt to cure syphilis was the use of potassium iodide in combination with mercury and various metals, but, unfortunately, this method was not effective.

It was possible to recover from syphilis only when an antibacterial drug called Penicillin appeared. Even until now, this medication is the main way to quickly eliminate the disease. It is recommended to be used to eliminate the symptoms of congenital syphilis, neurosyphilis and syphilis during pregnancy.

This is explained by the fact that the pale spirochete almost never survives after proper treatment with Penicillin. The positive side is also considered that the pathogen does not become resistant to the drug, even in the case of improper therapy.

The most commonly used treatment regimens are:

• For secondary or primary syphilis, benzathine benzylpenicillin is used, it is administered once at a dose of 2.4 IU intramuscularly.
• With early latent syphilis, treatment is carried out according to the previous scheme.
• Late latent syphilis. In this case, Benzathine benzylpenicillin is administered three times a day with an interval of 7 days. The amount of the drug per intramuscular injection should be 2.4 MO.

Please note that syphilis cannot be treated with oral Penicillin.

The use of other groups of antibacterial drugs

There are cases when the patient's body does not perceive penicillin medications. In such situations, the treatment regimen for syphilis consists of prescribing other antibiotics.

The course of treatment with Penicillin and its analogues is contraindicated in patients who have a history of allergic reactions to these drugs, because they can cause death. Such patients are also prohibited from prescribing cephalosporin drugs. This is explained by the fact that they have an almost identical chemical structure with penicillins. However, this medicine can be used in the form of tablets. With the question of how to treat syphilis for these individuals, we will now deal with it.

Persons who do not tolerate penicillin drugs are prescribed

• macrolides - Erythromycin, Sumammed;
• derivatives of the tetracycline series - Tetracycline, Doxycycline;
• antibiotics of synthetic origin - Levomycetin.

Women who are diagnosed with a disease during childbearing can only be treated by prescribing macrolides.

Treatment of women during childbearing

Without exception, all women who are diagnosed with syphilis during pregnancy should be treated. Its scheme and type will depend on the stage of development of the disease. With how to treat syphilis for pregnant women, we will now understand in more detail.

If a pathological condition is detected late in pregnancy, then even the administration of the recommended dose of penicillin in 30% of cases leads to the death of the fetus or the birth of a sick child. That is why, when diagnosing a primary or secondary case of the disease at an early stage in a woman during childbearing, it is recommended to treat with a double injection of Penicillin at a dose of 2.4 IU for seven days.

There is no need to take any additional measures, especially if there is no clinical and serological evidence of a new infection.

Some doctors are inclined to treat pregnant women with Erythromycin, but it should be noted that this drug is not the most effective in the fight against syphilis and does not penetrate the transplacental barrier.

When treating pregnant women, it must be remembered that there may be a complication in the form of the Jarisch-Herxheimer reaction. According to the observations, it was noted that a similar process can be observed in almost half of the pregnant women receiving treatment. This reaction appears as:

• chills
• fever;
• ailments;
• pain in the head;
• pain in the joints;
• pain in the muscles;
• nausea;
• the formation of elements of a rash on the skin.

In addition to taking antibacterial drugs, pregnant women should rest and drink as much fluid as possible. Pain in the pelvic area and uterine cramps can be eliminated by prescribing Acetaminophen.

Please note that a woman who is sick with syphilis is allowed to feed her child, but only if the infection of the mother occurred no earlier than six months ago. In all other cases, the application to the breast of the mother of a newborn baby is prohibited.

If a child has a congenital form of syphilis, then Penicillin 50,000 units per kilogram of body weight is prescribed twice a day. Such a treatment regimen should be performed in the first week of a child's life, then the drug is administered every 8 hours for 10 days.

Treatment at home

First of all, it is necessary to focus on the fact that it is impossible to cure syphilis by folk methods, it requires medication and physiotherapy, which will be controlled by a qualified doctor. The drugs of choice are antibiotics, as well as immunomodulators, vitamins, biogenic stimulants and pyrogenic substances.

Syphilis can be cured quite quickly, but only if therapy was started even before the formation of complications. However, it must be understood that herbal supplements in combination with traditional methods of treatment can make the treatment more effective and faster. Recommend to use:

• amino acids;
• vitamin C;
• bioflavonoids;
• zinc;
• colloidal silver;
• coenzyme Q10.

It should be noted that a considerable amount of herbal supplements is found in apricots, garlic, pine nuts, Canadian goldenseal, red clover.

Particular attention is paid to biological supplements with zinc. This is explained by the fact that it ensures the restoration of cellular metabolism, maintains the health of the organs of the reproductive system of the body, and also helps wounds heal faster and generally improves immunity.

Summing up, it is necessary to focus on the fact that the use of recipes from folk sources will not be able to alleviate the condition of a person, it is likely to cause the progression of the disease and the formation of various complications.

The use of physiotherapy procedures

To consolidate the therapeutic effect, such methods of physiotherapeutic treatment are prescribed as:

• Inductothermy. This procedure refers to electrotherapy, a high-frequency magnetic field is used.
• Magnetotherapy. During this procedure, the location of the inductors along the spinal column is carried out.
• Microwave therapy. It helps to restore the normal functional ability of the nervous system, stimulates blood circulation and metabolic processes. On the first day, the procedure is carried out in the areas of the epigastrium and thyroid gland, on the next - in the area of ​​the epigastrium and adrenal glands.
• Laser therapy. Helps to restore the functional ability of cellular and humoral immunity.

Local treatment

Since syphilis is accompanied by the formation of a hard chancre, wide condylomas and pustular-ulcerative syphilides, it becomes necessary to carry out their treatment too. For this purpose, lotions with 0.05% chlorhexidine, 50-70% dimexide solution are used. It is recommended to apply them until epithelialization or scarring of syphilitic ulcerative processes occurs.

Lymphoid infiltrates of a dense consistency are recommended to be lubricated with heparin ointment or an agent prepared from Podophyllin, a solution of dimethyl sulfoxide and glycerin in a ratio of 1: 5: 5. Their resorption occurs quite quickly when using a helium-neon laser.

The essence of pathogenetic therapy

Treatment should be comprehensive and include antibiotic, immuno- and enzyme therapy, local therapy and the elimination of chronic pathological processes that are localized in the organs of the genital area. It is these activities that help improve the effectiveness of therapy directed against syphilis.

Increasing the stability of human immunity makes it possible to suppress the formation of new foci of infection, to remove toxic substances from the body that were formed during the destruction of bacteria. For this purpose, apply:

• Pyrogens. The drugs of choice, which are endowed with the ability to stimulate the patient's immunity, are Pyrogenal and Prodigiosan.
• The preparations are made on the basis of interferon. The appointment of these drugs is considered justified, because syphilis is accompanied by a violation of the production of interferon, it decreases by 2-5 times. Most often, a remedy called Amiksin is prescribed.
• Means that are endowed with the ability to stimulate lymphocytes and phagocytes to perform their functional duties. This group includes Timalin, Taktivin, Timogen, Immunomax and Imunofan.
• Phagocytosis stimulators - Polyoxidonium, Likopid, Golovata, Methyluracil, Levamisole.
• Enzyme preparations that have the ability to stimulate microcirculation and tissue nutrition, the removal of toxic substances. Additionally, they also help to concentrate the highest concentration of antibacterial drugs in those areas where foci of inflammation are localized. The drugs of choice are Wobenzin, Phlogenzym, Vobe-mugos E.
• Vitamins. Particular attention is paid to ascorbic acid and B vitamins.
• Adaptogens - Pantocrine, Extract of radiola rosea and eleutherococcus, tincture of ginseng and lemongrass. These medicines help to increase the body's resistance
• Biogenic stimulants. Endowed with the ability to improve the body's defenses, metabolic processes and regeneration processes. Most often, the choice is stopped at such means as FIBS, Placental Extract, Plasmol, Splenin, Polybiolin.

How long can it take to heal

Individuals diagnosed with the disease are interested in how much syphilis is treated. It is immediately necessary to tune in to the fact that, regardless of the case, the treatment lasts a considerable amount of time, even when diagnosing the disease in the initial stages, it can last 2-3 months. All this time, medication should be taken.

As for the second stage, its treatment can last two or even more years. All this time it is forbidden to have sexual relations.

If a pathological condition is detected in a sexual partner, syphilis treatment should be carried out for both persons. In addition, preventive medication will need to be carried out by all family members of a sick person. Preventive treatment is also called primary. It is carried out to those persons who have had sexual or domestic contact with a sick person, but they do not have clinical signs of the disease. However, it must be remembered that such treatment will be necessary and effective only if three months have not passed since the moment of contact.

Such therapeutic therapy for syphilis should last two weeks, it is carried out with the help of water-soluble penicillins or penicillin novocaine salt. In the vast majority of cases, it is carried out on an outpatient basis, the following medications are used:

• Extencillin or Retarpen. Its single dose should be 2.4 IU, injections are carried out once every seven days. The course of treatment consists of three injections.
• Bicillin-1,2,3. The course of treatment consists of four injections, each two of which must be carried out within seven days. A single dose of Bicillin-1 and 5 is 1.5 IU of Bicillin-3 - 1.8 MO.

Penicillins are also prescribed, such treatment continues for 6 months.

If more than three months have passed since the infection, then in this case it is necessary to undergo several examinations with an interval of two months. If six months have passed since infection, a single examination is performed. As for treatment, it is carried out only when the diagnosis is confirmed.

Follow-up of people who have been treated

In a situation where a period of time from 3 to 6 months has passed after contact with a person with syphilis, control is established for the contact person by conducting a complex of serological reactions, RIT or RIF. It is necessary to conduct research twice with an interval of 60 days. In parallel with this, examinations related to general clinical are carried out.

If six months have passed since the contact, then the examination is carried out once. Patients who received a transfusion of infected blood or its components are examined every three months for a year. Persons who have been in close enough contact with a sick person and have undergone a course of primary treatment are examined once every 90 days and are not subject to follow-up.

Prevention and complications

Fast enough is the treatment of early syphilis, if it was diagnosed in a timely manner. As for the examination, it can be done in any hospital, and in some clinics even anonymously.

Syphilis, which is considered secondary, can be cured if seeking help is not too late. The duration of treatment is several weeks, but situations in which it lasts up to a year are no exception. If medical therapy is not carried out, then the formation of late complications can be observed. The late form of syphilis without proper treatment can be fatal, because there is damage to the internal organs, brain and spinal cord.

Even if the infection was one-time, and the treatment of syphilis was successful, then this is not evidence that the infection will not occur again. That is why it is very important to follow preventive measures to prevent re-infection.

• Use barrier methods of contraception.
• Avoid casual sex.
• Seek medical attention after casual sex.

In the event of the appearance of elements of a rash on the genitals or atypical discharge from them, it is urgent to consult a doctor for advice. During this period, it is forbidden to have intimate contacts.

Please note that douching and washing the genitals after intercourse are not able to protect against infection with syphilis and other STDs.

Patients who are being treated for syphilis should abstain from sexual intercourse, especially unprotected intercourse, until it is completed. Due to the fact that syphilis can be transmitted transplacentally from a sick mother to a fetus, perinatal screening must be carried out.

Complications

As already noted, the pathological condition we are talking about is considered a dangerous recurrent disease, because without treatment for syphilis, a large number of complications can form. It can be:

• damage to the organs of the cardiovascular system and disruption of their functioning;
• ulcerative processes of a destructive nature on the skin and bones;
• the formation of neurosyphilis;
• myelopathy of syphilitic origin, which is accompanied by muscle weakness and the appearance of discomfort in the muscle fibers;
• syphilitic meningitis.

That's practically all the basic information about how the treatment is carried out, and what you need to remember when going through a therapeutic course. In any case, you need to be very attentive to your health and careful, because even a cured person can get sick again.

Syphilis is a disease of an infectious form, which is classified as a sexually transmitted disease. The main signs of this disease are damage and changes in the skin, mucous membranes, internal organs, as well as bone and muscle tissues, the nerve system and a strict division at the developmental stage.

Etiology

Treponema pallidum, or pale treponema- this is the main and only causative agent of the disease, provoking the occurrence and development of syphilis.

It is a fairly long, thin, Gr- (non-Gram-staining) spirochete with 8 to 14 whorls. Its length is from 8 to 20 microns, diameter - 0.20-0.40 microns. Anatomically, it consists of an axillary body and flagella. This treponema is capable of independent movement by contracting its own body.

This treponema is detected only using the Romanovsky-Giemsa staining method, when it acquires a light pink color (hence its name - pale treponema). In addition, such microscopic diagnostic methods as dark-field microscopy, fluorescence, phase-contrast microscopy can be used.

Since pale treponema is, in fact, the only possible pathogen, the treatment of syphilis is aimed precisely at its eradication (destruction).

Transmission routes

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The mechanisms of transmission of syphilis are completely due to the biological characteristics of Treponema pallidum, namely, the necessary temperature conditions, a certain humidity and anaerobicity. Because of this, she cannot stay in the external environment for a long time on her own.

The most favorable route of infection for treponema is sexual contact. When transmitted sexually, syphilis primarily affects the vagina, rectum, and mouth.

Much less often, syphilis is transmitted during blood transfusions (blood transfusions), and transplacentally (from mother to child in the womb). The household route of infection is quite rare, since it requires direct direct contact with a patient who develops tertiary syphilis.

The incubation period lasts from 4-6 days to 4-6 weeks and averages 25 days. After that, as a rule, signs of syphilis become apparent, clinical symptoms of syphilis appear and patients seek treatment.

More about the disease

Symptoms of syphilis of various forms

Pale treponema begins the process of active reproduction immediately after it enters the human body, also releasing endotoxins. This period is called the incubation period, and its duration depends on the body's defenses, the number of treponemas that have penetrated, or the use of antibacterial agents in the treatment of other diseases (for example, tonsillitis).

After the time required for the incubation period, the first clinical symptom of the disease can already be detected at the site of the primary infection with syphilis.

In the further classical development of this pathology, 3 forms (they are also stages of development) of syphilis can be distinguished:

• Primary.
• Secondary.
• Tertiary.

The first manifestation of syphilis, as a rule, becomes a hard chancre. Further, after 4-8 days, other early signs of syphilis appear: regional lymphadenopathy (enlargement of local lymph nodes) and lymphangitis (inflammation of the lymphatic vessels), and scleradenitis (bubo) is gradually formed.

The main sign of primary syphilis, a hard chancre, is an ulcer of a dense consistency, not soldered to the surrounding tissues, which does not show a tendency to grow. As a rule, it occurs at the site of primary infection.

In addition to the classic chancre, there may be:

• Multiple chancre. The occurrence of two or more formations.
• Chancre amygdalite. It develops in the oral cavity and is accompanied by an increase in one of the palatine tonsils. At the same time, it bulges into the throat, disrupting swallowing and causing pain. Reminds me of a sore throat clinic.
• Chancre felon. Medical form. Occurs on 1-3 fingers of the right hand. In most cases, the symptoms resemble a typical panaritium.
• Inductive edema. It is characterized by a massive increase in the scrotum and labia, as well as a change in the color of the local horse covers - cyanosis occurs.

The primary form of syphilis is divided into two periods important for diagnosis:

• Seronegative. Lasts the first 3-4 weeks. In this period, standard diagnostic methods (RW - Wasserman reaction and ELISA - enzyme immunoassay) are negative.
• Seropositive. The transition to this stage takes place after the onset of primary syphiloma. In it, all diagnostic methods become positive and indicate the presence of the disease.

The total duration of the primary form of syphilis is 6 to 8 weeks.

It occurs 2.5-3.5 months after the initial infection. In the secondary stage, hematogenous (through the bloodstream) spread of treponema throughout the body occurs. In this case, new signs of syphilis appear - skin rash, rashes on the mucous membranes, symptoms of CNS damage (early neurosyphilis).

This form also has several periods:

• Early or fresh.
• Return or recurrent.
• Hidden.

The first signs of the transition of syphilis to a secondary form are specific skin rashes, which can be roseolous, papular or pustular. A similar manifestation occurs as a result of the abundant release of angioparalytic endotoxins of pale treponema, which are destroyed under the influence of the immune system. After 1-2 weeks, the body adapts to such conditions, and the rash disappears, and the disease becomes latent.

The presence of rashes, as a rule, is accompanied by subfebrile temperature (37.0-37.5°C), general malaise. Additionally, nonspecific symptoms of syphilis may occur: conjunctivitis, cough, runny nose.

Over time, when a person's immunity weakens, a relapse occurs - a skin rash reappears. Such manifestations of syphilis can be multiple, then they talk about recurrent syphilis.

With relapses, the symptoms of syphilis each time manifest themselves more and more intensely: the number of elements of the rash increases, there is a tendency for them to combine into foci.

The second stage lasts on average2-5 daysin some cases - up to 2 weeks.

The tertiary form occurs in case of inadequate treatment or its complete absence. At the same time, syphilis, due to a strong decrease in the body's resistance, gradually affects all organs and systems, after which gross deformations and changes in the function of the affected tissues occur. A characteristic feature of the tertiary form is the syphilitic gum.

Syphilitic gumma or deep syphilide is a node that forms in the tissues of the affected organ and causes irreversible changes in the structure of tissues, followed by the formation of scars. Clinically, it is a small tumor of a round or oval shape, 3-4 cm in diameter, which has a dense and elastic texture and is not soldered to the surrounding tissues. Gradually, it increases, loses its mobility, and the skin above it becomes pink. As gumma develops, painful ulcers appear on its surface, and then scars.

The most common gummas:

1. Nose gum. Causes total destruction of the nasal septum and deformation of the nasal concha. It can disrupt the integrity of the palate and provoke food to enter the nasal cavity.
2. Gumma soft palate. With its gradual development, the sky gradually loses its mobility, thickens and changes its pink color to dark red. With further progression, it simultaneously “breaks through” in 2-3 places, forming ulcers.
3. Gumma language. There are two options for the defeat of the tongue with syphilis:
   • Hummous glossitis. Formation of many small ulcers on the upper surface of the tongue.
   • Sclerosing glossitis. At the same time, the tongue thickens, loses its normal mobility, after which it shrinks and depletes (atrophies). As a result of such pathological changes, a person gradually loses the ability to speak, chew and swallow.
4. Gumma throats. It is characterized by a violation of swallowing, voice disorders and a feeling of "heaviness" in the throat.

In the tertiary stage, syphilis occurs with a certain cyclicity. Emerging exacerbations, as a rule, are associated with the influence of factors that reduce immunity: infectious diseases, stress, trauma, poor nutrition, etc.

In the absence of appropriate treatment for syphilis, violations of almost all organs and systems develop over 5-20 years.

Most often, syphilis affects:

• CNS - brain and spinal cord.
• Main vessels, incl. aorta.
• Tissues of the bone and muscle systems.
• Skin and mucous membranes.

In addition to the main forms of classical syphilis, another type of it that occurs in children is also possible - congenital syphilis.

Congenital syphilis can manifest itself in two forms:

• Early. In this case, the symptoms of syphilis occur immediately after childbirth. They include: deformation of the bones of the skull, constant crying of the child, exhaustion, brownish color of the skin.
• Late. It is characterized by the Getchinson triad: semilunar deformation of the teeth, signs of labyrinthitis (deafness, dizziness), keratitis.

Types of syphilis

Signs of syphilis in men and women, diagnosis of the disease

Signs of syphilis of the secondary and tertiary stages in representatives of the male and female states are exactly the same. Certain gender differences in the symptoms of syphilis arise in the diagnosis of the primary form. They are mainly due to anatomical differences between the male and female genital organs.

For men:

• Chancre in the lumen of the urethra (urethra). It is manifested by bloody secretions, a significant compaction of a limited area of ​​\u200b\u200bthe penis and an inguinal bubo.
• Gangrenous chancre on the skin of the penis. In the absence of appropriate treatment for syphilis, the risk of arbitrary self-amputation of part of the penis increases.

Among women:

• Chancre on the mucous membrane of the cervix. Symptoms of syphilis are practically absent. In the vast majority of cases, the diagnosis of "Syphilis" is established during a routine examination by a gynecologist.
• Great tendency to indurative edema of the genital organs.

The main diagnosis, both in men and women, is based not only on the clinical signs of syphilis, but also on laboratory diagnostic methods. The most used among them are: RW (Wasserman reaction) and ELISA (enzymatic immunoassay).

RW. It is a specific complement fixation reaction. It uses lipoid hypertension and reagin of the patient's blood serum. The resulting AG-AT complex is detected using the hemolytic system, which consists of: sheep erythrocytes and hemolytic serum. The result of RW is evaluated in "pluses": negative - "-", weakly positive - "+" or "++", positive - "+++" and sharply positive - "++++".

ELISA. The essence of the method lies in the binding of AG (antigen) of syphilis, with the AG of the patient's blood serum. The antigen of syphilis itself is sorbed (absorbed) on a solid-phase carrier. The purpose of the reaction is to identify a specific AG-AT complex (antigen-antibody) using immune serum labeled with the necessary enzyme. The reaction results are evaluated similarly to RW.

As alternative or additional studies, to confirm the primary diagnosis of "Syphilis", the following can be used:

• RIBT.
• RPGA.

Diagnostics

Treatment of syphilis, possible consequences and prevention

Treatment of syphilis is carried out only in the hospital of a specialized, skin and venereal dispensary. The course of therapy of the primary form lasts from 2 to 4 months of continuous treatment, with the secondary - up to 2.5 years.

Drug therapy primarily consists of antibacterial agents. Despite many years of use of antibiotics from the penicillin group, pale treponema is still sensitive to them. The drug of choice is Bicillin-5, at a dose for adults - 1.5 million units (action units) per day, and for children - 0.8-1.2 million / day.

Antibiotics from the macrolide range (erythromycin), cephalosporins (ceftriaxone), or tetracyclines (doxycycline) are used if the patient is resistant to this drug or has an allergic reaction.

Immunotherapy. It is used as an additional treatment in patients with an unfavorable prognosis for the outcome of the disease, with latent forms or severe comorbidities. In this case, syphilis is treated with biogenic stimulants (aloe extract or placenta) at a dose of 1.0 when administered subcutaneously.

Physiotherapy treatments are ineffective, since the main reason why syphilis develops - pale treponema - is immune to them. Some methods can be used as symptomatic therapy, but they are prescribed extremely rarely.

Treatment of syphilis with folk remedies is strictly prohibited, because. alternative medicine is unable to exert the necessary influence on pale treponema. Moreover, by eliminating individual symptoms of syphilis, it is possible to significantly complicate the course of the disease and further diagnosis and delay the necessary treatment for an indefinite period.

Having noticed the first likely signs of syphilis, you should immediately consult a doctor!

Syphilis can affect almost all organs and systems, so the list of possible consequences is quite large:

• The cardiovascular system:
  • Arterial hypotension.
  • Angina.
  • Myocardial infarction.
• CNS:
  • Meningitis.
  • Hydrocephalus.
  • Increased intracranial pressure.
  • Speech disorder.
  • epileptic seizures.
• Organs of vision and hearing:
  • Hearing loss.
  • Anomalies in the structure of the pupils.
  • Pigmentary retinitis.
  • Inflammation and atrophy of the optic nerve.
• Musculoskeletal system:
  • Osteoarthritis.
• Respiratory system:
  • Bronchitis.
  • Pneumonia.
• Digestive tract:
  • Yellow liver atrophy.
  • Gastritis.

Individual preventive measures for syphilis include such factors:

• Completely exclude promiscuous extramarital sex.
• The use of contraceptives and subsequent hygiene procedures in case there was sexual contact with a person in whom you are not sure.
• Appeal to the point of prevention in the first few hours after a potentially dangerous sexual intercourse.