External manifestations of syphilis. How does syphilis manifest in women?

Many people are interested in what the first signs of syphilis can be detected on their own. After all, its success depends on the timely start of treatment.

Ignorance of the symptoms of the disease leads to another disaster. An infected person becomes a source of its spread, which is a criminal offense under the laws of many countries around the world. The illiteracy of the population of the CIS countries in this matter is amazing. In the era of digital technology and an avalanche of diverse information, syphilis infections in Russia have increased sharply.

Syphilis (lues) is an infectious disease. Excited by Treponema pallidum. Affects various parts of the body: the outer layer of the dermis, liver, spleen, sometimes kidneys, bones and nervous system. The infection is mainly transmitted sexually, which is why the disease is classified as a sexually transmitted disease.

You can also become infected at the household level. Doctors, in this case, say: household infection is not a type of disease, but a route of transmission of infection.

This becomes possible due to the characteristics of life and reproduction of the microorganism. It is an anaerobe and lives and reproduces well without oxygen. But oxygen is not poison for him. Therefore, it is able to survive in the open air for 3 days, but at the same time, it quickly dies when dried out and under the influence of high temperatures. Survives well in deep freezing. Withstands minus 78 degrees.

Those infected with Lues, using household items: a mug, glass, towel, etc., and without treating them with antiseptics, are highly likely to infect their household.

Treponema pallidum can also enter the human body through the blood. You can become infected by receiving a transfusion, visiting a hairdresser, or dental office. Even taking blood tests can lead to infection if laboratory technicians violate sterility rules.

Drug addicts are at risk. Reusing syringes and needles leads to infection. One of the features of the disease that makes it more dangerous is the long incubation period.

Due to its small size, the causative agent of the disease cannot be seen in a laboratory microscope, or seen by coloring when special dyes are used. Therefore, before the first symptoms appear, the infection is hidden and cannot be diagnosed. A carrier of treponema during the incubation period is a source of infection.

The entry of the lues pathogen into the human body does not mean that he will necessarily become ill. In half of the cases, treponema pallidum disappears without a trace. Medicine cannot explain the body's reaction to its introduction.

Primary signs of the disease

The first external symptoms of syphilis in men and women are classic - a hard, round, bluish-red, painless ulcer(chancre) and enlarged lymph nodes. However, there is great difficulty in diagnosing the disease in women.

In men, chancre can most often be found on the penis, but it can appear on other parts of the body: groin area, thighs or stomach. Much less often, ulcers appear on the lips, mouth, and hands.

In women, the ulcer is located, in most cases, on the cervix or labia. Very rarely, ulcers appear in the pelvis or abdomen. Naturally, it is almost impossible to see the first signs of syphilis in women when there is an ulcer inside the vagina. Therefore, diagnosing infection in women is very difficult.

Firstly, before there was one abscess, but now there are two or more ulcers. Secondly, very often there is a change in the structure of the abscess. The name “hard chancre” is due to the presence of a dense infiltrate inside it. Now this compaction may not appear.

Ulcers, if left untreated, disappear on their own after 4-6 months, and the lump resolves. In most cases, there are no traces left on the body. Since their formation occurs without any painful symptoms, many men begin to be treated with brilliant green or potassium permanganate. Self-medication is also facilitated by the erroneously established point of view in society that ulcers, with lues, appear only on the genitals.

Therefore, only when any ulcers form on the penis or labia, a person sounds the alarm and goes to the doctors. The most important thing here is not to waste time. The atypical chancroid makes it difficult to diagnose the disease, not only among the population, but also among venereologists. It usually manifests itself in the form of other diseases:

Amygdalitis is inflammation of the tonsil glands. An ulcer appears on the tonsil. The disease proceeds according to the scenario of a typical sore throat, with fever, headaches, weakness, and difficulty swallowing. Lues can be distinguished by the low effectiveness of treatment and unilateral damage to the tonsil;
Panaritium is an acute, purulent inflammatory process of the fingers (less commonly, toes). It differs from the usual disease in that the abscess takes several weeks to heal;
Regional lymphadenitis is inflammation of the neck or face. Occurs when animal saliva enters the human bloodstream. Identify the Treponema pallidum bacterium that causes inflammation lymph nodes, in this case it is very difficult.
Mixed - when first an abscess without compaction appears, and only then a classic chancre. A soft ulcer covers a hard chancre, which is why the vast majority of infected patients do not think about another reason for their appearance.

Another sign of LUES infection is enlarged lymph nodes near the groin and throat. Changes occur approximately a week after the appearance of chancre. Oddly enough, it is the manifestation of thickenings in the lymph nodes that leads the majority of infected people to the doctor.

In addition to chancre, additional symptoms of syphilis appear in women and men. In both the female and male body:

Body temperature rises for no apparent reason;
The number of leukocytes in the blood increases;
Hemoglobin decreases (anemia occurs);
Headaches occur;
Insomnia is tormenting;
Loss of appetite;
Irritability and aggressiveness appear;
Joints and bones hurt;
Sometimes the tonsils, larynx and genitals swell. In the latter case, pain appears when walking;
The whole body is covered with a syphilitic rash.

Features of the manifestation of infection in newborns

It is very difficult to diagnose an infection in a newborn. Very few children are born with signs of the disease right away. For many, symptoms of primary syphilis appear within a month, for some after 3 years of life, and for most at 14–15 years of age - this is a latent form of lues. It can be detected before manifestation only by various analyzes and tests. Practice shows that here, too, laboratory testing often gives a negative result.

Immediately after birth, the presence of infection in newborns can be detected by pemphigus, runny nose, enlarged lymph nodes, damage to internal organs and bones.

Pemphigus – small rash with cloudy fluid on the soles of the feet and palms, and in rare cases may appear on the face, elbows and knees. Runny nose - persistent rhinitis without signs of allergy. If the infection is not treated, the nasal septum will collapse. Enlarged lymph nodes - in infants, lumps form in the area elbow joints.

Damage to internal organs - the destructive effect of infection affects everything vital organs: hepatitis develops, increases to a dense state, the spleen, bronchi expand, and sometimes the kidneys are affected.

Damage to the bones - the skull is deformed, the cartilage becomes inflamed, and osteochondritis develops. Damage to the nervous system - convulsions occur, there is a lag in physical development, lethargy and apathy occur.

Timely detection of the first signs of syphilis means quickly and successfully treating the disease. Otherwise, a secondary period of lues begins, which is more difficult to treat and is more destructive for the body. Let us note, however, that the first symptoms of syphilis in men are much easier to identify.

Therefore, when ulcers appear on the body, examine them. If you find a lump inside, additionally examine the lymph nodes. Their increase also indicates infection with Treponema pallidum. Don't feel ashamed, be sure to consult a doctor.

Syphilis (Lues) is an infectious disease that has a long, undulating course. In terms of the extent of damage to the body, syphilis is classified as a systemic disease, and in terms of the main route of transmission it is considered a sexually transmitted disease. It affects the entire body: skin and mucous membranes, cardiovascular, central nervous, digestive, musculoskeletal systems.

What kind of disease is this, the first signs and causes of development, as well as what syphilis rashes look like on the skin of an adult, and what is prescribed as treatment - we will look further in the article.

What is syphilis?

Syphilis is the most severe venereal disease, characterized by a long-term course and affecting all human organs.

IN environment The causative agent of syphilis can live in the presence of moisture for several hours, but dies almost immediately when dried, exposed to high temperatures, or disinfectants. It remains viable when frozen for several days.

The disease is highly contagious even during the incubation period

The symptoms of syphilis are so varied that it is quite difficult to understand them right away. As the disease develops, the manifestations change fundamentally: from a painless ulcer at the first stage to severe disorders psyche in a state of disrepair. The same symptom differs in different patients depending on the immune system, place of occurrence, or even the gender of the person.

Classification

The course of syphilis is long-term, wave-like, with alternating periods of active and latent manifestations of the disease. In the development of syphilis, periods are distinguished that differ in the set of syphilides - various forms of skin rashes and erosions that appear in response to the introduction of pale spirochetes into the body.

Depending on the length of time that has passed since infection, there are:

early syphilis - up to 5 years,
more than 5 years - late.

According to typical symptoms, syphilis is divided into:

primary (chancroid, scleradenitis and),
secondary (papular and pustular rash, spread of the disease to all internal organs, early neurosyphilis)
tertiary (gummas, damage to internal organs, bone and joint systems, late neurosyphilis).

You can find out what syphilis looks like only after the incubation period has passed. The disease has four stages in total, each of which has its own symptoms. The long incubation period lasts 2-6 weeks, but sometimes the disease may not develop for years, especially if the patient took antibiotics or was treated for infectious colds. At this time, laboratory tests will not give a reliable result.

Primary syphilis

Lasts 6-8 weeks, characterized by the appearance of pale spirochetes of primary syphiloma or chancre at the site of penetration and subsequent enlargement of nearby lymph nodes.

Secondary stage

This stage of the disease lasts about 2 – 5 years. It is characterized by a wave-like course - the symptoms of syphilis appear and disappear. The main signs at this stage include the appearance of a rash. Rashes can form on various areas of the skin, including the torso, legs, arms and even the face.

With secondary syphilis, it is often possible to diagnose syphilitic roseola - these are peculiar rounded pale pink spots that can reach 10 mm in diameter. Such spots can appear on any part of the patient’s body.

Distinctive feature syphilitic roseola- this is its gradual manifestation of 10-12 spots per day for seven days. If you press on roseola, it disappears.

It should be noted that secondary syphilis can be of several varieties:

Tertiary stage

Tertiary syphilis manifests itself as focal destruction of the mucous membranes and skin, any parenchymal or hollow organs, large joints, nervous system. The main signs are papular rashes and gummas, degrading with rough scarring. Rarely detected, it develops within 5-15 years if no treatment is provided.

Congenital form

Congenital syphilis can be divided into several types:

The early form of the disease, as a rule, manifests itself already in the first two months of the baby’s life. The first signs of syphilis are the formation of a papular rash, as well as damage to the nasal mucosa. More serious complications include partial or complete destruction nasal septum, hydrocephalus, hepatosplenomegaly, retardation in mental and physical development.
The late form of congenital syphilis is characterized by the so-called Hutchinson triad. Such children have corneal lesions, dental pathologies, and labyrinthine deafness.

Incubation period

During the entire incubation period, no matter how long it was, a person is contagious. Therefore, after the patient is diagnosed, he should inform his sexual partners about this.

The duration of the incubation period varies under the influence of many factors. It is shortened for a number of reasons:

Secondary infection after complete cure syphilitic infection(superinfection).
Sexual infections (especially gonorrhea).
Heavy accompanying illnesses(cirrhosis, tuberculosis, malaria).
Drug and alcohol abuse.
The presence of more than two foci of penetration of Treponema pallidum.

It lengthens due to the following factors:

Old age (55-60 years). This is due to withering metabolic processes in organism.
Long-term diseases that are accompanied by weakened immunity. Previous operations.
Individually reduced susceptibility to spirochete bacteria. The reason for this phenomenon has not been established.
Use of antibiotics (for pneumonia, sore throat, flu, sexually transmitted infections). This masks the disease and slows down the development of the pathogen.

How syphilis manifests itself: the first signs

Appearance syphilitic rash on hands

The time between infection and the appearance of the first signs of syphilis depends on the person's immunity and on the method by which the bacteria were transmitted. As a rule, this occurs after a month, but manifestations may appear earlier or later, or be absent altogether.

The first signs you need to pay attention to:

The very first visible symptom of syphilis is an ulcer, which appears in the place where the syphilitic bacteria have invaded.
At the same time it becomes inflamed lymph node located nearby, and behind it - lymphatic vessel. For doctors, this stage is distinguished in the primary period.
After 6-7 weeks, the ulcer goes away, but the inflammation spreads to all lymph nodes, and a rash appears. This is how the secondary period begins. It lasts from 2 to 4 years.

One of the signs is the appearance of chancre on the face

In men, this is the appearance of a painless ulcer called chancre. Its location in almost all cases is on the genitals. A chancre can appear on the head, on the foreskin, on the penis itself, and can even appear on the scrotum.

The chancre itself is round and hard to the touch, covered with a white greasy coating on top. Its consistency is cartilage-like. In almost all cases there is only one, only occasionally several small ulcers may appear close to each other.

Among women skin manifestations characterized by the appearance of hard chancre on the genitals. There have also been cases of the first signs of infection appearing in the form of a chancre on the lips or near the nipple on the chest. Sometimes there are several small ulcers, sometimes it is single.

Causes

The causative agent of the disease is a bacterial microorganism, Treponemapallidum (treponema pallidum). It enters the human body through microcracks, abrasions, wounds, ulcerations, from the lymph nodes it enters the general bloodstream, affecting mucous surfaces, skin, internal organs, the nervous system, and the skeleton.

The likelihood of infection depends on the number of bacteria entering the body, that is, regular contact with a sick person increases the risks.

Having got from a sick person to the skin or mucous membranes of a healthy person, the pathogen penetrates through microscopic surface injuries and spreads throughout the body. In this case, complex immune processes occur. However, after treatment, stable immunity is not formed, so you can become infected with syphilis more than once.

External ulcers, erosions, papules are very contagious. If a healthy person has microtraumas of the mucous membrane, then if he comes into contact with a sick person, he runs the risk of becoming infected.

The blood of a person with syphilis is contagious from the first to the last day of the disease, so transmission of infection can occur not only through transfusion, but also through injury to the mucous membranes and skin.

How is syphilis transmitted?

Syphilis is transmitted in the following ways:

sexual (95%) after contact with a sick partner;
It is very rare to get sick with syphilis at home (this is due to the fact that the bacterium dies without the conditions it needs when it dries);
in utero - this is how children become infected in the womb
through breast milk from sick mother to child;
during childbirth during the passage of the child through the birth canal;
through blood used for transfusion.

The most contagious patients– patients with primary and secondary periods of the disease. During the tertiary period, the concentration of Treponema pallidum in the patient’s secretions decreases sharply.

Symptoms of syphilis

Syphilis is quite diverse in its manifestations. This depends on a number of factors, ranging from the state of immunity of the person affected by treponema, and ending with the number of pathogens penetrating the body.

The first symptoms of syphilis in most cases are characteristic enough to be seen and recognized. If you contact a venereologist at the first suspicion, you can avoid a lot of trouble and really quickly get rid of this disease.

There are skin manifestations of syphilis and internal lesions. Characteristic symptoms are:

the appearance of chancre - a smooth, painless ulcer with rounded, slightly raised edges up to a centimeter in diameter, bluish-red in color, which can sometimes hurt;
enlarged lymph nodes;
headaches, malaise, muscle and joint pain;
elevated temperature;
decreased hemoglobin, increase in blood;
indurative edema;
panaritium - inflammation of the nail bed that does not heal for several weeks;
amygdalitis - hard, swollen, reddened tonsils, difficulty swallowing.

What does syphilis look like on human skin: photo

This is what the rash on the palms looks like

Signs of the primary form of syphilis

The initial symptoms of the disease appear at the place through which the treponema entered the human body. A painless ulcer with dense edges forms there - a chancre. Most often it occurs in the genital area - on the skin or mucous membrane.
A week after the formation of a skin lesion, first the inguinal and then all groups of lymph nodes enlarge. The duration of this period is one and a half months.

5-6 weeks after its occurrence, the primary chancre heals spontaneously, even without treatment. This is one of the main dangers of syphilis - a person thinks that everything is fine, but the main clinical symptoms appear later.

Symptoms of secondary syphilis

The first rashes (papules or roseola) often occur with residual symptoms of chancre and scleradenitis. After 1-2 months they disappear without a trace, and the period of early latent syphilis begins. After a few weeks (months), a wave of generalized rashes (secondary syphilis) occurs, which lasts approximately 1-3 months.

Most often the rash occurs:

roseola - in the form of rounded pink spots;
papular - pink and then bluish-red nodules, resembling lentils or peas in shape and size;
pustular - pustules located on a dense base, which can ulcerate and become covered with a dense crust, and when healing often leaves a scar.

Different elements of the rash, such as papules and pustules, may appear at the same time, but any type of rash contains a large number of spirochetes and is very contagious.

The first wave of rashes (secondary fresh syphilis) is usually the brightest, most abundant, accompanied by generalized lymphadenitis.
Later rashes (secondary recurrent syphilis) are paler, often asymmetrical, located in the form of arcs, garlands in places exposed to irritation ( inguinal folds, mucous membranes of the mouth and genitals).

Despite the fact that during this period purely skin symptoms are observed, Treponema pallidum, which has seeded all tissues and organs, can cause various forms:

meningitis,
liver pathology (icteric or anicteric),
lipoid nephrosis or other kidney diseases,
syphilitic gastritis,
and various lesions bones and joints.

Symptoms at the tertiary stage

If a patient with syphilis has not been treated or the treatment has been inadequate, then several years after infection he will develop symptoms of tertiary syphilis. Serious violations of organs and systems occur, the patient’s appearance is disfigured, he becomes disabled, and in severe cases, death is likely.

The tertiary form is characterized by gummas - round, large, painless syphilides. They can appear both on the surface of the skin and on internal organs. This disrupts the functioning of the heart, kidneys, and digestive system.

One of typical symptoms late syphilis– destruction of the saddle of the nose, due to which the profile takes on a characteristic shape.

After some time, the infection of the nervous system begins to take its toll. Neurosyphilis leads to gradual degeneration of the entire nervous system:

sensory disturbance,
altered reflexes,
sensory errors
paralysis,
change in character
weakening of memory,
dementia.

The secondary and tertiary periods have almost the same symptoms. Differences in symptoms for men and women are present only in the primary period, when chancre appears on the genitals:

chancre on the cervix. Signs of syphilis, when hard chancre is located on the uterus in women, are practically absent and can only be detected during a gynecological examination;
gangrenous chancre on the penis - there is a possibility of self-amputation of the distal part of the penis;
chancre in the urethra is the first sign of syphilis in males, which is manifested by discharge from urethra, dense penis and inguinal bubo.

Complications

The most serious consequences of syphilis are:

First of all, damage to the central nervous system. This is fraught with the manifestation of neuritis.
Very often, in patients with neurosyphilis, the functioning of the organs of hearing and vision is impaired.
Quite often, osteoarthritis appears as a consequence of syphilis.
The cardiovascular system is also subject to complications: sometimes syphilitic myocarditis appears, later the functioning of the aortic valves is disrupted, and attacks occur periodically. Due to impaired blood circulation, the patient suffers from myocardial infarction.

Diagnostics

If a rash or ulcer appears on the skin, you should consult a dermatologist. Patients often see a urologist or gynecologist. Doctors of all these specialties, after appropriate tests and detection of syphilis, refer the patient to a venereologist.

Laboratory diagnostic methods include:

Test for syphilis. Treponema pallidum is detected under a microscope in the biomaterial taken (blood, cerebrospinal fluid, secretions from skin elements).
Wasserman reaction, testing for rapid plasma reagins. The patient donates blood for syphilis, where the patient is found to have antibodies that are produced against certain parts of the treponema and tissues destroyed by the pathogen.
PCR – polymerase chain reaction – method laboratory diagnostics, which also allows you to identify treponema in material taken from the patient.
Various types of serological tests: RPGA, RIBT, RIF, ELISA.

Treatment

The main method of treating syphilis is antibacterial therapy. At the moment, as before, penicillin antibiotics are used (short and long-acting penicillins or durable penicillin medications).

In the event that this type of treatment is ineffective, or the patient experiences individual intolerance to this group of drugs, he is prescribed drugs from the reserve group (macrolides, fluoroquinolones, azithromycins, tetracyclines, streptomycins, etc.)

It should be noted that in the early stages of syphilis Antibacterial treatment is the most effective and leads to complete cure.

There are two main methods of treating syphilis: continuous (permanent) and intermittent (course). During the process, control tests of urine and blood are required; the well-being of patients and the functioning of organ systems are monitored. Preference is given complex therapy, which includes:

Antibiotics (specific treatment for syphilis);
General strengthening (immunomodulators, proteolytic enzymes, vitamin-mineral complexes);
Symptomatic drugs (painkillers, anti-inflammatory, hepatoprotectors).

The most commonly used tablets are:

Rovamycin. The dose is determined by the doctor. Cannot be used for liver complications or pregnancy. An overdose may manifest itself in the form of vomiting or nausea.
Sumamed. Negatively affects the liver and kidneys. Treatment is carried out at an early stage of syphilis, often used as additional remedy to stronger drugs.
Cefotaxime. Dosage varies depending on the stage of the sexually transmitted disease and the patient's response to the medication. Prohibited if you are allergic to penicillin.
Amoxicillin. Weakly effective compared to penicillin and its derivatives. Do not take together with antibacterial drugs.

Prevention

It is impossible to ward off syphilis in advance. Against of this disease There is no vaccine or other active prevention methods. It is important to follow the rules of safe sex and refuse casual relationships.

Public prevention should be carried out in accordance with the general rules for the fight against sexually transmitted diseases. Components of such prevention:

mandatory registration of all patients,
examination of his family members and persons who were in close contact with him,
hospitalization of infected people and monitoring them over the next few months,
constant dispensary monitoring of the treatment of sick patients.

If you are forced into close contact with a person who has syphilis, it is important to take all measures to prevent the disease from spreading. To do this, it is enough to strictly follow all the rules of hygiene, as well as avoid close bodily contact with an infectious patient. If you follow all these rules, the risk of infection is significantly reduced.

Syphilis is a very dangerous infectious disease, both for the person himself and the people around him. It is important, when the first signs appear, to contact a dermatologist or venereologist to make an accurate diagnosis, take tests and begin proper treatment with medications.

The incubation period lasts about 3-4 weeks, which makes it difficult to determine the carrier of the disease, however, if a person for some reason takes antibacterial drugs, the period can last up to six months or be shortened to 2 weeks otherwise.

The important point is that that the infection can actively develop in the body, the manifestations are not yet visible and laboratory tests cannot detect the disease within 2-4 weeks after the start of the primary period. Based on this, all sexual partners after infection have a high chance of becoming infected and should mandatory undergo laboratory examination.

For precise definition disease photos from textbooks or the Internet are not suitable, because a beginning chancroid can easily be confused with big pimple or allergic rash, but how soon you discover the disease in yourself depends on how the treatment process will proceed. We advise you to immediately consult a doctor at the first signs of illness, who can accurately diagnose.

Periods of syphilis

Before selecting the correct treatment for syphilis, it is worth knowing at what stage of the disease the disease develops.
The disease itself has 4 stages – let’s look at them in more detail.
Treatment of the disease is quite possible at each of its stages, with the exception of the last, when all organs and systems are affected and cannot be restored - the only difference is the duration and intensity of the course.

Incubation period

Symptoms of syphilis during its incubation, latent period do not manifest themselves as such - in this case, the disease is diagnosed not by its external manifestations, but based on the results of tests carried out using the PCR technique. The duration of the incubation period is 2-4 weeks, after which the disease passes to the stage of primary syphilis.

Syphilitic sore throat

One of the reasons for the development of tonsillitis is syphilis, or rather, one of the external manifestations of infection with Treponema pallidum is symptoms that are characteristic of tonsillitis, but have certain differences.

For example, against the background of a sore throat, enlarged tonsils, lymph nodes and dry mouth, patients will experience the following signs of infection: an inflammatory process in only one tonsil, the manifestation of erosions followed by transition to small red wounds, absence of temperature, painlessness of the lymph nodes , gray plaque in oral cavity and the presence of one or more large ulcers with smooth edges.

In addition, one of the first signs that it was treponema that caused the patient’s condition, similar to a sore throat, is the duration of the disease, which in this case lasts several times longer than a regular sore throat.
The first manifestations of syphilitic tonsillitis can only be observed in people who engage in oral sex, since treponema pallidum first manifests itself at the site of the entrance gate.
Another method of infection is the use of the patient’s personal belongings for oral hygiene.

The smell of syphilis

Women may often experience a sign of infection such as an unpleasant odor in the discharge. This is especially typical for the second period of the disease, when the amount of hostile microflora is greatest.

Therefore, if a woman’s discharge begins to have a strong odor without any obvious reasons, for example, failure to observe basic personal hygiene, leading to mixing of the secretions of the sebaceous glands, uterine mucus and vaginal discharge, then herpes, chancroid or syphilis begin to be suspected, which inflame the tissue.

In this case, in addition to unpleasant odor A change in the consistency of the discharge itself and a change in its color will also be observed.
Such discharge can cause pain, burning and herpes.
However, infection with treponema does not always lead to a combination of all these external manifestations of the disease, so no matter what signs, in addition to an unpleasant odor, are observed, it is worth contacting a gynecologist or virologist for advice and timely detection of the infection.

Pain

Pain is rare, especially on initial stages progression of the disease. The appearance of the first pain is usually a sign of the transition of the disease from the first period to the second. In this case, episodic headaches and joint pains appear a week before the first signs of the second period of spirochete infection. In later stages of infection, pain is usually associated with damage to the musculoskeletal system and ulceration of the gumma on the skin and mucous membranes of internal organs.

If we are talking about musculoskeletal pain, the first manifestations can be observed in the primary period of infection in the form of aches and pains at night and in the evening, which are usually complained of by people with rheumatism.
In the second period, bone damage may occur in the form of periostitis of the cranial or tibial obliques.
Although joint damage occurs after infection, it usually does not lead to pain.

A sign of infection in the second stage may be calcific growths on the tubular bones on an x-ray, but only in case of repeated recurrent development of the disease. During primary infection, such changes in x-rays are missing.

Definition of disease

The severity of the disease depends on how much time has passed after infection until the first diagnosis is made. correct diagnosis. However, the problem remains - how to determine syphilis? The problem of definition is associated not only with the variety of symptoms in the initial and other stages, but also with the frequency of infection, as well as the tendency of many citizens to self-medicate instead of seeing a doctor. It is easier to identify other diseases, but infection with Treponema pallidum is not so simple.

Once the first signs appear, they may remain invisible or may be mistaken for another disease.
In the second case, self-medication usually begins, the visible result of which is the disappearance of external signs of the disease, which should be associated not with healing, but with the body’s immune response to the pathogens of the disease.
The man, being in full confidence that he was treated correctly, he calms down, and when after some time other signs appear, they are no longer associated with chancroid.
Therefore, you should not try to determine skin infections yourself, it is better to immediately contact specialists so as not to miss the onset of a serious infection.

Itching with syphilis

It is also worth considering what signs are not typical for infection with spirochetes. For example, if, based on a “diagnosis” made independently using a reference book or after an authoritative statement from “Nyura’s neighbor,” it was established that the cause of the rash is secondary syphilis, you should not rush to your suitcases in a panic and pack your things in venereal dispensary. The first thing you need to do is contact a specialist, answer his questions and, if necessary, take the appropriate tests.

Before that, you can calm down and think whether all the manifestations and their nature correspond to infection with spirochetes.

So, if a person’s rash itches, it’s worth thinking about whether syphilis itches?

And having searched for more detailed information on this issue, find out that rashes caused by spirochetes cannot be accompanied by itching, which means that itching is a clear sign absence of Treponema pallidum in the body.

Therefore, if “syphilis itches,” then it is not syphilis and you can calm down.

Lymph nodes with syphilis

The first signs of syphilis are not limited to the formation of hard chancre at the entrance gate. Following this, regional inflammation of the lymph nodes should appear. In this case, the lymph nodes almost always become inflamed and increase in size, while remaining mobile and painless.

Their size can reach a large walnut.
As the first signs of syphilis, photos of inflamed lymph nodes will show a person with a large lump, not far from the site of infection, while the skin in the area above the nodes will not change its color.
Such changes in the lymph nodes are associated with foci of spirochete proliferation in them.

Enlargement of all lymph nodes or their soreness indicates another type of infection, not associated with pallidum treponema.

Buboes or inflamed lymph nodes have been considered the main signs of syphilis since the Middle Ages, when it was believed that they simply could not exist without each other. However, due to people taking various medications in the last decade, the number of cases in which the presence of Treponema pallidum in the body was not accompanied by regional lymphodermitis has increased.

Detection of syphilis

Testing for syphilis is an important stage in making a diagnosis, monitoring the quality of treatment, as well as mandatory regular monitoring for several years after successful therapy.
Considering what the first signs of syphilis may be in a patient and how similar they are to the manifestations of other diseases, even experienced doctor will not be able to make a diagnosis without undergoing an examination aimed at identifying treponema pallidum.
In the course of identifying the causes of symptoms that appeared suspicious and atypical to the doctor, important role plays anamnesis collection, which will allow you to clarify the number of sexual partners, possible time infection, as well as the presence or absence of factors that could give a false positive or false negative result when examining a patient.

Since diagnosis and treatment for treponema infection is a serious task, several studies are usually carried out at once, designed to complement and verify the data of other tests.

During the treatment process, repeated studies are designed to determine the success of therapy and, if necessary, adjust it to obtain a better result.
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Signs of primary syphilis

The following signs of primary syphilis can be distinguished:

Primary syphilis in its normal course appears three to four days after the treponema enters the body. This stage lasts on average for five to six weeks.

Currently, venereologists are noticing changes in the course of primary syphilis. If years earlier syphilis manifested itself through a single chancre on the patient’s body, now there are two or more such ulcers on the body. Also, if previously it was possible to feel a clearly defined compaction of chancre, now this compaction may not appear.

Primary

Naturally, people are primarily interested in the question of what are the first signs of syphilis. This information is really important, because the sooner you notice changes in your own body, the sooner you will see a doctor and receive appropriate help.

In fact, there is a certain pattern according to which syphilis develops in most cases. The stages of the disease are as follows: primary, secondary and tertiary forms of the disease, which follow one after another. Moreover, each of these stages has a very characteristic clinical picture and is accompanied by a unique set of symptoms.
First, treponema penetrates the body and migrates to the lymph nodes, where it begins to actively multiply. As a rule, the first manifestation of syphilis occurs four weeks after infection - this is the incubation period. At the site where microorganisms invade, a so-called chancre is formed, which opens as the disease progresses, forming a small ulcer. In this case, pain practically does not bother the sick person.
Most often, chancre appears in the area of the external genitalia. For example, in men it is often located on the head of the penis. However, the ulcer can be found on the skin of the thighs, abdomen, and sometimes near the anus. It is worth noting that sometimes chancre forms on the mucous membrane of the rectum, the cervix, or even on the tonsils - in such places it is almost impossible to detect it on your own, so infected people simply do not go to the doctor.

After some time, you can replace the enlarged lymph nodes next to the chancre - most often the infection invades the nodes located in groin area. In most cases, a person himself can detect an enlarged node, which is usually hard to the touch. In some cases, due to impaired lymphatic drainage, swelling of the labia, foreskin, scrotum, and tonsils appears (depending on the location of the infection).

This stage of the disease lasts about 2 – 3 months. If left untreated, chancre disappears. Of course, this does not indicate recovery - the disease moves to a new, more dangerous level.

The first signs of syphilis of the secondary form

It should be noted that secondary syphilis can be of several varieties:

Fresh- this type of syphilis is a consequence of the primary form. Symptoms - small polymorphic rash and chancre;
Hidden- even the incubation period of syphilis does not manifest itself in any way externally, but can be detected through serological studies;
Recurrent- with this form of secondary syphilis, relapses alternate, and during each relapse a rash appears on the body. But unlike fresh syphilis, the rash during relapses is less abundant, the spots are larger, and foci of rashes can be identified.

Secondary form of the disease: main symptoms of syphilis

By the way, the rash in this case can be different.

Most often it looks like small spots of red or pink color with clear edges. The formation of papules or pustules is also possible.
Sometimes another bacterial infection is associated with syphilis - in such cases, pustules can form on the skin.
In any case, the rashes, as a rule, do not cause physical discomfort - there is no itching, no pain, no fever.
Therefore, sick people rarely seek help from a specialist, which, naturally, allows the disease to progress further.

As for the other signs, when a rash appears on the scalp, partial alopecia develops - the hair in these areas falls out. In addition, the patient may notice an increase in certain lymph nodes.

By the way, in some patients a rash appears on the body only at the initial stage - over the next years they do not have any visible signs syphilis. At the same time, other patients suffer from relapses constantly - rashes appear and disappear. It is believed that a weakened immune system may trigger a new outbreak of the disease, frequent stress, hypothermia, exhaustion of the body, etc.

Tertiary syphilis

The third stage of the disease, as a rule, begins 3 to 10 years after infection. It is accompanied by the appearance of so-called gummas. These are infiltrative tubercles with clear boundaries, formed on the tissues of internal organs. They are prone to decay and scarring.
In fact, gummas can affect almost any organ system, leading to dangerous complications. For example, if such tubercles “grow” on bone tissue, then a person develops arthritis, periostitis or another disease.
Damage to the intra-abdominal lymph nodes leads to the development of mesadenitis, which is accompanied by severe pain.
No less dangerous are gummas in the central nervous system, since their appearance often leads to damage to certain parts of the brain and gradual degeneration of the personality.

If left untreated, syphilis is fatal.

If left untreated, tertiary syphilis develops in 30% of people with secondary syphilis. Tertiary syphilis kills one fourth of those infected. It is extremely important to recognize the signs of syphilis in women and men at least at this stage.

Signs of tertiary syphilis:

In men, tertiary syphilis is diagnosed through the appearance of tubercles and gummas. The tubercles are quite small in size and quite a lot of them form on the body. Gummas are rare, quite large and located deep in the tissues. Inside these formations there is not such a large number of treponemes, so the risk of infecting another person is much lower than with secondary syphilis.
In the tertiary form, the first signs of syphilis in women are tubercles and gummas as in men. Both tubercles and gummas eventually turn into ulcers, which will leave scars after healing. These scars have a detrimental effect on the condition of organs and tissues, severely deforming them. Gradually, the functions of organs are disrupted, which ultimately can lead to fatal outcome. If syphilis infection occurred from a partner through sexual contact, then the rash will primarily be in the genital area (on the vagina, etc.).
In children, tertiary syphilis affects the skin, internal organs and nervous system with special tubercles - syphilides. Syphilides are formed due to the development hypersensitivity the child’s body to treponemes, which are found in abundance in the child’s body.

Tertiary syphilis can last for decades. The patient may suffer from the development of mental insanity, deafness, loss of vision, and paralysis of various internal organs. One of the most important signs of tertiary syphilis is significant changes in the patient’s psyche.

If previously a person was quite calm, then as a result of prolonged exposure to syphilis on the body, a person begins to panic, suffers from paranoia, attacks of rage and depression, which are followed by periods of euphoria.

Often at this stage of the development of the disease, the patient experiences hallucinations - this occurs as a result of the destruction of brain tissue.

Congenital form of the disease

As already mentioned, infection can also occur during pregnancy, since bacteria can easily penetrate fetal tissue through the placental circulatory system. As a rule, transmission of the pathogen occurs after the end of the first trimester. That is why pregnant women are strongly recommended to get tested for syphilis. The earlier the disease is detected, the easier it will be to eliminate the threat to the child’s health.

Of course, an infection can lead to disruption of the normal development of the fetus - in some cases, doctors even hold a consultation regarding termination of pregnancy. On the other hand, the child may be born quite viable. Congenital syphilis can be divided into several types:

The early form of the disease, as a rule, manifests itself already in the first two months of the baby’s life. The first signs of syphilis are the formation of a papular rash, as well as damage to the nasal mucosa. More serious complications include partial or complete destruction of the nasal septum, hydrocephalus, hepatosplenomegaly, and retardation in mental and physical development.
The late form of congenital syphilis is characterized by the so-called Hutchinson triad. Such children have corneal lesions, dental pathologies, and labyrinthine deafness.

In some cases, syphilis in children causes extreme severe complications up to and including death. However, if the presence of infection is determined in time and adequate treatment is started, the prognosis for the child can be favorable. Therefore, you should never ignore symptoms or self-medicate.

Signs of syphilis in men, women and children: how different types of syphilis manifest

You can select the following types syphilis and their symptoms in men and women:

Atypical syphilis manifests itself in the form of an atypical chancre. These may be indurative edema, chancrapanaricium, chancre on the tonsils and paraphimosis. Indurative edema is characterized by development in the area of the labia and preputial sac, and such edema is not accompanied by pain. The chancre looks like a rather large ulcer, dense when palpated.

The skin takes on a purplish hue. Another sign of syphilis in men and women in an atypical form is chancre-felon, which can be found near the nail phalanx on the fingers.
At the same time, the ulcer has uneven edges, creating painful sensations on the affected phalanx. At the same time, the lymph nodes in the elbows enlarge, but do not hurt. When hard chancre appears on the tonsils, erosion and ulcers occur, and the tonsil increases in size.
Patients do not experience pain from an ulcer on the tonsil. Paraphimosis in atypical syphilis is an inflammation of the preputial sac that develops when the head of the penis is exposed. Long-term paraphimosis without proper treatment can lead to necrosis of the head.

Congenital syphilis

Congenital syphilis- a transplacentally transmitted disease, that is, infection of the fetus with syphilis through the mother’s blood. This disease is distinguished in two forms - early and late. The early form of congenital syphilis begins with fetal development and continues until early childhood. Late congenital syphilis manifests itself after the child has reached the age of 15, and before that it can be assumed that the child is healthy - the disease does not show itself in any way.

If syphilis affects the fetus (usually this occurs in the fifth month of pregnancy), then treponema begins to destroy the internal organs of the child and skeletal system. The chances of such a child surviving are negligible. According to official statistics If a pregnant woman is sick with secondary form of syphilis, then in 90% of cases the pregnancy will end in the birth of a stillborn child or the death of the fetus.

Signs of congenital syphilis are diagnosed in the fetus: they may be an increased weight of the placenta (1:3 instead of the norm 1:6), and the placenta itself increases in size and is easily ruptured. Quantity amniotic fluid decreases. The organs and tissues of the fetus are affected.
If a child with syphilis is born and survives, the newborn will have loose and wrinkled skin (similar to senile skin), body disproportion (enlarged head), and specific rhinitis and other diseases will develop. Children with congenital syphilis lag behind their peers in development.

One of the varieties of syphilis, when the brain tissue, its membranes and blood vessels are affected by gumma. Neurosyphilis can be latent (diagnosed only through special studies, no external signs are observed), early (develops against the background of primary or secondary syphilis, affects the blood vessels and membranes of the brain, accompanied by syphilitic meningitis and meningomyelitis), late (occurs seven years after infection with treponema and develops against the background of tertiary syphilis, accompanied by tabes dorsalis , progressive paralysis and syphilitic gumma of the brain).

Neurosyphilis manifests itself through the following symptoms:

syphilitic meningitis - syphilis is accompanied by meningeal symptoms (severe headaches, aversion to light, nausea and vomiting, high fever);
syphilitic meningoencephalitis - essentially it is syphilitic meningitis, which is accompanied by mental disorders(hallucinations may occur);
tabes dorsalis - with this manifestation, neurosyphilis affects the spinal cord, so the patient loses sensitivity in the limbs, has difficulty seeing, and has problems with urination and defecation;
progressive paralysis - with neurosyphilis, a patient with paralysis loses reading and writing skills, develops dementia and complete personality collapse.

Hidden syphilis

Hidden syphilis- a type of syphilis when the disease is completely asymptomatic. Such syphilis can only be detected through laboratory tests. Diagnosis of latent syphilis is quite complex - it is a set of procedures based on the body’s specific reactions to syphilis.

Venereologists suggest that the development and spread of latent syphilis in the world is associated with the widespread use of antibiotics: patients mistake the symptoms of syphilis for signs of another sexually transmitted disease and try to cure it with an antibiotic. The drug suppresses the symptoms of syphilis, and the disease begins to be asymptomatic.

Latent syphilis can be early or late. Early latent syphilis is the period from primary syphilis to secondary syphilis, which usually corresponds to two years.

Despite the fact that latent syphilis does not manifest itself in any way externally, a person infected with it is dangerous to others.
Late latent syphilis is diagnosed more than two years after infection with treponema. Such patients are not dangerous to others.
Most often in medical practice, latent syphilis is unspecified - the patient does not have any information about the expected date of infection with syphilis.

Household syphilis

Household syphilis can be obtained non-sexually. This usually occurs as a result of poor personal hygiene or lack thereof. It is enough for a person to use someone else’s towel or toothbrush, drink water from someone else’s glass - and treponema penetrates the body. In general, treponema is quite tenacious only at low temperatures - its ability to infect can persist for several years. However, at temperatures above 45-50 degrees, treponema dies.

Corresponding to the signs of sexually acquired syphilis, the differences are only in the location of the hard chancre on the body of the infected person: with sexual infection, the chancre most often appears in the genital area, and with domestic infection it can be found on any other part of the body.

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Other types of disease

Today in medicine there are several forms of this disease. The classic type of the disease is easy to notice and, accordingly, cure. But there are more dangerous types of syphilis that you also need to know about.

Latent syphilis today is considered one of the main problems in venereology. Why? The fact is that in some people, treponema pallidum after penetration into the body does not cause any visible symptoms. In 90% of cases, this form of syphilis is discovered completely by accident, for example, during a routine examination or screening during pregnancy. At the same time, an infected person is not even aware of his problem, as a result of which he becomes a source of pathogenic microorganisms for everyone around him.
There is another, no less dangerous type of the disease - sero-resistant syphilis. This form is spoken of in cases where, after a course of treatment, treponema is still present in the tests. Patients with a similar diagnosis require an additional course antibacterial therapy. Unfortunately, it is not always possible to cure the resistant form of infection. And in some cases, the infected status remains with the person throughout his life.

Diagnostic methods

Today, there are many studies in which it is possible to determine the presence of treponema in the human body. When the first symptoms appear, you should go to the doctor. After visual inspection The venereologist will decide which tests are needed.

In case of primary syphilis, as a rule, bacterioscopic methods are informative, for which fluid from a chancre or a biopsy obtained from a lymph node is used as a test sample. It is considered no less accurate serological analysis for syphilis, during which the presence of a specific immunoglobulin IgM can be detected in the body. But it is worth considering that these tests are carried out only at the primary stage of the disease.

Secondary and tertiary syphilis require other studies.
In particular, the most popular is the Wasserman test (RW analysis) - this is the test that is used in clinics for mass examination of patients.
Such testing makes it possible to determine the presence of bacteria at any stage of the disease.
However, the possibility of a false negative or false positive result cannot be excluded.

The most accurate method today is considered to be the immunofluorescence reaction (RIF). This method allows you to identify even hidden forms of the disease. Naturally, there are other methods of laboratory research. For example, in some cases to obtain additional information The doctor refers the patient for a spinal tap, after which cerebrospinal fluid samples are sent to the laboratory.

Modern methods of therapy

Treatment of syphilis is a long process. At one time, a single injection of large doses of penicillin was used to eliminate the infection. Now such a treatment regimen is considered incorrect.

Only the attending physician can select medications for the patient. Moreover, the sick person is obliged to follow all the specialist’s recommendations and strictly follow the intake schedule. In most cases, the presence of such an infection requires taking fairly large doses of antibiotics - most often substances of the penicillin series (penicillin, erythromycin, tetracycline) are used for this purpose. Patients who are allergic to these antibiotics receive other antibacterial drugs.

Since the doses of drugs in this case are really large, it is extremely important that treatment of syphilis takes place in inpatient conditions under constant supervision of medical personnel.
In addition to antibiotics, immunomodulatory drugs are used.
If there is a rash, the doctor may prescribe a special ointment that speeds up the healing process.
To protect microflora, it is recommended to take products containing live strains of beneficial microorganisms.

If one of the sexual partners is diagnosed with syphilis, the other is also required to get tested and undergo a full course of treatment. Even if no signs of Treponema pallidum have been detected in the body, so-called preventive therapy is carried out. Compliance with this condition helps to avoid re-infection.

Primary and secondary syphilis is treated, as a rule, in 1.5 - 3 months. The tertiary stage of the disease requires longer therapy, which often lasts more than a year.

Course of antibiotic treatment

Each patient, man and woman, is prescribed antibiotics during the course of treatment - the causative agent of this infectious disease is sensitive to them. So the drug itself, the duration of its use and dosage are prescribed by the doctor on an individual basis, taking into account all the tests and results of the patient’s examination.

The disease is sensitive to the following groups of drugs:

drugs containing penicillin.
macrolides and the antibiotic ceftriaxone.

Thus, antibiotics containing penicillin act very effectively during treatment, having a detrimental effect on the causative agent of the pathology. When diagnosing primary syphilis, they provide excellent treatment dynamics. Today, dermatovenerologists do not practice the first method. loading dose administration of penicillin - a more effective technique intramuscular injection the drug at intervals of every 3 hours, which ensures its constant concentration in the body.

PENICILLIN (A REMEDY FROM SOME TYPES OF MOLD)

Thus, drugs containing penicillin are excellent in combating the early stages of neurosyphilis, but so far the nervous system has not undergone irreversible changes in its functioning, and also given the congenital nature of syphilis damage to the body.

If the third stage of syphilis is diagnosed, before taking penicillin you should undergo 2 weeks of therapy with drugs such as tetracycline or erythromycin.

AZITHROMYCIN – A NEW GENERATION DRUG

Syphilis and its treatment with azithromycin, a new generation drug (antibiotic), and macrolides also show good results, in its effectiveness, not inferior to antibiotics penicillin group. At the same time, the side effects and negative effects from the drug are minimal.

The only limitation for prescribing azithromycin is the diagnosis of HIV infection in the patient.
Daily intake 2 g . Azithromycin allows you to cure even late forms of syphilis in a six-month course of treatment, but the congenital form of the disease is not treated with this drug.

Treatment of syphilis with a drug such as ceftriaxone also gives its positive results and dynamics - it is prescribed even to pregnant women and in especially advanced cases. All compounds that are part of this drug suppress the internal synthesis of division and growth of Treponema pallidum cells. The treatment regimen is simple - 1 injection per day, course of treatment for at least six months. The only limitation is that doctors do not treat the congenital form of syphilis with this drug.

If the doctor diagnoses a latent form of syphilis, the treatment regimen and medications are similar, supplemented by a course of immunostimulants and physiotherapeutic procedures.

To date, doctors and scientists have not yet invented special vaccines that act effective prevention syphilis. If the patient has previously had this sexually transmitted infection, he can become infected and get it again. As a result, only preventive measures will help avoid infection and thereby prevent damage to the internal organs and systems of the body.

First of all, it is worth excluding promiscuous sexual relations with an untested partner, especially without a condom. If you have had such sex, immediately treat your genitals with an antiseptic and visit a doctor for a preventive examination and examination.
It is enough to understand that not every person knows that he is currently a carrier of the infection and, if the patient has a regular sex life, doctors recommend regular examinations by highly specialized doctors, tests for STDs, thereby identifying the disease in its early stages currents.tvojajbolit.ru

Disease prevention

Unfortunately, today there is no vaccine that can permanently protect against similar disease. People who have had syphilis can become infected again. Therefore the only effective measure prevention is the prevention of infection. This means that you should avoid promiscuous sexual intercourse, especially without using condoms. If unprotected sex did occur, it is worth treating the genitals antiseptic solution and make an appointment with a doctor.

It should be understood that not all carriers of the infection are aware of their own problem. Therefore, doctors recommend that people who are sexually active regularly get tested for STDs, as this helps to identify the disease in the early stages and, accordingly, eliminate the likelihood of the infection spreading. In addition, the disease is much easier to cure in the initial stages.
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What is chancre?

Chancre with syphilis is a specific local reaction organism to the penetration of Treponema pallidum. It all starts with a slight redness with clear edges, in place of which a painless scaly papule (nodule) appears, and later an erosion or ulcer (a deeper defect) forms, this is a chancre (that’s what ulcers were called in the old days).

Chancre has a number of features: it does not hurt, has a dense base, smooth edges, gentle walls (they resemble a saucer), and a red shiny surface. The size of the chancre is variable - from millimeters to centimeters, and the shape of the formation can also be different (round, oval, resembling a crack).

Primary syphiloma usually persists on the body for several weeks. Then the healing process begins, without any treatment. Features of healing depend on the type of chancre. So, after erosion, traces may not remain, but an ulcer always leaves a scar.

The disappearance of primary syphiloma does not at all indicate recovery.
The disease just goes to next stage, that is, secondary syphilis develops, during which the infection spreads to the internal organs.

Atypical forms of primary syphilomas

Chancroid is typical manifestation syphilis. However, there are other clinical forms of primary syphiloma. These include:

Chancroid felon is an inflammation of the extreme phalanx of the finger.
Indurative edema is dense swelling of the genitals.
Chancroid-amygdalitis is an enlargement and hardening of one palatine tonsil, but there are no ulcers, erosions or plaques on the lymphatic formation.

These manifestations of syphilis are very similar to diseases of a completely different nature, so doctors have a hard time making the correct diagnosis. Regional lymphadenitis prompts them to think about syphilis in such situations.

In addition, syphilis in the initial stages may not manifest itself at all or may have a smoothed clinical picture and a longer incubation period (for example, if a person takes antibiotics). Therefore, to clarify the diagnosis, a number of laboratory tests are always carried out.

Syphilis is an infectious inflammatory disease sexually transmitted. Despite the fact that the main route of infection is sexual contact, syphilis affects not only the genitourinary system, but also all organs and systems of the body, starting from skin and ending with bone tissue.

In the early stages, the disease’s symptoms are similar to other infections, and even an experienced doctor cannot always recognize the enemy right away, as syphilis manifests itself at all stages and during the incubation period in our article.

The disease is caused by a pathogenic microorganism - Treponema pallidum - a spiral-shaped bacterium that reproduces by transverse division. At the initial stage, after penetration into the body, it is concentrated in the lymphatic system, since this is the optimal environment for its reproduction.

Further, after adaptation to the conditions of the body, it begins to affect the bloodstream, penetrating through small blood vessels, from where it spreads throughout the body, affecting organ after organ. Syphilis is a disease that has a wave-like course - periods of exacerbation alternate complete absence symptoms.

This is the insidiousness of the disease - the infected person does not suspect the seriousness of the situation because the symptoms suddenly disappear and everything is attributed to other diseases, and at this time the bacterium continues to infect the body from the inside.

How can you get infected?

The favorite habitat of the pathogen is all body fluids.

Therefore, infection occurs through contact between a sick and healthy person during fluid exchange, which involves:

blood;
saliva;
mother's milk;
sperm;
vaginal fluid.

The only condition for bacteria to penetrate the body is the presence of wounds, microcracks in the skin and mucous membranes of the body.

Sexual route of infection

The most likely and common route of transmission is sexual contact, which occurs in 95% of all cases of infection. The highest concentrations of bacteria in the body are semen, saliva and vaginal fluid.

During sex, the mucous membranes of the genital organs come into contact, and if a healthy person has injuries, an inevitable infection occurs. The probability of infection after one sexual act is 30%. Even if sexual intercourse is interrupted before ejaculation, the probability of infection is the same, since the lubricant released during arousal contains no less than Treponema pallidum.

Not only traditional vaginal sex is dangerous, but also oral and anal sex. At orally During sex, there is the same exchange of fluids in which saliva is involved - the source of pathogen concentration.

Anal sex, according to statistics, brings the greatest risk of infection. Most patients diagnosed with syphilis are gay people.

The pathogenic pathogen penetrates through the smallest damage to the mucous membranes, and the rectum is a constant concentration of microcracks. In addition, due to the acidic environment of the vagina, some of the bacteria are neutralized, but the rectum does not have such a protective function and the concentration of the pathogen will be many times greater. And the entry of a large amount of pathogen into the body at one time greatly speeds up clinical manifestations syphilis and aggravates the course of the disease.

Infection during a kiss is an unlikely occurrence, but cannot be completely ruled out, since the survival of treponema is possible only in a humid environment, which is saliva, and if there is a wound in the oral cavity, infection is guaranteed.

Household route of infection

Infection at home occurs very rarely, but is still possible. Although treponema pallidum is sensitive to the environment, it is still able to survive in a humid environment until it dries out completely.

The source of infection can be any fluid in the body of a sick person left on household items - saliva or skin manifestations of syphilis that secrete fluid (chancre, roseola, pustular rashes).

What can cause household infection:

utensils for common use;
bath;
bed linen and sleeping area sick;
personal hygiene products – scarves, towels, clothes of the infected person.

Important. Taking a bath after being infected can risk infection, since Treponema pallidum does not die at temperatures below 55°C, and the moisture in the bath maintains its activity for reproduction.

Transplacental route of infection

Vertical or transplacental route infection occurs only in newborns, since infection occurs from mother to fetus or newborn.

Routes of infection:

through the placenta, infection occurs after the fourth month of pregnancy (through the lymphatic slits of blood vessels and through the blood if the placenta is damaged);
at the time of birth, when the child passes through birth canal from fluids during labor.

Transplacental infection is becoming less and less common in modern medical practice, since every pregnant woman is required to undergo a syphilis diagnosis at least three times during pregnancy. But cases still occur; more often these are dysfunctional families and women with drug and alcohol addiction who were not registered during pregnancy.

A timely diagnosed disease in an expectant mother is completely curable and does not harm the unborn child, but ignoring therapy threatens:

miscarriage;
giving birth before the due date;
stillbirth;
the appearance of a child with congenital syphilis.

When a child is infected from the mother, syphilis is called congenital. It is divided into:

early congenital, which manifests itself from birth to 4 years;
late congenital - from 5 to 17 years, but more often it appears during puberty from 13 years and older.

How does early congenital syphilis manifest:

papular rash in the area anus, genitals, in the mouth and on the skin;
syphilitic pemphigus - rash in the form of blisters on the palms and soles;
rhinitis manifests itself after damage to the nasal mucosa by a syphilitic rash;
osteochondritis - a syphilitic lesion of bone tissue, which is manifested by swelling and pain in the area of inflammation;
eye damage;
disruption of the functioning of all body systems and internal organs.

The first manifestations of syphilis in the late congenital period:

eye damage and blindness;
deafness as a result of damage to the inner ear;
gummous syphilides of the skin and internal organs;
destruction of the bones of the nose and nasal septum;
defeat endocrine system and other body systems.

Important. The risk of infection of the fetus from the mother is highest during the secondary period of the disease. During this period, the pathogen is most active in the body. In the tertiary period of the disease, the risk of infection decreases, since the concentration of the pathogen is minimal.

Blood transfusion and occupational route of infection

The professional route of infection occurs among doctors who have direct contact with patients with syphilis. Infection occurs when a person has minimal damage to the skin and when fluids from the patient’s body enter the wound.

How does infection occur and what is dangerous?

saliva for dentists;
manifestations of syphilis on the skin (roseola, papules, chancre) and their fluid secretions for a venereologist;
vaginal discharge for the gynecologist;
blood for surgeons and pathologists (treponema pallidum in dead body a person remains active for another 72 hours after death).

The blood transfusion route of infection is the entry of infected blood into the body of a healthy person. The patient's blood contains the pathogen in high concentrations and infection occurs in 100% of cases.

How infection can occur:

through a syringe, most common among drug addicts;
when infusing donor blood from a patient;
through medical instruments containing the blood of an infected person.

Important. When infected blood enters the body, syphilis is called decapitated syphilis. Its danger lies in the fact that the symptoms of the first stage are completely absent and the manifestation of syphilis on the skin of the secondary stage of the disease immediately appears - secondary syphilides, which means earlier diagnosis of the disease has already been missed.

Course of the disease and clinical picture

Due to the specifics of the disease, its undulating course and characteristic clinical picture, several stages of the disease are distinguished:

incubation period of the disease;
primary syphilis– first stage of the disease;
secondary syphilis– second stage of the disease;
tertiary syphilis– third stage of the disease.

Incubation of the disease

This period in medicine is called incubation or asymptomatic. It proceeds from the moment of infection until the pathogen fully adapts to the body, when the bacteria begins to actively multiply and the first symptoms of syphilis appear.

This period does not show any clinical picture and the infected person may not be aware of the infection. The duration of incubation of the disease can last from 10 to 90 days, but the average and most common periods are 20-45 days.

Such a large range from minimum to maximum term associated with certain factors. How long it takes for the symptoms of syphilis to appear depends on the state of the body and external influences on it.

For example, incubation is accelerated by weakened immunity and penetration of a large amount of pathogen into the body. Increase the asymptomatic period - elderly age infected, reception antibacterial agents and concomitant diseases with the presence of hyperthermia.

First stage

Where and how syphilis begins to manifest itself in the first stage depends on the route of infection. The fact is that the first symptom of infection - erosion or ulcer occurs at the site of infection, which is called chancre.

If the infection occurs during sex, the chancre will appear on the genitals, near the anus, or in the mouth. If infected through household contact, it can be anywhere on the skin and in the oral cavity.

The primary symptom of syphilis is chancre, which looks like a round ulcer with a diameter of up to 10 mm and raised smooth edges. It has red or Blue colour, does not cause at all pain and if it is localized in an inaccessible place (rectum, cervix), it may be completely invisible. And since it goes away on its own, without treatment, primary syphilis can go undetected.

The second sign of the primary disease is inflammation and enlargement of the lymph nodes, since the pathogen, at the beginning of the disease, concentrates there. As a rule, only the lymph nodes in the area where the chancre is located make themselves felt.

If it is localized on the genitals, the nodes in the groin area become inflamed; if it is located in the oral cavity, the submandibular nodes become inflamed. In some individual cases, the first sign, chancre, may appear in an atypical form on the skin.

Table No. 1. How syphilis manifests itself on the skin at the primary stage and what are the atypical manifestations of chancre:

Photo	Manifestation
	Unilateral damage to the tonsil. It becomes denser and acquires a red or blue tint. This phenomenon is not accompanied by painful sensations or a hyperthermic reaction, which makes it possible to exclude sore throat and tonsillitis and accurately diagnose syphilis.
	It is common when infection occurs in the area of the phalanx of the finger, where it is located. Its characteristic features are severe inflammation, swelling and pain during mechanical action.
	In most cases, it develops during sexual infection and is localized on the genitals. Characteristics - high density(there is no indentation left when you press it), pale pink shade.

Atypical chancre is difficult to diagnose, as they are similar to most other diseases, but an experienced venereologist will be able to recognize syphilitic chancre by inflammation of the nearby lymph nodes:

indurative edema is accompanied by inflammation of the inguinal lymph nodes;
amygdalitis - cervical and submandibular;
panaritium - ulna.

How syphilis manifests itself at the end of the primary period depends on the condition of the body, but in most cases everything is limited to chancroid and enlarged lymph nodes.

In very rare cases and in cases of weakened immunity, the following may occur:

headache;
a slight increase in temperature, within 37.2°-37.5°C;
symptoms of diseases of the upper respiratory system (ARVI).

Important. Some lucky people are born with individual immunity to Treponema pallidum, and they cannot become infected with syphilis. This is influenced by the presence of a special type of protein in the blood that neutralizes the pathogen.

Second stage

How quickly syphilis of the second stage manifests itself can be said with confidence - no more than three months after the appearance of the primary chancre, but even an experienced doctor cannot predict its duration. The second stage can last from two to six years with periodic changes in exacerbations and latent course.

Secondary syphilis is characterized by the same damage to the skin as in the primary stage, but it will differ in external manifestations.

Skin manifestations of syphilis of the second stage:

Syphilitic roseola– the most common type of rash of the second period. It looks like a round spot correct form with a blurred outline of the boundaries and a smooth surface. Color – pale pink, sometimes with a bluish tint. The local location of roseola is the sides of the torso. Roseola disappears on its own, without therapy, a few weeks after its occurrence. In rare cases, this cutaneous syphilide may have atypical manifestations - peeling on the surface, swelling.
Syphilide papular has the appearance of papules of regular shape with a dry or moist surface, sometimes with peeling.
Syphilide pustular- a bluish-colored spot with high density.
Syphilitic leucoderma – dark spots round in shape, of different sizes and diameters, due to their similarity with lace, they were called the “necklace of Venus”. This symptom appears only when the central nervous system is disrupted.
Syphilitic alopecia– baldness occurs when Treponema pallidum enters the skin and destroys the hair follicle. Baldness can be small-focal or diffuse. Alopecia has a benign course and, with adequate therapy, the hair is completely restored.

All skin rashes of secondary syphilis are accompanied by inflammatory processes in the lymph nodes, but not in a certain area, as in the primary stage, but throughout the body (neck, groin, armpits, femoral lymph nodes).

In addition to the skin, secondary syphilis affects the mucous membranes of the body, which manifest themselves:

erymatous tonsillitis with damage to the soft palate and tonsils;
papular sore throat - papules turning into erosions in the pharynx area;
pastular tonsillitis - purulent rashes on the oral mucosa.
pharyngitis - defeat vocal cords with possible loss of voice.

Secondary syphilis gradually affects all body systems and internal organs:

Gastrointestinal tract - gastritis, dyskinesia.
Liver – malfunction, increase in size and pain.
Kidneys – lipoid nephrosis.
CNS – increased irritability, sleep disturbances. In rare cases, meningitis.
Skeletal system – periostitis, osteoperiostitis, pain in the extremities.

Important. In some cases, a latent form of syphilis is diagnosed, in which the symptoms of the disease are completely absent and the presence of the pathogen in the body is recorded only after laboratory diagnosis.

Third stage

How long does it take for stage three syphilis symptoms to appear?

The answer is ambiguous, literary sources They call it 6 years from the moment of infection, and modern research increases the period from 7 to 10 years. The third stage is characterized by a series of exacerbations and long latent periods, reaching up to several years.

The third stage of syphilis is the last, in which pathological changes occur throughout the body and treatment is not aimed at getting rid of the disease, but at maintaining the condition and alleviating the patient’s symptoms.

Manifestations during late syphilis- tubercular and gummous syphilides:

Tuberous syphilide has the appearance of a node in the thickness of the skin, with a diameter of up to 7 mm and a dense consistency. Gradually it begins to protrude above the skin, acquiring a reddish tint. Tuberous syphilide is characterized by a wave-like manifestation and each of the nodes is at a certain stage of development. At the moment of ripening, it takes the form of an ulcer, which can heal for several months, leaving behind scar tissue. Repeated education node does not occur in the same place.
Syphilitic gumma or gummous syphilide of tertiary syphilis is a nodular formation in subcutaneous tissue. Gumma has a single location with predominant localization in the forehead, shin, knees and elbow joints. At the beginning of development, the gumma has mobility, but after increasing in size, it adheres to neighboring tissues and mobility is lost. Gradually, the syphilitic gumma emanates with the flow of gelatinous fluid, taking on the appearance of an ulcer with a necrotic core.

The danger of the tertiary period is that not only the skin is affected by syphilides, but also:

cartilage and bone tissue;
vessels;
muscles;
soft tissues;
internal organs.

How long does it take for syphilis to appear on internal organs during tertiary syphilis? As a rule, this is 10-12 years after infection. In 95% of cases of tertiary syphilis, the cardiovascular system and central nervous system are affected. Untreated syphilis in the third stage leads to inevitable death.

Important. External manifestations of syphilis - ulcers are dangerous for others. The fluid leaking from them is a source of infection.

Complications of all stages of syphilis

Table No. 2. Complications of all stages of syphilis:

Stage of syphilis	Complications
Primary	Complications in the primary period are rare. Exceptions are patients with weak immunity, chronic diseases and HIV-infected patients. Balanoposthitis. Balanitis. Gangrene. Phimosis. Parophimosis.
Secondary	Complications of the secondary period depend on the damage to internal organs by Treponema pallidum when affected: CNS – meningitis, hydrocephalus, neuritis. Cardiovascular system – syphilitic myocarditis. Liver – syphilitic hepatitis. Kidneys – nephrosis, nephritis. Musculoskeletal system – polyarthritis, arthralgia.
Tertiary	Central nervous system – neurosyphilis with paralysis, dementia. Cardiovascular system – myocarditis, aortitis, heart failure, myocardial infarction. In case of defeat of cardio-vascular system death occurs in 25% of cases.

Syphilis therapy

Before prescribing treatment for syphilis, it is necessary to fully confirm the diagnosis, since the disease’s symptoms are similar not only to STDs, but also to other diseases not related to the genitourinary system. For example, syphilitic tonsillitis is similar to ordinary inflammation of the tonsils, skin rashes of secondary syphilis - rubella or allergic reactions, chancroid on the genitals organs - genital herpes.

Diagnostic measures include:

external examination to detect skin syphilides;
RW diagnostics – Wasserman reaction;
enzyme immunoassay - ELISA;
passive agglutination reaction - RPGA;
polymerase reaction - PCR.

After a complete diagnosis, a venereologist prescribes therapy and monitors the treatment. The duration of therapy depends on the stage of the disease - primary syphilis is treated for up to 3 months, and the secondary stage, depending on its neglect, up to 2 years. The main direction of therapy is the use of antibacterial agents, against which Treponema pallidum is sensitive.

Table No. 3. Antibacterial agents for the treatment of syphilis:

Antibiotic group	Description	Drugs
Penicillins	Most active against Treponema pallidum. Treatment with this group of drugs is carried out in a hospital setting, since they are quickly eliminated from the body and require frequent administration (every three hours). The popularity of the penicillin group is influenced not only by the effectiveness of their use, but also by the price, which is several times lower antibacterial drugs other groups.	Retarpen. Extensillin. Bicillin. Ampicillin. Oxacillin.
Macrolides	Prescribed for intolerance to the penicillin group. They affect protein synthesis in the cells of the pathogen and stop the spread of infection.	Azithromycin. Sumamed. Erythromycin.
Tetracyclines	Drugs of choice for penicillin intolerance. They can be prescribed as an additional therapy and primary therapy if Treponema pallidum is resistant to penicillin. The instructions for the medications prohibit standing on straight lines. sun rays during use, as they increase the sensitivity of the skin to ultraviolet radiation.	Tetracycline. Doxycycline.
Cephalosporins	Third generation of antibacterial agents with minimal side effects. Used as an alternative to penicillin and, if necessary, an additional course of therapy. During the first 24 hours after the start of therapy, a feverish state with headache may occur; antipyretics are taken to relieve symptoms.	Of all the drugs in the cephalosporin group, only Ceftriaxone is approved for the treatment of syphilis.

Important. Treatment of syphilis traditional methods unacceptable, this can lead to complications and death. It can only be used as an additional therapy to support the body and relieve symptoms.

The disease is considered completely cured if, after a course of antibacterial therapy, repeated tests are negative or the antibody titer is reduced four times compared to the initial diagnosis.

What is relapse

Syphilis is a disease that is difficult to diagnose as completely cured. Relief from the disease can only be reliably confirmed after several months with the help of control tests.

Before this, after a course of therapy and the absence of symptoms, the disease may return; such cases are called relapse of syphilis. This means that the causative agent of the disease was not completely destroyed by therapy

It is difficult to say how and how long it takes for syphilis to manifest itself in relapse; it all depends on the state of the immune system and on the concentration of the pathogen remaining in the body; it can be a month or several. There may also be re-infection, which should be distinguished from relapse of the disease.

Table No. 4. Difference between relapse and re-infection:

The video in this article is about how to correctly diagnose syphilis using laboratory tests.

Frequently asked questions to the doctor

Chancre or not

Good afternoon, a week ago I noticed in pubic area compaction, released after squeezing out clear liquid, but the wound has not healed for several days. This may be the primary symptom of syphilis - chancre.

Hello, yes, this is quite possible, but without an examination by a venereologist, it is impossible to confirm or refute this. Contact the nearest venereology clinic and get tested.

How long does it take for syphilis to become noticeable?

Hello, how and how long does it take for syphilis to manifest itself after unprotected sexual intercourse? I really doubt my current partner, although he claims that everything is fine with him.

Good afternoon, how long does it take for the first symptoms of the disease to appear depends only on your immunity. This period can vary from 10 to 90 days, but the average is 20-45 days. Primary symptom syphilis - a neoplasm in the form of an ulcer or erosion.

It will be located at the site of infection, that is, on the genitals, if there was oral sex - in the oral cavity, and during anal sex - in the rectum or anus. If you doubt your partner, do not wait for the disease to manifest itself, but consult a doctor. You will most likely be offered preventative treatment.

Syphilis in the mouth

Good afternoon, I discovered small white formations in my mouth (inner cheek). When pressed, they do not hurt and do not bother you in any way. Could this be syphilis? The fact is that two weeks ago I had oral sex with a stranger whom I never saw again and cannot know whether he is sick or not. And the analysis will not show anything, since a month has not yet passed.

Good afternoon, it is quite possible for a hard chancre to appear in the oral cavity, but according to your description it is more likely to look like stomatitis. It is better for you to consult a dentist.

every woman needs at least twice a year. In a woman’s life, situations often arise when it is necessary good advice obstetrician-gynecologist, answer to question, consultation. But even if a woman has no complaints, it must be borne in mind that recently the asymptomatic course of gynecological diseases, including sexually transmitted infections and gynecological tumors, has become very common. Even pathological vaginal discharge does not always occur with such diseases. Without analysis, distinguish them from normal discharge difficult. With the latent course of female diseases, there is no abdominal pain, bleeding, or disturbances. menstrual cycle and other symptoms. Therefore, every woman needs preventive gynecological examinations and basic tests (general blood test, urine test, smear for flora and cytology), the results of which allow us to identify the presence of hidden asymptomatic gynecological diseases and infections in the early stages. The number of preventive gynecological examinations depends on previous diseases and other factors.

When you need good advice from a doctor, you can come for a consultation with a gynecologist at our gynecological clinic, ask the doctor questions about your health, undergo an initial gynecological examination and, if necessary, further examination and treatment.

Consultation with a gynecologist for early diagnosis of pregnancy

A consultation with a gynecologist and a gynecological examination are also necessary for early diagnosis of pregnancy. The first signs of pregnancy are inaccurate and often mislead women. During pregnancy, menstrual-like vaginal discharge is possible, and pregnancy tests may be falsely negative. For accurate early diagnosis of pregnancy, a consultation with a gynecologist, pelvic ultrasound and determination of hCG level in a blood test.

A good gynecologist is, first of all, a good diagnostician. Diagnosis of gynecological diseases is based on experience and knowledge. During the initial gynecological examination, the gynecologist will determine whether there is a need for more detailed diagnostics and consultations with other doctors. According to your indications, you will receive all the necessary treatment recommendations and referrals for tests. This will allow you to dispel many fears and doubts and notice unfavorable changes in time. women's health, take measures to correct them, start treatment on time.

A woman is sometimes scared or ashamed to come to a consultation with a gynecologist and a gynecological examination. She is frightened by the examination procedure, and even by the sight of the gynecological chair. However, it is advisable for even a healthy woman to visit a gynecological clinic twice a year. The main task of an obstetrician-gynecologist gynecological clinic is to preserve the health of a woman, which is only possible with the prevention of gynecological diseases and their timely detection in the initial stages. At an appointment with a gynecologist in our gynecological clinic, you will forget about the fear of a gynecological examination. The polite staff of the clinic does everything possible to quickly and efficiently provide you with the necessary medical services.

Features of gynecologist consultation. Gynecological examination

Every healthy woman should undergo a gynecological examination twice a year to maintain her health, prevent and identify gynecological diseases in the early stages. To avoid the development of sexually transmitted diseases, infectious diseases and gynecological tumors, it is better not to postpone a visit to the doctor, but to come for a preventive examination and consultation with a gynecologist.

The gynecologist should know individual characteristics your body, all gynecological diseases that you have suffered. Communication with a gynecologist at an appointment should be easy and confidential. Every woman should have her own obstetrician-gynecologist.

It is advisable to come to a gynecologist’s consultation for the first time at the age of 15-16 years, especially if the girl has not yet started her menstrual cycle. It is also necessary to come to an appointment with a gynecologist if a woman has already begun or plans to begin sexual activity. Gynecologists advise not only to undergo a preventive gynecological examination twice a year, but also to undergo basic tests, especially when a new sexual partner appears, to do colposcopy and gynecological ultrasound, because the asymptomatic (hidden) course of gynecological diseases is very common and difficult to diagnose. Many gynecological diseases, if not treated promptly, can lead to infertility, ectopic pregnancy or miscarriage.

Stages of consultation with a gynecologist and gynecological examination

Questions for a gynecologist

You can come for a consultation with a gynecologist and a preventive gynecological examination if you have no complaints or already have certain complaints. A consultation with a gynecologist begins with a conversation. First, the gynecologist asks questions and fills out a medical record. By asking questions, the gynecologist will find out what problem the woman came to the doctor’s office with. It is important for a gynecologist to know what diseases a woman has had throughout her life, which will tell him about her predisposition to certain diseases. Some questions may seem too intimate or unnecessary, but they must be answered absolutely honestly. Answer all the gynecologist's questions and do not hesitate to ask him questions, because the state of your health depends on it.

External gynecological examination

A consultation with a gynecologist may include procedures such as measuring blood pressure, determining weight, and examining mammary glands. After which the gynecologist proceeds to a gynecological examination of the female genital organs. To do this, the woman needs to lie down in a special gynecological chair. The gynecologist conducts an external examination to identify possible releases, irritations, rashes, condylomas, gynecological tumors and other pathological changes in the external female genital organs. Having completed the external gynecological examination, the gynecologist proceeds to the internal gynecological examination.

Internal gynecological examination

During an internal gynecological examination, an obstetrician-gynecologist inserts disposable plastic speculum into the vagina to examine the cervix. The gynecologist also evaluates the presence of discharge and other pathological processes. After removing the speculum from the vagina, the gynecologist performs a vaginal examination. The gynecologist inserts the fingers of one hand, dressed in sterile disposable gloves, into the vagina. The gynecologist places the other hand on the front abdominal wall. Thus, the doctor notes the size, shape, position, mobility, pain of the uterus and appendages, and draws attention to the presence of pathological volumetric formations in the small pelvis. If you experience pain when palpating, you should immediately inform your gynecologist, as this may be a sign of an inflammatory or other gynecological disease. Sometimes a gynecologist can perform a rectal examination (for example, when examining virgins) when the data from other examinations is insufficient.

Taking a smear for flora during an internal gynecological examination

A mandatory stage of a preventive gynecological examination should be taking a smear. A bacteriological study is a study of a smear of gynecological discharge. The number of leukocytes is counted in the smear and pathogens are looked for. More than 10 leukocytes in the field of view may indicate the presence of a sexually transmitted infection or inflammation of the female genital organs. Based on the results of the smear, you can detect fungi (candidiasis), “key cells” (bacterial vaginosis), changes normal flora in discharge from vaginal dysbiosis. The gynecologist prescribes culture of discharge and PCR diagnostics of discharge to clarify the causative agent of the infectious process if a smear shows the presence of infection, but does not identify its causative agent.

Taking a smear for cytology during an internal gynecological examination

Cytological examination (cytology) is a mandatory stage in the early diagnosis of diseases of the cervix and mandatory analysis carried out before her treatment. Even if nothing bothers the woman and the cervix seems unchanged to the naked eye, the woman should regularly (every year) undergo a cytological examination of cervical scrapings. The gynecologist takes a scraping during an internal gynecological examination. The scraping is taken with slight pressure, while the deeper layers of cells are scraped off. This is a painless procedure. This is done because the malignant process begins from the lower layers of the cervical epithelium and progresses to the surface of the mucous membrane. Therefore, if the analysis includes only surface layer, the diagnosis can only be made when the disease is already at a late stage of development.

Colposcopy

Colposcopy is an examination of the cervix under a special microscope - a colcoscope. The gynecologist uses colposcopy during an internal gynecological examination in order not to miss initial signs a malignant tumor, if nothing bothers the patient and the cervix seems unchanged to the naked eye.

Colposcopy has a huge diagnostic value if you suspect cervical cancer, for diagnostics erosions cervix, dysplasia, leukoplakia. Only extended colposcopy can help make an accurate diagnosis of cervical disease in the early stages and determine its malignancy.

Extended colposcopy is an examination of the cervix after treatment with a 3% acetic acid solution. The action of acetic acid lasts about 4 minutes. After studying the collopscopic picture of the cervix treated acetic acid, the gynecologist performs the Schiller test - lubricating the cervix with a cotton swab moistened with 3% Lugol's solution. Iodine contained in the solution colors glycogen in the cells of healthy, unchanged squamous epithelium necks dark brown. Thin cells (atrophic age-related changes), as well as pathologically altered cells in various dysplasias of the cervical epithelium ( precancerous conditions) are poor in glycogen and are not stained with iodine solution. Thus, a gynecologist during colposcopy identifies areas of pathologically altered epithelium and, if necessary, marks areas for cervical biopsy.

Ultrasound of the pelvis and fetus

In gynecology, pelvic ultrasound complements the gynecological examination and is used very widely, because with its help, with a high degree of reliability, you can examine the pelvic organs and monitor the development of pregnancy (fetus). Pelvic ultrasound is an examination method that allows a gynecologist to get an idea of all the pelvic organs, including the uterus and ovaries, which is of great importance in the diagnosis of gynecological tumors and inflammation of the female genital organs, and abnormalities of the uterus.

A pelvic ultrasound makes it possible to determine the causes of pathological discharge, uterine bleeding, pain in the lower abdomen and menstrual irregularities that are not visible during a routine gynecological examination.

Ultrasound allows you to determine the presence of pregnancy and fetal abnormalities. Ultrasound also plays a decisive role in the diagnosis of ectopic pregnancy and is necessarily performed before the abortion procedure to confirm the presence of a fertilized egg in the uterine cavity.

Consultation with a gynecologist based on the results of a gynecological examination and tests

To make a diagnosis, a gynecologist compares the results of a gynecological examination with data from anamnesis (the history of the woman’s life and illness), gynecological tests, complaints and the results of other examinations. Therefore, in order to make a diagnosis or ensure the absence of gynecological diseases, a woman needs at least two consultations with a gynecologist.

At the first consultation, the gynecologist performs the gynecological examination described above, colposcopy, pelvic ultrasound and collects material for gynecological tests. If a woman has complaints and symptoms of gynecological diseases, the gynecologist during the first consultation recommends to the woman what tests (except smears) she needs to take and prescribes symptomatic treatment to reduce symptoms of the disease (pain in the lower abdomen, bleeding, itching, etc.).

A woman can take many tests during her first gynecological examination, but to take some tests she needs to come to the gynecologist again for fence material for analysis on a certain day of the menstrual cycle, after the necessary preparation or on an empty stomach.

At a follow-up appointment, the gynecologist advises the woman on the results of smears and other tests, if they were taken during the first gynecological examination. Test results may indicate the presence of a gynecological disease in the absence of symptoms, confirm a preliminary diagnosis made during the first examination, or indicate the need for further examination to make a diagnosis.

A complete treatment regimen for a gynecological disease is signed by a gynecologist after diagnosis. After treatment, and sometimes during treatment, a woman needs to come for a consultation with a gynecologist and take gynecological tests again to monitor the results of treatment.

Preparing for a gynecological examination

A woman needs to visit a gynecologist’s office several times a year if she cares about her health. The most optimal period for a preventive examination by a gynecologist is after menstruation. One day before consulting a gynecologist, it is not recommended to be sexually active. It is necessary to take a shower before examining a gynecologist, but douching does negative effect, because the doctor needs to see the real condition of the vaginal discharge and take a swab. There is no need to shave your hair before examining a gynecologist. If a woman has taken antibiotics and other medications, then it is necessary to warn the doctor about this. Sometimes testing for infections must take place no earlier than two weeks after the end of treatment in order to obtain correct results. If you have to get tested for chronic infections, it is better to do this before or immediately after your period.

A consultation with an obstetrician-gynecologist and examination usually takes about 30 minutes. Try not to be nervous during the examination. Answer all the doctor's questions and do not hesitate to ask him questions, because... The state of your health depends on this.

It is necessary to come to see a gynecologist in the following situations:

Recently, the asymptomatic course of gynecological diseases, including sexually transmitted diseases, has become very common. Vaginal discharge occurs in such diseases, but more often they are the only symptom and appear periodically. Without analyzes It is difficult to distinguish them from normal discharge. Therefore, every woman needs a preventive examination by a gynecologist at least twice a year.

Pathological vaginal discharge is the main symptom of almost all gynecological diseases, including sexually transmitted diseases. If they appear, it is necessary to consult a gynecologist with an examination and tests for determining infections, including sexually transmitted ones.

Uterine bleeding in the middle of the cycle, increased and prolonged bleeding during menstruation. Consultation with a gynecologist with examination and Ultrasound in this case, they are necessary to determine the source of bleeding. Bleeding that occurs during pregnancy requires immediate hospitalization.

Abdominal pain. In female gynecological diseases, it is most often observed in the lower abdomen. A consultation with a gynecologist with an examination, tests and other examinations are necessary to identify the cause of the pain.

Problems with conception. Conceiving a child requires preparation. Gynecological diseases can negatively affect pregnancy and the unborn baby. Therefore, it is very important to come for a consultation and examination with a gynecologist to identify and treat them before conception.

At planning pregnancy a woman needs to come for an examination and consultation with an obstetrician-gynecologist, be examined and take a test in advance tests to identify infections, including - ureaplasmosis. Pregnancy planning and during pregnancy gynecological examination allows you to avoid complications and unpleasant surprises during pregnancy.

Diagnosis of pregnancy. The first signs of pregnancy before a missed period are inaccurate and often mislead women. During pregnancy, menstrual-like discharge is possible. In order to diagnose pregnancy in a timely manner, at the slightest suspicion, you need to consult a gynecologist, do an ultrasound and a blood test for hCG.

Termination of pregnancy (medical abortion). In the event of an unwanted pregnancy, you will receive qualified advice from an obstetrician-gynecologist on how to terminate it. Medical abortion is the least traumatic for a woman.

Contraception. Every woman should, with the help of a gynecologist, choose the most suitable means of protection against unwanted pregnancy for her. This requires a consultation with a gynecologist with an examination, ultrasound, and, if necessary, research hormonal levels and other tests.

Hormonal disbalance. Often the main cause of diseases of the female reproductive system is hormonal changes (hormonal imbalance). During your consultation, your gynecologist will prescribe the necessary examinations to diagnose hormonal disorders.

Menstrual irregularities. Ovarian dysfunction is most often a symptom of serious gynecological diseases. A consultation with a gynecologist and an examination is necessary to identify these diseases.

From symptoms of premenstrual syndrome ninety percent of all women are affected. Before your period a woman may experience many unpleasant and painful sensations, which should not normally exist. A woman should not put up with these sensations and suffer in silence; she must come for a consultation with a gynecologist.

Tides and painful sexual intercourse are the most frequent symptoms menopause. During the consultation, the gynecologist will tell the woman how to alleviate the pathological menopause. Very dangerous symptom- appearance bloody discharge from the genitals after menopause. When they appear, a woman should consult a gynecologist for an examination immediately.

Cervical erosion. One of the most common diseases, which may not manifest itself in any way and can only be detected during a preventive gynecological examination.

Uterine fibroids. It may also not manifest itself in any way and be detected only during a preventive gynecological examination. Asymptomatic progression can lead to severe growth of the node, bleeding and surgical intervention.

Endometrial hyperplasia often asymptomatic, but more often manifests itself as dysfunctional uterine bleeding. Often the diagnosis of endometrial hyperplasia is made when a woman comes to see a gynecologist about infertility.

Polyps of the uterus (endometrium) and cervix(cervical canal). In recent years, polyps of the uterus and cervix have been found even in girls adolescence. They do not manifest themselves in any way for a long time and over time can become malignant. For their timely detection Every woman needs a consultation with a gynecologist and a preventive examination twice a year.

Ovarian cyst. At preventive examination On an ultrasound, a gynecologist can detect an ovarian cyst in a woman. Some cysts may disappear on their own, but in many cases a course of hormonal treatment is required, and in some cases it is also necessary. surgery to get rid of the source of danger.

Spikes are formed when an acute inflammatory process in the female genital organs becomes chronic and the healing process extends over time. Adhesive disease practically untreatable. Therefore, to avoid the formation of adhesions, if symptoms occur inflammation Immediately come for an appointment with a gynecologist.

Cervicitis- inflammation of the mucous membrane of the cervix. May manifest as pathological discharge, burning, itching. If the flow is hidden, it may not manifest itself in any way. Therefore, every woman needs a preventive consultation with a gynecologist with an examination at least twice a year. The causative agents of infection are often gonococci and Trichomonas.

Thrush (or vaginal candidiasis) Caused by yeast-like fungi of the genus Candida. Often acquires chronic course with improper self-medication. To select the correct treatment and identify infections that often accompany exacerbation of thrush, which a woman may not even suspect (including sexually transmitted infections), it is necessary to consult a gynecologist for an examination.

Vaginal dysbiosis- this is a violation of the normal microflora of the vagina. This disease affects most women; it is often the result of improper self-medication. Dysbacteriosis can lead to the development of inflammatory gynecological diseases. Before prescribing medications to normalize the vaginal microflora, a consultation with a gynecologist, examination and tests is necessary.

For examination on syphilis a woman can also come for a consultation and examination with a gynecologist . Syphilis is a chronic venereal disease that affects the skin, mucous membranes, many internal organs, bones and the nervous system. Recently, it has often been completely asymptomatic. The RW (Wassermann reaction) used to diagnose syphilis is often false-positive and false-negative and is very outdated.

Advantages of the Demetra Gynecological Clinic

The consultation is conducted by highly qualified gynecologists with extensive experience.
Considering the frequent imitation of gynecological diseases in the pathology of other organs, close cooperation is carried out between gynecologists and the therapist for the benefit of patients
Modern methods of diagnosis and treatment of diseases, incl. laboratory tests, pelvic ultrasound and pregnancy ultrasound, colposcopy
Treatment of diseases without hospitalization (outpatient)
Convenient location of the clinic in Kyiv: Darnitsky district, near Poznyaki metro station
Convenient working hours by appointment only
If you have any questions, call us, our employees will provide all the necessary information