Find out if you have syphilis. The first symptoms of syphilis in men and women are the incubation period, skin appearance and discharge

The course of syphilis is wavy, with alternating periods of exacerbation and subsidence of the symptoms of the disease. In severe cases, the disease leads to damage to internal organs, osteoarticular and nervous systems.

Etiology and routes of infection

The causative agent of syphilis is Treponema pallidum, so called because it remains invisible through a light microscope when stained with conventional dyes.

In most cases, infection occurs sexually through contact with an open source of infection (chancroid, syphilitic gum). Transmission of the pathogen is also possible through household means (for example, when using shared utensils), through blood products, and also from mother to fetus (in this case we speak of congenital syphilis). Through entrance gate infections (microtraumas on the skin of the groin area, torso, oral mucosa, genital organs), the pathogen enters the lymph nodes and then into the systemic bloodstream.

Symptoms

The incubation period averages about 3-6 weeks. The first sign of the disease is the formation at the site of contact of the chancre of a painless, dense, round ulcer with a diameter of 0.5-2 cm, with a smooth, shiny bottom. Such ulcers usually do not bleed and are not prone to fusion. During the first week after the appearance of hard chancre, the lymph nodes of the affected area enlarge (regional occurs). This period of the disease is called primary syphilis. Sometimes there may be no primary lesions at all, or they are located on the internal genital organs (for example, on the vaginal wall in women), which makes diagnosis much more difficult. A syphilitic ulcer can become secondarily infected. This process is accompanied by severe swelling and redness in the chancre area, and pus may separate from the surface of the ulcer. When analyzing discharge from the area of an ulcer, it is not always possible to isolate Treponema pallidum, which is why one can erroneously conclude that there is no syphilis.

Approximately 2-3 months from the moment of infection, when a generalized rash appears on the skin and mucous membranes, we can talk about the transition of the disease to the secondary period. By this time, the primary lesions, as a rule, disappear, leaving behind scar changes. Skin manifestations of secondary syphilis are caused by vascular changes in the deep layers of the skin. The rash is localized on the trunk, limbs, face, as well as on the palms and soles. The rash may be macular, vesicular or pustular and has a dark red coloration that fades over time. Foci of the rash form against an unchanged background; individual elements are not prone to merging. Very rarely, the appearance of a rash is accompanied by itching. When analyzing scrapings from secondary syphilides, treponema pallidum is detected, which indicates their contagiousness. In 10% of cases, elements grow on the mucous membranes, under the mammary glands, in the armpits, anus; then they start to get wet. These are so-called condylomas lata, which are characterized by a high degree of contagion.

The appearance of a rash is sometimes accompanied by mild discomfort, slight increase temperature. The duration of the secondary period of illness is several days. Without treatment, the disease becomes latent (asymptomatic).

Sick latent form Syphilis remains contagious, and transmission from mother to fetus is also possible. During this period, which can last several years or even a lifetime, antibodies to the pathogen are detected in the blood. In approximately 30% of patients, the disease progresses to the tertiary period, which is characterized by severe destructive damage to internal organs and systems. Tertiary syphilides (gummas) on the skin are single, painless, dense tubercles that involve the deepest layers of the skin and the subcutaneous fat layer. In the center of the gumma it often forms an area of necrosis, followed by the formation of a rough, retracted scar. Exactly the same gummas can appear in any internal organ. Most often, the process involves osteochondral tissue and nervous system. In the first case, holes are formed in the hard and soft palate, cartilage of the nose and larynx. Infection of the nervous system (neurosyphilis) leads to the appearance of symptoms of damage to the meninges, the development of paresis and paralysis, as well as mental disorders. The formation of gummas in the cardiovascular system is fraught with the development of aneurysms, inflammation of the aortic wall, and narrowing of the blood vessels of the heart.

Diagnostics

There are many blood tests that can detect syphilis. All of them are based on the identification of specific antibodies and are divided into two groups: non-treponemal and treponemal. For mass examination, the so-called non-treponemal qualitative Wasserman reaction (RW) with cardiolipin antigen is used. Under certain conditions, the result of this test may be false positive. In this case, confirmation is required using treponemal studies (RW with treponemal antigen, RIBT), the results of which remain positive after the disease for life. Allergies to penicillin are prescribed antibiotics from a number of macrolides or cephalosporins. The drugs are prescribed intramuscularly or in tablets. Treatment active forms the disease passes in inpatient conditions, patients with a latent form can receive outpatient therapy. The duration of treatment depends on the stage of the disease and can take from several weeks to several years.

What is syphilis? We will discuss the causes, diagnosis and treatment methods in the article by Dr. Agapov S.A., a venereologist with 36 years of experience.

Definition of disease. Causes of the disease

Syphilis- a chronic infectious disease caused by Treponema pallidum, with a course in the form of active manifestations alternating with latent periods, which is transmitted predominantly sexually and is characterized by specific systemic damage skin, mucous membranes, nervous system, internal organs and musculoskeletal system.

WHO data states that 18 million cases of syphilis infection were reported worldwide in 2012, with an incidence rate of 25.7 cases per 100,000 population. Syphilis was associated with 350,000 adverse pregnancy outcomes, including 143,000 stillbirths, 62,000 neonatal deaths, 44,000 premature babies, and 102,000 infected infants. In 2015, 34,426 new cases of syphilis were registered in the Russian Federation, with an incidence rate of 23.5 per 100,000 population.

The cause of the disease is infection with Treponema pallidum, a small spiral-shaped microorganism that natural conditions can exist and reproduce only in the human body. Treponema pallidum dies almost instantly in external environment due to drying, it is easily destroyed by boiling and exposure to antiseptics and ethyl alcohol. In addition to the typical spiral shape, it exists in the form of cysts and L-forms, into which it is reorganized to survive in an unfavorable environment.

The infection is transmitted sexually (including through oral and anal sexual contact), transplacentally, transfusionally, and rarely through household contact. Cases have been described in which bites, kisses, and vaginal-digital contact led to infection with syphilis. Children can become infected with syphilis through close household contact if adult family members have the disease. The contact and household method of infection also includes the professional one - infection with syphilis mainly of medical personnel when performing diagnostic and therapeutic procedures.

Three conditions under which infection occurs:

There are two points of view on the contagiousness of syphilis. According to some authors, infection occurs in 100% of cases, according to others - only in 60-80%, which is facilitated by a number of factors: intact skin and the acidic pH of its surface, viscous vaginal and urethral mucus, competing microflora of the genital organs, phagocytosis and others local defense mechanisms organism.

The contagiousness of syphilis depends on the stage of the disease: as a rule, the primary and secondary forms are especially contagious, latent syphilis can spread transplacentally and transfusionally.

Symptoms of syphilis

Primary syphiloma (chancre)- a symptom of the primary period of syphilis, a sign of which is erosion or ulceration that occurs at the site of penetration of pale treponema into the skin or mucous membranes. The formation of a chancre begins with the appearance of a small red spot, which after a few days turns into a nodule with a crust, when rejected, a painless erosion or ulcer of the oval or oval is exposed. round shape with clear boundaries.

Based on their size, chancre is classified into:

ordinary - 1-2 cm in diameter;
dwarf - from 1 to 3 mm;
giant - from 2 to 5 cm.

Most often, chancre is single, but with repeated sexual intercourse with an infected partner, multiple rashes may appear. Multiple chancres include “bipolar” chancre, in which ulcers occur simultaneously on different parts of the body, and “kissing” chancre on contacting surfaces.

In 90-95% of cases, the chancre is located in any area of the genital organs. The fact that it is often found at the base of the penis indicates that the condom is not fully effective in preventing syphilis. Very rarely, chancre can appear inside the urethra, in the vagina and on the cervix. An atypical form of chancre in the genital area is indurative edema in the form of extensive painless thickening of the foreskin and labia majora.

Outside the genital organs, chancres are most often found in the mouth area (lips, tongue, tonsils), less often in the area of the fingers (chancres-felons), mammary glands, pubis, and navel. Casuistic cases of the appearance of chancre in the area are described chest and century.

Vollmann's syphilitic balanitis- This clinical variant hard chancre, a sign of which are spots with scales on the head of the penis, combustiform chancre - reminiscent of a superficial burn, herpetiform chancre - in the form of a group of pinpoint microerosions, hypertrophic - simulating skin carcinoma.

Syphilitic lymphadenopathy- enlarged lymph nodes - is a symptom of the primary and secondary periods of syphilis.

Syphilitic roseola (spotted syphilide)- a manifestation of the secondary, early congenital and, less commonly, tertiary periods of syphilis, occurring in 50-70% of patients.

Late roseola (erythema) of Fournier is a rare manifestation of tertiary syphilis, usually occurring 5-10 years after infection. Characterized by the appearance of large pink spots, often grouped into bizarre shapes. Unlike roseola, with secondary syphilis it peels off and leaves behind atrophic scars.

Papular syphilide- a symptom of secondary and early congenital syphilis, appears with relapse of the disease in 12-34% of cases. It is a rash of isolated dense nodules (papules) of a hemispherical shape with a smooth surface from pink-red to copper or bluish in color. Itching and painful sensations no, but if you press on the center of the papule, patients note sharp pain (Jadassohn's symptom).

Condyloma lata- observed in 10% of patients. The warty surface of the papules, which almost always merge into large conglomerates, is weeping, eroded and often covered with a gray foul-smelling coating. There is severe pain during sexual intercourse and defecation. In rare cases, condylomas lata can be located under the armpit, under the mammary glands, in the folds between the toes, or in the recess of the navel.

Pustular syphilide most often found in patients who abuse alcohol and drugs, are infected with HIV, and have hemato-oncological diseases.

Syphilitic alopecia (baldness)-this characterizes untreated secondary and early congenital syphilis. Usually appears in 4-11% of cases a few weeks after the appearance of the primary rash (fresh roseola) and spontaneously regresses after 16-24 weeks.

Pigmentary syphilide- change in skin color - the manifestation of secondary syphilis in the first 6-12 months after infection. Clinically, it is an alternation of pigment and depigment spots (mesh form), and at first only hyperpigmentation of the skin is noted. Depigmented (white) round spots with a diameter of 10-15 mm in the neck area (spotted form) are traditionally called the “necklace of Venus”, and in the forehead area - the “crown of Venus”. Without treatment, the rash spontaneously regresses within 2-3 months. More rare is the “marble” or “lace” form.

Syphilitic sore throat- a symptom of secondary syphilis, a sign of which is the appearance of roseola and (or) papules on the mucous membrane of the mouth, pharynx, soft palate. If the papules are localized on the vocal cords, a characteristic “hoarse” voice appears. Sometimes syphilitic tonsillitis is the only clinical manifestation of the disease, and then it is dangerous in terms of the possibility of sexual (during oral sex) and domestic infection due to the high content of treponemes in the elements of the rash.

Syphilitic onychia and paronychia occur at all stages and with early congenital syphilis.

Tuberous syphilide (tertiary papule)- the main symptom of the tertiary period of syphilis, which can appear 1-2 years after infection. But as a rule, it occurs after 3-20 years. It is characterized by the appearance of isolated brownish-red seals up to 5-10 mm in size, which rise above the skin level and have a smooth and shiny surface. The outcome of the existence of a tubercle is always the formation of a scar.

Syphilitic gumma (gummy syphilide) characterizes the tertiary period and late congenital syphilis. In this case, a mobile, painless, often single node with a diameter of 2 to 5 cm appears in the subcutaneous tissue. Gummas can occur in muscle and bone tissue, on internal organs. Most often they are localized in the mouth, nose, pharynx and pharynx, resulting in perforation of the hard palate with food entering the nasal cavity and a “nasal” voice, deformation of the cartilaginous and bone parts of the nasal septum with the formation of a “saddle” and “lornette” nose.

Symptoms of neurosyphilis:

Symptoms from internal organs (visceral syphilis) observed in patients with visceral syphilis and depend on the localization of the process. Yellowness of the skin and sclera occurs with syphilitic hepatitis; vomiting, nausea, weight loss - with “gastrosyphilis”; pain in muscles (myalgia), joints (arthralgia), bones - with syphilitic hydrarthrosis and osteoperiostitis; cough with sputum - with syphilitic bronchopneumonia; pain in the heart - with syphilitic aortitis (mesaortitis). Characteristic is the so-called “syphilitic crisis” - paroxysmal pain in the area of affected organs.

Symptoms of early congenital syphilis:

syphilitic pemphigus;
syphilitic rhinitis;
diffuse papular infiltration;
osteochondritis of long bones;
Parrot's pseudoparalysis is a symptom of early congenital syphilis, in which there is no movement of the limbs, but nerve conduction is preserved;
Sisto's symptom - the constant cry of a child - is a sign of developing meningitis.

Symptoms of late congenital syphilis:

Parenchymal keratitis is characterized by clouding of the cornea of both eyes and is observed in half of the patients;
Clutton's joint (syphilitic drive) - bilateral hydrarthrosis in the form of redness, swelling and enlargement of the joints, most often the knees;
The buttock-shaped skull is characterized by enlargement and protrusion of the frontal and parietal tubercles, which are separated by a longitudinal depression;
Olympic forehead - an unnaturally convex and high forehead;
Ausitidian symptom - thickening of the sternal end of the right clavicle;
Dubois's sign - shortened (infantile) little finger;
Saber shin - characteristic symptom late congenital syphilis in the form of an anterior bend of the tibia, resembling a saber;
Hutchinson's teeth - dystrophy of the permanent upper middle incisors in the form of a screwdriver or barrel with a semilunar notch on the free edge;
Gaucher diastema - widely spaced upper incisors;
Corabelli's cusp is the fifth additional cusp on the chewing surface of the first upper molar.

Pathogenesis of syphilis

The introduction of Treponema pallidum occurs in damaged areas of human skin and mucous membranes. With the help of the adhesin protein, T. pallidum, interacting with fibronectin and other cellular receptors, “sticks” to various types host cells and migrates throughout the body through the lymphatic system and blood. Penetration into tissue is facilitated by treponema induction of the formation of matrix metalloproteinase-1 (MMP-1), which is involved in the destruction of collagen, as well as its spiral shape and high mobility. Fixing in lesions, treponemes cause endarteritis blood vessels with the participation of lymphocytes and plasma cells, which during the development of the disease are replaced by fibroblasts, causing scarring and fibrosis. The antigenic structure of treponemes consists of protein, polysaccharide and lipid antigens. The body's response to the introduction of a pathogen is realized by cellular and humoral systems. Macrophages participate in the implementation of the cellular response, carrying out phagocytosis of spirochetes, T-lymphocytes - directly destroying the pathogen and promoting the production of antibodies, and B-lymphocytes, responsible for the production of antibodies. During the development of infection, fluoresceins (IgA) are first produced, then antibodies to protein antigens, then reagins (IgM), and as the disease progresses, immobilins (IgG) are produced. An important feature is the ability of Treponema pallidum, due to its unusual molecular architecture, to “evade” the humoral and cellular immune response.

Natural history of syphilis

After the introduction of the spirochete, a latent period (incubation period) begins - the period of time between the primary infection and the appearance of the first clinical symptoms, lasting from 9 to 90 days (average 21 days). The lengthening of the incubation period, first of all, is facilitated by taking antibiotics in doses that are insufficient for cure.

In 90-95% of cases, at the end of the incubation period, a primary focus - syphilitic chancre - appears at the site of treponeme penetration. In 5-10% of cases, the disease initially occurs latently - without its formation (decapitated syphilis). After 7-10 days of chancre appearance, regional lymph nodes begin to enlarge. After 1-5 weeks, the chancre spontaneously regresses. The interval between the appearance of chancre and its disappearance is usually called the primary period of syphilis.

1-5 weeks after the formation of the primary chancre, due to the spread of treponemas throughout the body, a skin rash appears, which lasts for 2-6 weeks, after which it spontaneously disappears. After a certain time, the rash may recur. This wave-like course of syphilis is associated with the activation of treponemas or the inhibition of their reproduction due to the body’s immune response. The interval between the first appearance of the rash and the appearance of tertiary syphilides is usually called the secondary period of syphilis, and the intervals between relapses are called the latent period of syphilis. Secondary syphilis with relapses is observed in 25% of patients.

It should be noted that in a sufficient number of cases, syphilis may initially exist in a latent form, transition into it after the primary period or after the first episode of secondary syphilis, and then proceed asymptomatically. In such cases, a distinction is made between early latent syphilis with a disease duration of less than two years and late latent syphilis with a disease duration of more than two years after infection. Secondary and latent syphilis can last for several years and even decades.

Approximately 15% of patients with untreated syphilis develop a skin rash in the form of tubercular or gummous syphilis 1-45 years after infection, which indicates the transition of the disease to the tertiary period. As with secondary syphilis, the rash can disappear and recur.

Neurosyphilis

In 25-60% of cases, the nervous system is affected already with primary and secondary syphilis. Neurosyphilis detected in the first 5 years after the onset of the disease is called early. In 5% of cases it occurs with symptoms - damage to the cranial nerves, meningitis, meningovascular disease, in 95% of cases no symptoms are observed. Neurosyphilis detected after 5 years after the onset of the disease is called late. In 2-5% of patients it occurs in the form of progressive paralysis, in 2-9% - in the form of tabes.

Visceral syphilis

With early visceral syphilis (up to 2 years from the moment of infection), only functional disorders develop, and with late visceral syphilis (over 2 years) - destructive changes internal organs, bones and joints. In 10% of patients with late visceral syphilis, 20-30 years after infection, cardiovascular syphilis develops, which is the main cause of death from this disease.

Congenital syphilis

Occurs as a result of infection of the fetus through umbilical vein and umbilical cord lymph nodes from a sick mother. Infection is possible as early as 10-12 weeks of pregnancy. It can occur latently or with clinical manifestations.

Classification and stages of development of syphilis

The International Classification of Diseases, 10th revision, divides syphilis into:

1. Early congenital syphilis:

early congenital syphilis with symptoms
early congenital latent syphilis;
early congenital syphilis, unspecified;

2. Late congenital syphilis:

late congenital syphilitic eye damage;
late congenital neurosyphilis (juvenile neurosyphilis);
other forms of late congenital syphilis with symptoms;
late congenital syphilis latent;
late congenital syphilis, unspecified;

3. Congenital syphilis, unspecified;

4. Early syphilis:

primary genital syphilis;
primary syphilis of the anal area;
primary syphilis of other localizations;
secondary syphilis of the skin and mucous membranes;
other forms of secondary syphilis;
early latent syphilis;
early syphilis, unspecified;

5. Late syphilis:

syphilis of the cardiovascular system;
neurosyphilis with symptoms;
asymptomatic neurosyphilis;
neurosyphilis, unspecified;
gumma (syphilitic);
other symptoms of late syphilis;
late or tertiary syphilis;
late latent syphilis;
late syphilis, unspecified;

6. Other and unspecified forms of syphilis:

latent syphilis, unspecified as early or late;
positive serological reaction to syphilis;
syphilis unspecified.

Complications of syphilis

The following complications are distinguished: primary syphilis:

At secondary syphilis complications may occur in the form of nodular syphilis, manifested by multiple nodes, and malignant syphilis, which most often occurs in HIV infection and is characterized by multiple pustules, ecthymas and rupees.

Serious complication syphilis is abortion- in 25% of pregnant women there is fetal death, in 30% of cases there is death of newborns after childbirth.

HIV infection- Patients with syphilis are several times more likely to become infected with HIV.

Death from syphilis occurs due to damage to internal organs. The most common cause is aortic rupture due to syphilitic aortitis.

Diagnosis of syphilis

To diagnose syphilis, microscopic, molecular, immunohistochemical, serological and instrumental methods are used.

Material for research:

discharge from erosions, ulcers, eroded papules, blisters;
lymph obtained by puncture of lymph nodes;
blood serum;
cerebrospinal fluid (CSF), obtained by puncture of the spinal cord;
tissues of the placenta and umbilical cord.

Indications for examination:

Microscopic methods used to diagnose early forms and congenital syphilis with clinical manifestations. Two methods are used:

Dark field research identifies living treponema in the discharge from erosions and ulcers and differentiates it from other treponemes.
Morozov's silvering method allows identifying treponema in tissue biopsies and lymph.

Molecular methods are based on the identification of specific DNA and RNA of the pathogen by molecular biological methods (PCR, NASBA) using test systems approved for medical use In Russian federation .

Serological diagnostic methods are aimed at identifying antibodies produced by the body to Treponema pallidum antigens (non-treponemal and treponemal tests).

False-positive serological reactions for syphilis- positive results of serological reactions in persons who are not sick and have not previously had syphilis.

Acute false-positive reactions are observed up to 6 months and are associated with pregnancy, vaccination, infectious diseases, menstruation, some dermatoses, endemic treponematoses, Lyme disease.
Chronic are observed for more than 6 months and are most often associated with cancer, autoimmune diseases, liver, lung, cardiovascular and endocrine systems. They can also be observed in drug addiction and in old age.

False-negative serological tests for syphilis observed in secondary syphilis due to the “prozone phenomenon” and in persons with severe immunodeficiency and certain infections (HIV, tuberculosis).

Clinical assessment of serological reactions

To diagnose syphilis, a complex of serological reactions is used, which must include one non-treponemal test (usually RMP) and two confirmatory treponemal tests (in Russia, most often these are ELISA and RPGA). According to the presence of a combination of positivity of these three tests the diagnosis is made or rejected.

Cerebrospinal fluid examination is carried out to diagnose neurosyphilis and is indicated:

patients with syphilis with clinical neurological symptoms;
persons with latent and late forms of infection;
patients with secondary recurrent syphilis;
if congenital syphilis is suspected in children;
in the absence of negative non-treponemal serological tests after complete specific treatment.

The diagnosis of neurosyphilis is considered confirmed if the patient has syphilis, proven by serological tests, regardless of its stage, and a positive result of RMP with cerebrospinal fluid.

Seroresistance considered the absence of negativity or decrease in titers of non-treponemal tests within a year in persons who have received adequate treatment for primary or secondary syphilis, and for 2 years in persons who have received adequate treatment for latent early syphilis.

Treatment of syphilis

Benzylpenicillin and its derivatives are used in the treatment of syphilis. If intolerance to the drug is detected, alternative ones are prescribed: semisynthetic penicillins (ampicillin, oxacillin), erythromycin, doxycycline and ceftriaxone.

Specific treatment is aimed at eliminating the causative agent of the disease and is prescribed to all patients with clinical and latent forms of infection.

Preventive treatment consists of prescribing drugs to patients who have had sexual or close household contact with a patient with early forms of syphilis, if no more than 2 months have passed since the contact.

Additional treatment prescribed to persons with seroresistance after adequate treatment.

Treatment regimens for syphilis in adults

Forecast. Prevention

If treatment for syphilis is started in a timely manner, the prognosis will be favorable. Prevention of the disease consists of health education, screening of decreed population groups that are at risk, and, of course, the implementation of full-fledged specific therapeutic measures and subsequent clinical and serological control.

To prevent congenital syphilis, a three-time serological examination during pregnancy is necessary (at registration, at 28-30 weeks and 35-37 weeks), adequate specific and preventive treatment when detecting syphilis in pregnant women and preventive treatment of children born from an undertreated or sick mother.

Individual prevention involves the use of barrier methods of contraception (condoms).

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Clinical cases

Damage to internal organs due to syphilis

Author of the clinical case:

Introduction

In September 2018, a patient came to the self-supporting clinic at the Youth Library (Ufa) with rashes in the neck and abdomen, which also appeared in the intergluteal fold.

Complaints

General condition in Lately worsened. The patient began to experience weakness, sore throat, stomach discomfort, loss of appetite and deterioration in performance. Recently I noticed a rash on my skin. Before their appearance, I applied for medical care see an otolaryngologist with complaints of a sore throat and a general practitioner due to discomfort in the stomach.

Due to the deterioration of his general condition, the patient was unable to go to work. He took painkillers prescribed by his general practitioner and otolaryngologist. At the time of treatment, the condition did not change; apathy appeared.

Anamnesis

The sore throat appeared in July 2018, accompanied by discomfort when swallowing and a temperature of 36.4°C. After examination by an otolaryngologist, the diagnosis was made: Chronic pharyngitis J31.2", therapy and additional types of research (endoscopy-FGS and consultation with a general practitioner) were prescribed.
During an examination with a general practitioner, the patient complained of discomfort in the stomach area. The patient's condition was assessed as satisfactory, consciousness was clear, position was active. The skin was of normal color. Lymph nodes are not enlarged and painless. RR - 16, HR - 72, BP - 120/80 mm Hg. The tongue is coated. The abdomen is painful in the epigastric region. After examination, a preliminary diagnosis of “Chronic gastritis K29.0” was made, therapy was prescribed with the drugs “Rebagit” (gastroprotector) 100 mg three times a day and “Odeston” ( choleretic agent) 200 mg twice a day. Additional examination of the CBC, OAM, and renal ultrasound is also recommended.

The patient was born in 1984. He grew and developed according to his age, and did not lag behind his peers. He started going to school at the age of seven and studied well. After the eighth grade I entered a technical school. An electrician by education. Occupational hazards does not have.
Of the diseases suffered, notes hemorrhagic fever with renal syndrome in 2016. Heredity is not burdened. Denies chronic diseases. There is no allergic history.
Bad habits: smoked one pack a day since the age of 24, smoker index - 40 (very high). According to the patient, he abuses alcohol, but in moderation.

Survey

The skin has diffuse cyanosis, visible mucous membranes are cyanotic. The skin is flabby, turgor is reduced. Skin rashes, roseate spots on the abdomen. Skin moisture is normal. Hair growth corresponds to age and gender. The nails are regular in shape, non-brittle, and there are no transverse striations observed.
Subcutaneous fat is of moderate severity, its thickness under the scapula is 5 cm. There is no swelling.
The submandibular and inguinal lymph nodes are soft and mobile, the size of a pea, painless on palpation, and not fused to the surrounding tissues. The occipital, cervical, supraclavicular and subclavian lymph nodes are not palpable.
In the groin area, in the intergluteal fold, there is a skin defect “minus tissue” measuring up to 0.5 cm in diameter, the edges are raised, the center of the defect is dark red “meaty” in color, and is wet.

Bright rose-colored rashes in the abdominal area disappear with pressure. They are abundant and widespread in nature, presented in the form of small bright symmetrical spots distributed on the skin of the body. They do not group or merge. A skin defect in the intergluteal fold is classified as “Chancre.” To confirm the diagnosis, the patient underwent laboratory species studies of antibodies to Treponema pallidum (IgG+IgM). The result is a positive titer of 16.260.

Diagnosis

Syphilis of the skin and mucous membranes

Treatment

Based on the results of the examination, the patient was given a referral for inpatient treatment at the Republican Dermatovenerological Dispensary. He was shown antibacterial therapy with the drug "Penicillin" 1 million units four times a day intramuscularly for 20 days.

The dynamics of treatment are positive, all social, everyday and sexual contacts have been identified, all groups of people have been treated.

As a result of the therapy, complete recovery was achieved. After treatment, the patient should be under clinical and serological control. Also, control must be carried out before removal from the dispensary register.

Conclusion

An important criterion for the quality of treatment is the condition of the internal organ systems. Therefore, medical specialists must correctly identify and promptly suspect syphilitic symptoms of the disease:
⠀ ophthalmologists should contact Special attention per condition optic nerve(possible complications such as syphilitic neuritis, primary optic nerve atrophy);
⠀ otolaryngologists - for the state of bone and air conduction (bone-air dissociation is possible with neurosyphilis, it is necessary to conduct a study with a C128 tuning fork or audiometry);
⠀ cardiologists - for the condition of the cardiovascular system (possible myocarditis, mesaortitis and aneurysms).
It is also important to undergo an examination by a therapist and a neurologist, who must exclude or confirm specific damage to internal organs or the nervous system.

This article will talk about syphilis - venereal infection, contagious to both men and women and children. The causative bacteria is described, the symptoms of syphilis, its periods, treatment methods and preventive measures are described in detail.

It's called syphilis infectious pathology bacterial nature, known to mankind for many centuries and is characterized by several stages, successively replacing one another. The outdated name is lues (Lewis, lues). Before the discovery of antibacterial treatment, a diagnosis of syphilis was equivalent to a death sentence.

Corkscrew Treponema pallidum, a member of the spirochete family, is the only bacterial agent capable of causing Lewis's disease in humans. It is slightly stained by preparations (hence the name “pale”).

When exposed to unfavorable conditions for treponema pallidum (for example, when treating syphilis with antibiotics), active bacteria are able to encyst. In the form of cysts, the pathogen persists in the body for a long time. Then the cysts take on the usual spiral shape and provoke the return of syphilis symptoms. In addition, the L-form of Treponema pallidum is distinguished.

Treponema is not resistant: when heated to a temperature of 60 degrees for 10 minutes, it dies. Treponema pallidum does not withstand boiling or exposure to solutions of phenol, ethyl alcohol and hydrochloric acid. The causative agent of syphilis can survive 48 hours in a corpse and 2 times longer in secretions.

Mechanism of infection

Infection with syphilis is possible only from a sick person (and the disease spreads both from man to woman and from woman to man).

Interesting! There are people who are not susceptible to syphilis genetically: the reason lies in the production of a special protein that immobilizes Treponema pallidum and dissolves the pathogen’s membrane.

There are the following options for treponema entering the body of a healthy person:

Sexual transmission of syphilis is the most common.

Important! Syphilis is transmitted from one partner to another not only during traditional sexual intercourse: any unprotected contact is dangerous.

Less commonly, infection occurs through a kiss: a person with syphilis should have syphilides on the lips or mucous membrane of the mouth, and a healthy person should have damage to the skin or mucous membrane.

Household syphilis: infection occurs through household items (shared dishes, towels, toothbrushes, etc.).
An extremely rare transfusion route of transmission, if a donor suffering from secondary syphilis, for some reason, was not tested for infection, and his blood was used for direct transfusion. It is possible to become infected with syphilis when several people use the same syringe. It is characterized by the absence of chancre due to the entry of treponema pallidum directly into the blood (the so-called decapitated syphilis) - after the incubation period, symptoms of the secondary period develop.
Transplacental transmission of syphilis to the fetus; infection during the expulsion of the fetus from the uterus.
A virtually unheard of occupational route of infection typical for medical personnel. Employees of the maternity ward theoretically risk getting an infection by coming into contact not only with the blood of a sick woman, but also with the blood of a child (in the case of congenital syphilis). Doctors from other departments who come into contact with biological fluids are also at risk for syphilis.

Classification of syphilis and stages of progression

ICD-10 reflects a detailed classification of syphilis, taking into account the period of the disease, the predominant damage to one or another organ, the result serological analysis. Disease code A50-A53.

Experts distinguish between early (infection less than five years ago) and late (more than 5 years have passed since infection) syphilis.

Most general classification includes next stages pathologies that consistently follow the incubation period:

Primary syphilis.
Secondary (early and late) syphilis.
Congenital syphilis (early and late).

Symptoms characteristic of syphilis

Signs typical of Lewis are varied and directly depend on the stage of the disease. Syphilis has an incubation (latent) period of about a month (however, it can vary from 9 days to 6 months).

The primary period of syphilis is characterized by the appearance of hard chancre (from the French “chancre” - ulcer). This syphiloma is observed at the site of first contact with infection: most often on the genitals (chancre on the penis in men, chancre in women on the cervix or labia) or in close proximity to them (chancre on the skin of the pubis or thighs).

There are hard chancre of extragenital localization: erosions and ulcers appear on the mucous membrane of the mouth, on the lips, on the tip of the tongue. Less commonly, chancre forms on the gums, tonsils or palate, as well as in the area near the anus and on the fingers. Hard chancres that have arisen on the conjunctiva have been described.

A typical syphilitic chancre is an erosion or ulcer of a round, red color. The ulcerative bottom of the formation is dense (that’s why such a chancre is called hard) and smooth, and the edges have smooth outlines. The size of the chancre ranges from a few millimeters to five centimeters (usually a diameter of 1-2 centimeters).

Important! The skin surrounding the chancre is not changed. The chancre itself never causes discomfort: it is absolutely painless.

Often patients do not go to the doctor when they notice a chancre on their body, but self-medicate. Some chancres are not visible (for example, on the cervix, on the mucous membrane, small chancres), they may remain completely unnoticed.

When pressing on the chancre from the sides, a yellow liquid is noticeable.

After approximately 10 days from the moment of infection with syphilis, there is a significant thickening and enlargement of the lymph nodes located near the chancre. On palpation, the lymph nodes are mobile and painless, increasing asymmetrically (one is always slightly smaller). The skin over the lymph nodes has no signs of an inflammatory reaction, the temperature is normal.

Healing of hard chancre occurs a month after its appearance, even in a person who does not receive treatment. A noticeable scar remains at the site of the chancre.

There are atypical manifestations of primary syphilis and atypical chancre:

Indurative edema is characterized by the fact that the compaction is concentrated not only inside the chancre, but also spreads to the surrounding tissues surrounding the syphiloma. In men, it is formed on the prepuce, in women, the development of such a chancre is possible on the labia.
Chancroid-amygdalitis, localized on one of the tonsils. Accompanied by pain. This manifestation of syphilis is often mistaken for tonsillitis (tonsillitis). Sore throat is characterized by bilateral lesions, pain in the regional lymph nodes and fever. With syphilis, the temperature remains normal, and the lymph nodes are painless. Unlike ordinary hard chancre, chancre-amygdalitis does not cause ulceration of the tonsil.
Syphiloma-herpes in men resembles balanoposthitis and occurs on the inner layer of the foreskin and the head of the penis. After opening the head, it is not always possible to return the foreskin to its place, which is fraught with such infringement (typical of syphilis).
Chancroid felon: accompanied by a rise in body temperature, purulent inflammation on the swollen distal phalanx of the affected finger, and the duration of the process. The edges of the chancre are uneven. During the process, nail rejection often occurs. This form of syphilis, chancre-felon, occurs when infected medical workers through non-sterile instruments.
Multiple chancre.
Mixed chancre occurs when there is simultaneous infection not only with the causative agent of syphilis, but also with a bacterium that causes the formation of soft chancre. In the case of mixed chancre, clinical manifestations of the secondary Lewis period appear several months later than expected.

In persons with atypical symptoms of primary syphilis (without the characteristic chancre), diagnosis is delayed, which can lead to severe consequences up to gangrene, bleeding, perforation of the urethra.

At the end of the primary Lewis period, a person feels unwell: body temperature rises to 38 degrees, sleep is disturbed, headaches and muscle pain appear. Women note swelling of the labia; in men, the scrotum and head of the penis become thicker and swollen.

Important! The disappearance of chancre does not at all indicate recovery; the person remains contagious to the sexual partner.

Secondary syphilis is characterized by a long, wave-like course: it develops over several (up to five) years. Various rashes appear on the body, and treponema pallidum spreads throughout the body. TO at this moment the chancre may still remain unhealed. Upon examination, the doctor sees papules (tubercles), macules (spots), vesicles (vesicles), pustules (pustules formed when the vesicle becomes infected), erosion and ulceration.

The patient may complain of a slight rise in temperature and symptoms typical of ARVI. Generalization of syphilis occurs, which is accompanied by “cold lymphadenitis” (lymph nodes throughout the body are enlarged, but painless, the skin over them is not changed).

Diagnostically important features elements of the rash with secondary fresh Lewis:

no tendency to merge
painlessness,
no peeling,
round shape,
cover the entire body, including mucous membranes, feet and palms,
disappear without treatment,
dense to the touch.

Typical for secondary fresh syphilis is a roseola rash, which is pinpoint subcutaneous hemorrhages.

Then hidden secondary syphilis sets in, worsening from time to time.

Important! During the relapse of secondary syphilis, a person is extremely contagious even through household contacts!

Each subsequent exacerbation of the secondary period differs from the previous one in the smaller number of rash elements and their increasing tendency to merge. A large rash forms formations (lenticular syphilides) resembling garlands, and there are also round confluent lesions.

Several months (about six months) after infection with syphilis, women may experience discoloration of the skin on the sides and back of the neck (“Venus necklace”).

The following types of skin formations are characteristic of secondary recurrent syphilis:

psoriasiform (resembling manifestations of psoriasis) syphilide, accompanied by peeling,
seborrheic syphilide.
In large folds of skin (armpits, groin, neck, abdomen), due to friction, eroded surfaces of syphilide (the most contagious manifestation) are formed. The liquid discharge from erosions and macerated papules contains many pathogens.
Papular syphilide, on the surface of which a syphilitic callus (horny papule) can form.
Ring-shaped syphilide usually occurs in men on the penis.
Herpetiformis (resembling herpes simplex) syphilide.
Syphilides in the form of a red miliary rash. Merging, small rounded elements form uneven, grainy surfaces to the touch.
Nummular (in the form of coins) syphilides.

Interesting! Patients whose secondary syphilis is located on the vocal cords complain of hoarseness. An untreated person may lose their voice completely.

The formation of pustules (pustules) on the skin is unfavorable. In weakened patients, ecthymas can form - large and deep, asymmetrically located elements of the secondary period of pathology. The shape of this syphilide is funnel-shaped. After healing, a rough, dark-colored scar remains on the skin. Ecthymas can develop into deeper syphilides - rupees. Ecthymes and rupees are not contagious.

Pustules resembling acne, smallpox, and impetigo have also been described.

Every fifth patient with syphilis notices hair loss (syphilitic alopecia).

Eyebrow loss, starting from the part located closer to the nose, as well as eyelashes of different lengths (Pincus symptom), may suggest secondary syphilis.

Condylomas can form in large skin folds. In addition, some patients have syphilitic tonsillitis, syphilides on the tongue, and diseased nail plates.

After 5 years, a person who does not receive treatment for syphilis enters the tertiary period. How does tertiary syphilis develop?

Interesting! After the end of the secondary period, some patients never have any symptoms of syphilis again in their lives.

Tertiary syphilis progresses slowly. The process can develop in almost any organ.

In some patients, the very beginning of this period is marked by such terrible manifestations as meningoencephalitis, meningitis, acute cerebrovascular accident, mesaortitis, aortic aneurysm, liver and kidney disorders. Syphilis can trigger myocardial infarction.

On skin In patients, gummas develop from the hypodermis - large (up to the size of a chicken egg) nodes. The gumma increases with syphilis, and over time the skin color becomes bluish-red. The next stage is ulceration of the gumma, and the bottom of the defect has a yellow color specific for the diagnosis of syphilis and greasy look. The ulcer may exist on the body for many months. At the site of gumma healing, large star-shaped scars remain.

Gummas and smaller elements of the tertiary period of syphilis - tubercles - often form on the palate. Ulcers formed at the site of gum disintegration lead to the destruction of the bones of the palate, the oral cavity and nose can begin to communicate. The patient's voice becomes nasal. Gummas on the face lead to a complication typical of syphilis - a recessed nose. Gummas also form on the legs and near the joints.

Gummas can merge with each other, forming extensive ulcers. In the most weakened patients, gummas can irradiate (mutilating gummas) and spread deep into the tissues.

The dark red tubercles, which also appear in patients with syphilis and are shaped like hemispheres, appear shiny and smooth, also undergo spontaneous decay with the subsequent formation of an atrophic scar.

Manifestations late period neurosyphilis include tabes dorsalis (in pathological process the spinal cord is involved), optic nerve atrophy and, as a result, blindness and progressive paralysis, characterized by mental disorders.

Separately, the issues of congenital syphilis should be addressed.

From a sick woman, the causative agent of syphilis is transmitted transplacentally to the fetus developing in the uterus. Stillbirth is common. Surviving children suffer from malnutrition and their skin appears wrinkled. Their diagnosis was early congenital syphilis. The skull of children can be deformed, and hydrocephalus, keratitis and inflammation of the meninges are often diagnosed. In newborns, a vesicular rash is noted on the feet and palms.

In ten-day-old children with early syphilis the skin thickens. Lesions develop on the face, palms, genital area and buttocks. Lips crack and bleed. In children three months of age, scars typical of syphilis remain.

The rash that appears in children with early syphilis after one year heals with the formation of scars. Due to syphilides located in the nose, a runny nose develops and difficulty breathing through the nose. ¾ of patients with congenital syphilis suffer from complications from the osteoarticular system.

Late congenital syphilis manifests itself between 10 and 16 years of age. Its classic manifestations make up the Hutchinson triad:

a crescent-shaped notch on the edges of the teeth,
deafness caused by a pathological process in the inner ear,
eye damage, sometimes leading to blindness.

In addition to the symptoms described, children develop gummas, disorders of the endocrine glands and immunity.

Features of syphilis in women

In the genital area, women have a developed lymphatic network, which is why the labia with syphilis increase in size due to swelling.
If a hard chancre has formed on the cervix, the lymph nodes located in the pelvis enlarge.
In pregnant women, pathology can develop almost asymptomatically. In only 10% of cases, chancre is found.

Features of syphilis in men

Chancre during the primary period of syphilis can be complicated by such conditions as balanitis (inflammation of the glans penis), balanoposthitis, phimosis, paraphimosis, gangrene on the penis.
The addition of a secondary infection is accompanied by swelling of the scrotum.

Therapy for syphilis

Therapy (including the duration of treatment) largely depends on the period of syphilis.

Antibiotics are used either in courses (intermittent therapy) or continuously (permanent therapy). Patients receiving treatment for syphilis are tested regularly.
During the entire treatment period, a person (both men and women) must maintain sexual rest and refrain from drinking alcoholic beverages and smoking. Patients with syphilis should refrain from physical activity; they need to eat intensively, focusing on sources of protein.
The doctor prescribes a set of medications, which includes not only antibiotics for the direct treatment of syphilis, but also drugs that increase the body's resistance.
Inpatient treatment is not indicated for all patients with syphilis. The decision about hospitalization is made by the doctor.
Preventive treatment is indicated for persons who have had sexual contact with a person diagnosed with syphilis.

Drugs used

Diagnosis of syphilis

Examination under a microscope of discharge elements characteristic of syphilis (chancre, erosion, syphilitic condylomas);
RPGA,
Linked immunosorbent assay,
Serological studies aimed at searching for IgM,
Wasserman reaction with cardiolipin or treponemal antigen.

Complications

Syphilis affects many systems and organs, so the presence of complications depends on how quickly the correct diagnosis was made and how timely therapy was started.
The tertiary period of syphilis often leads to disability, since disintegrating tubercles and gummas not only disfigure a person, but also affect internal organs.
Syphilis can be complicated by complete loss of vision and/or hearing, disorders of the musculoskeletal and cardiovascular systems.
Syphilis damage to the brain is often fatal.
Treatment of syphilis, which can take a month or more, with antibiotics has a negative effect on the liver.

Currently, in Russia, a disease such as syphilis is quite common, so it is distinguished as socially significant pathology, which threatens the life and health of people. According to medical statistics, the incidence rate is only growing every year. Those who have not encountered this disease should familiarize themselves with it in detail, considering what it is syphilis, symptoms and treatment, prevention photo.

Syphilis - what is it? Syphilis is a serious illness, which is characterized by the pathological process affecting the skin, mucous membranes and internal organs of the patient.

The causative agent of syphilis is a microorganism called spirochete pallidum. It looks like a curved spiral, can move in different ways, and can divide transversely.

Favorable conditions for the development of this bacterium are found in the human lymphatic tract and nodes, so it is there that it begins to rapidly multiply. The presence of such microorganisms in the blood can be detected at the stage of the secondary type of disease.

The bacteria are pretty long time may be in a warm and humid environment, the most optimal temperature is 37°C. In addition, they are resistant to low temperatures. Pathogenic microorganisms die when dried, heated to 55°C-100°C, or treated with disinfectants, acidic or alkaline solutions.

Household syphilis, symptoms and treatment, prevention, photo can lead to many negative consequences for human health, even end very tragically. But the prognosis depends on whether this dangerous disease is detected in a timely manner.

Morbidity

Symptoms diseases directly depends on the stage at which it occurs. Moreover, the clinical manifestations in different genders may vary. Experts distinguish 4 degrees of development of the disease, which begin with the incubation period and end with the tertiary type. The first signs of syphilis disturb a person only when the incubation period ends, which passes without causing any sensations. Taking apart syphilis, symptoms and treatment, prevention, photo All stages of infection development should be considered.

Primary stage

The initial symptom of the disease is appearance on the female labia or glans of the male genital organ chancre which is characterized by pain.

It occurs in places where pathogenic microorganisms have entered the body. Therefore, rashes can appear on other parts of the skin, but most often they occur on the patient’s genitals. This is explained by the fact that in most cases the infection process occurs through sexual contact.

1-2 weeks after the rash has formed, an increase in the lymph nodes located near it is observed. This suggests that pathogenic bacteria spread throughout the body through the circulatory system, affecting the internal organs of the patient.

Once it appears, it disappears without the use of medications in 20-40 days. But this does not mean at all that the disease has receded, because in fact the pathology is only developing.

When the primary stage ends, the patient may feel weakness throughout the body, lack of desire to sleep and eat, headache, fever, soreness in the muscle tissue and joints.

Secondary stage

The first period of development ends, the secondary one begins to develop, which is slightly different. Clinical manifestations in this case are rashes.

It may appear on the hands and other parts of the body. It is not accompanied by any unpleasant sensations, but is considered initial symptom this stage. It begins to bother the patient 8-11 weeks after the very first rashes appeared on the patient’s body.

Most often, skin manifestations occur in those areas of the body that are more exposed to mechanical stress, for example, on the folds, inguinal folds, and mucous membranes.

Some patients note that they experience significant hair loss and also develop tumors in the genital area.

If the patient does not treat the pathology at this stage of development, then gradually the skin manifestations will go away on their own, but the infection will not disappear, but will become a latent type that can last up to 4 years. After some time, the disease will relapse.

Tertiary stage

Fortunately, It is now quite rare to detect this stage of the disease, only if therapy was not carried out on time. Then, several years after the infection entered, the tertiary stage may occur. With it, damage to internal organs is observed, the appearance of foci of infection on the skin, mucous membranes, heart, lungs, liver, organs of vision, brain, bones. The surfaces of the nasal cavity can become sunken, and during eating, food can enter the nose.

Clinical manifestations are associated with the fact that the nerve cells of the brain and spinal cord die, so the patient often experiences dementia and progressive paralysis. In no case should the disease be started before this period; if you notice the first signs, you should immediately consult a doctor. Otherwise, the consequences will be dire.

At the first stage, small rashes with a red color are observed. Over time, they transform into small ulcers. They have a compacted base, smooth edges and a brown-red bottom. They disappear a few weeks after infection.

Many people are interested in the question Does syphilis itch men and women? No, no such manifestation was noticed.

At the second stage of development, small tubercles appear on the skin, which have a pale pink tint. Gradually they begin to change their color, after which brown or bluish spots form. Sometimes doctors observe the appearance of pustules on the patient’s body.

At the third stage, the skin, legs, back and other areas of the human body do not appear so significantly. Are detected small bumps, which have a red-blue tint, but there are very few of them. After all, the main symptom is damage to the body from the inside.

Definitely say what does syphilis look like, it is impossible, because the nature of skin manifestations may be different. The rashes vary depending on what nature they have, how many they appear, and whether they can occur singly or in multiples.

Almost always syphilis in women and men, or rather, its symptoms that appear on the skin gradually disappear. Instead, they leave small scars and scars. However, this does not mean at all that the disease has receded. Outwardly, it may not cause any sensations, but inside the body is increasingly exposed to danger.

Photo of syphilis

Now the most reliable method of research is blood test for syphilis - Wasserman reaction. The purpose of this examination is to detect the antibodies of the immune system that the body produces if it does not contain pathogenic microorganisms that cause it. dangerous disease.

Where biomaterial is taken and how long does the procedure take?? Extraction required quantity blood is produced not from a finger, but from a vein. Sometimes it is taken from blood vessels that are located on the hands or forearms.

Special preparation not needed before analysis. The only thing necessary donate blood on an empty stomach, for this you need not to eat 6-8 hours before the procedure. This will help to obtain the most reliable information during laboratory research.

If the result is negative, then there is no pathology, if positive, then an infection develops in the body. However, there are some exceptions in which the survey result may be false. That is, even if the analysis showed negative result, the patient may still be infected, and vice versa. This is possible if:

At the time of the examination, the person had been infected for only a few days.
A person suffers from the secondary and tertiary stages of the disease, in which the content of protective antibodies becomes less.

If a positive result is obtained, specialists V mandatory carry out repeated laboratory testing to make sure the results are correct. After all, false reactions occur quite often.

How is syphilis transmitted?

There are several ways how can you get infected with syphilis. These include:

Sexual act of any kind.
Blood, this is how drug addicts who share syringes often become infected. The infection can also be transmitted through a razor blade shared by several people.
Breast milk, due to which the pathology is transmitted to the child.
The intrauterine route, in which the baby is born already infected.
Transmission of bacteria by everyday means, for example, when the patient and other people use the same towel or utensils.
Saliva, which rarely acts as a carrier of infection, usually, if such infection occurs, is among dentists who work without gloves.

How does syphilis manifest? after infection?

Unfortunately, not at all. Therefore, it is impossible to feel that there is an infection immediately. In this regard, if unprotected sexual contact occurs, then to prevent infection no later than 2 hours later, you must do the following:

Be sure to wash your genitals and thighs with soap.
Treat these parts of the body with a solution of antiseptics such as Chlorhexidine, Miramistin. Women should insert the product into the vagina, and men into the urethra.

This method is not guaranteed to prevent the penetration of pathogenic microorganisms, the risk of infection transmission will be reduced only by 70%. In addition, using this method will not always work, so it is best to use condoms. Even if sexual contact took place with a trusted partner, you should still not neglect treating the genitals with antiseptic agents.

Also, after casual sexual intercourse, it is advisable to undergo examination by a venereologist to make sure that there is no infection in the body. To detect syphilis it is necessary go to the doctor only in a few weeks after sexual intercourse, because it will not manifest itself in any way before.

All manifestations on the skin and mucous membranes are highly contagious, so even short-term contact with a sick person leads to the transmission of bacteria. Blood is also considered dangerous. If it gets on medical or cosmetic instruments, and then healthy man damaged by them, the infection is guaranteed to pass to him.

To prevent family members from becoming infected with the virus, it is necessary to reduce the likelihood of household transmission of infection as much as possible. The patient must have personal utensils, hygiene items, and must try not to come into contact with healthy people.

All sick patients are primarily concerned with the question: Is there a cure for syphilis? Favorable prognosis possible, but the most important thing is the timely detection of pathology. Further recovery depends on this. A dermatovenerologist who specializes in this area knows how to treat syphilis.

Treatment time This illness is quite long-lasting. If he was discovered at the primary stage, then therapy takes 2-3 months, and if - at the secondary stage, it will last about 2 years. During treatment, the patient is strictly forbidden to be sexually active, and family members are recommended to take preventive measures.

In most cases, the patient is treated in a hospital under the supervision of a doctor. Treatment regimen depends not on what symptoms are present in a person, but based on the results of laboratory tests. The doctor prescribes drugs to treat syphilis, the most effective of which are penicillins. They are administered by injection every 3 hours. Such the course is 24 days.

The causative agent of the infection is quite sensitive to these drugs, but sometimes they are ineffective or cause allergic reaction at the patient. Then the specialist recommends such means as fluoroquinolones, macrolides or teracyclines. Immunostimulants and vitamin therapy are also prescribed.

If a woman wants to have a baby

But in the past I suffered from this dangerous disease, how to plan conception? In order to prevent the birth of a baby with an acquired disease, expectant mothers undergo repeated examinations. A person who has had this infection can conceive a child., but it will be necessary to diagnose and take preventive measures.

Talking about syphilis, symptoms and treatment, prevention photo it should be said that no recipes traditional medicine and therapy without the help of a doctor cannot help in the fight against this disease. This is, in principle, unacceptable, because not only will it bring absolutely no benefit, but it can also turn out to be dangerous. Therefore, if there is a possible infection or the first symptoms appear, you should immediately consult a doctor. How earlier illness will be detected, the more favorable the prognosis for recovery.

We looked at the disease syphilis. Symptoms and treatment, prevention, photos will help fight the disease. Have you observed this? Leave your opinion or feedback for everyone on the forum.

Everyone needs to know how to recognize syphilis. Timely detection this disease will help to heal quickly.

The first observations of patients with syphilis in Europe date back to the 15th century; the symptoms of syphilis were described by the Italian physician Hieronymus Fracastoro. The pathology is named after the shepherd Syphilus, punished by the gods for his insolence, who was sent a disease that affected the genitals and turned him into a monster.

Europe experienced several disease pandemics during the Middle Ages; Depending on the countries from which the infection spread, it was called the French, Spanish or Italian disease. One of the common names for the disease is LUES.

Until the mid-fifties of the last century, the disease was actually a “delayed death sentence”, very quickly shortening a person’s life. The study of the disease and its treatment in medicine deals with a special field - syphilidology.

Syphilis - chronic venereal disease, spreading both sexually and by contact, systemically affecting the body. A distinctive feature of the disease is its cyclical course.

The widespread use of antibiotics (since 1943) has made it possible to completely cure the disease in the primary and secondary stages. The unjustified use of antibiotics in medicine has led to the erosion of the clinical symptoms of the pathology and made the course of syphilis hidden. According to medical statistics, 12-15 million people in the world are infected every year, so the question of how to identify syphilis remains relevant today.

The following cycles of the disease are distinguished:

Hidden;
Primary;
Secondary;
Tertiary.

Each of these cycles is divided into periods. Primary syphilis is classified depending on the blood test results:

Seronegative;
Seropositive.

The second cycle of disease development forms:

Hidden;
Fresh;
Recurrent syphilis.

In the last stage, or tertiary, both latent and active syphilis is observed.

The causative agent of the disease and routes of infection

The cause of the pathology is the spiral-shaped bacterium Treponema pallidum (spirochete), which lives exclusively in the human body. It is not stable in the external environment, can withstand heating at a temperature of 50 degrees for no more than half an hour, does not survive contact with alcohol, soap, and dies when dried. It has the ability to penetrate the human body through the slightest lesions and microcracks in the mucous membranes and skin.

Direct infection occurs through sexual contact with an infected partner; the risk during unprotected sex with a new partner is 50%.

Treponema penetrates through microcracks in the intestine or oral cavity.

If you have close household contact with an infected person (without knowing it), you can become infected through the use of shared utensils or hygiene items, household items (lipstick, cigarettes, cups, toothbrushes). Nowadays, this route of transmission of infection is quite rare.

Infection with the pallidum spirochete can occur when unprotected contact with the patient's blood:

When injecting infected, untested blood;
If one injection syringe is used by spill people;
Due to a violation of safety precautions by medical workers when treating an infected person (delivery, dental treatment). Cases of infection of doctors during the autopsy of a patient suffering from syphilis have been described.

The first signs of infection in classical syphilis can be detected precisely at the point of penetration of the pale spirochete. Women are more susceptible to infection due to the specific structure of the genital tract - wide, prone to the appearance of wounds and cracks.

Distinctive signs of the disease in the first stage

The onset of the disease begins from the moment the infectious agent enters the body and lasts up to 40 days. If the spirochete enters the body simultaneously in several places, the incubation period is reduced to 10-15 days. If treatment with antibiotics is carried out, the period of transition of the disease to the second cycle extends to three months. During the incubation period, the disease cannot be visually recognized.

The beginning of primary syphilis is the moment of appearance of the main sign of the disease - chancre. OK occurs at the site of penetration of the spirochete and makes it possible to diagnose the method of infection.

A chancre is a hard round formation, often single, with clear, sharply defined edges raised above the skin, usually the size of a small coin, with a red, dark pink, glossy surface. It often has the shape of a concave disc, is hard to the touch, and the color is bloody red - this indicates infection.

When healing, such a chancre (you can see in the photo) will leave a scar on the surface of the skin. It is not painful, does not cause itching or discomfort. But to confuse this skin formation It’s difficult with ordinary skin defects – chancre manifests itself on:

The head of the male penis;
Foreskin;
Labia in women;
Border of mucous membranes and skin in the anus area;
Lips, tongue, corners of eyes;
Between the fingers.

A characteristic symptom in men is the appearance of a characteristic thickening surrounding the root of the penis - syphilitic lymphadenitis. It is painless and does not cause any inconvenience.

The manifestation of these signs with sufficient attention and having sex with stranger allows you to recognize infection after self-examination. An additional sign will be an enlargement of several lymph nodes in the area where the chancre appears - when palpated under the hands, lumps the size of beans will move painlessly.

But in some cases, chancre is not detected after infection:

Treponema enters the body through the skin with deep wounds or lesions, then rashes will immediately appear on the skin;
Chancre is formed in the internal genital organs of women, the inside of the anus of men and is not detected in a timely manner;
When affected in the nail area, felon forms, which is difficult to diagnose.

When a patient is diagnosed with chancre and enlarged lymph nodes, the doctor uses laboratory methods to determine the disease. Laboratory tests may be negative for up to a month, since the main marker of the disease, nonspecific antibodies, is critically low in the blood. After 28 days, the presence of specific proteins for treponema can be determined.

Latent syphilis in men in the first cycles of the disease can only be determined by testing. This most often occurs during mandatory examination of a partner for syphilis during pregnancy.

Quite often, the first symptoms of the disease remain undetected; after the chancre disappears, the disease enters the second cycle, in which the lesions are much easier to visually recognize.

How to identify secondary and tertiary syphilis

Syphilis can be distinguished from the secondary form of syphilis at the beginning of the disease by the appearance of a characteristic rash - bright, multicomponent, located symmetrically over the body. Most often it is detected on the sides of the body, arms and legs. The rash is characteristic, painless, without peeling.

When pressed, the rash turns pale and disappears. The appearance of a rash is often accompanied by symptoms similar to ARVI. After some time, the rash will disappear, the active phase of the disease will turn into secondary latent syphilis. Sick latent syphilis have no external symptoms, but remain highly contagious.

When contacting a doctor at this stage, direct methods for diagnosing syphilis are used. Several laboratory methods are used for accuracy.

Recognition by analytical diagnostic methods

The identified complex of symptoms of syphilis in a patient must be confirmed by methods laboratory diagnostics. The following methods are used for this:

Microscopic (bacteriological) examination involves studying the wet contents of chancre or ulcers. Disadvantage - can only be used when severe forms diseases;
A blood serum test (serological), which analyzes the presence of specific proteins (globulins) in the blood that are produced as antibodies to Treponema pallidum, is effective after the 28th day of infection, but may give incorrect results;
Tissue examination (histology) is prescribed if previous methods have not yielded results; tissue from subcutaneous or lymph nodes is examined to determine treponema pallidum.

The following types of tests are most often prescribed:

Immunofluorescence reaction;
Passive hemagglutination (reaction);
An enzyme immunoassay will detect the disease a month after infection.
Treponema pallidum immobilization reaction;
The Wasserman reaction is an outdated, inaccurate analysis with many errors.

To prevent the disease, a mass examination of certain categories of people who may potentially become infected or transmit the disease is carried out - doctors, teachers, pregnant women, donors, persons in custody, military personnel.