General symptoms of syphilis. All about syphilis interview with a venereologist of the highest category Viktor Ivanovich Likhodeev, head of the dermatovenerological dispensary

Syphilis is a bacterial infection, predominantly sexually transmitted, which, if left untreated, causes serious damage to the patient's health and leads to death. It appears a few weeks after infection in the form of a solid formation on the genitals, skin or mucous membranes. Diagnosis of syphilis is also carried out at home using special tests, but PCR analysis is considered the most accurate.

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Description of the disease

Pale treponema (Treponema pallidum) is a bacterium that belongs to the family of spirochetes. Mobile, spiral, gram-negative. Its length is from 5 to 12 microns and the thickness is 0.2-0.4. Outside, it is surrounded by a shell of polysaccharides and lipids, so the body is resistant to antibodies. The pathogen divides every 28-32 hours at a temperature of 36.6-37.5 degrees.

Treponema belongs to facultative anaerobes, that is, it exists without oxygen. In the body, it settles in the interstitial space near the lymphatic and blood vessels and in nerves.

Outside the body is unstable to influence environment. Negative impact it is affected by drying, heating up to 55 degrees, etc. In a humid environment, it remains active for up to 12-13 hours.

In the process of activity, it produces endotoxins, which cause a reaction from the immune system. The ability to produce them determines the ability of bacteria to infect organs and tissues.

Methods of infection

98% of syphilis cases are related to sexual contact. Even when using a condom, there is a small chance of infection.

Bacteria easily penetrate through small injuries and cracks in the mucous membranes. You can get sick not only after intercourse, but even a kiss, if the pathogen is in the partner's saliva.

The infection also comes through blood transfusion or organ transplantation. It can be on poorly processed tools from a beautician, manicurist and dentist.

There is a possibility of infection in everyday life when using a common razor, towels, toothbrush. In public places, in a bathhouse, in a pool, there is a risk of finding a spirochete. It is necessary to follow the rules of personal hygiene, cover the shelves in the bath with your own sheet, be interested in disinfection.

A sick mother is able to transmit syphilis during childbirth and lactation to the child. Infection rarely occurs in workers associated with people or animals infected with the microbe.



Signs of syphilis

To determine if you have syphilis, you need to track it initial symptoms. In both men and women, the first sign of the disease is manifested in the form of an ulcer (hard chancre).



It is formed in the form of a tubercle in the groin, on the penis of a man (at its base or on the head), it can appear on the scrotum, in the anus, on the oral mucosa.



Symptoms of primary syphilis

The first stage begins with the detection of a chancre on the surface of the skin or mucous membranes. At first, it does not cause serious discomfort, but then inflammation occurs: it becomes red or cyanotic, which is characteristic of a pronounced inflammatory process.

For 1 week, lymph nodes or regional vessels are affected. The lymph nodes become inflamed in the form of glomeruli, forming edema and swelling around the chancre. When the formation is concentrated in the oral cavity, this is fraught with inflammation of the tonsils and swelling of the throat, which makes breathing and swallowing difficult. The symptoms are distressing verbal communication and meals. With the appearance of foci in the genital area, the process of walking and defecation becomes difficult.

The onset of secondary syphilis is the appearance of a specific rash. You can identify the disease after the first signs appear using enzyme immunoassay and PCR, which are prescribed by a general practitioner or venereologist.

You can also understand that an infection has occurred by the nature of the discharge with syphilis. In women they become thick, in men yellowish. In more advanced cases - with impurities of blood and pus.

The analysis will be relevant only at the stage of primary syphilis; during the incubation period, the results will show nothing but a seronegative reaction, which indicates the absence of pale treponema.

Signs of secondary syphilis

The skin near the chancre is covered with spots up to 15 mm in diameter. The rash (syphilides) grows extensively and combines into zones on the skin and mucous membranes, causing discomfort, there are 3 types:

1. 1. roseolous- pink spots up to 5 cm in diameter, no cavities, borders can be clear or blurred, does not protrude above the skin.
2. 2. papular- small cone growths (papules) Pink colour. Peeling at the top. They look unpleasant.
3. 3. Pustularrash- growths (pustules) with purulent cavities.



In parallel with the appearance of a rash, damage to the central nervous system begins, degradation nervous tissue, vision, memory, attention, coordination of movements worsens. Treatment of the disease does not lead to the restoration of the functions of the central nervous system, but only stops the process of further damage.

Symptoms of baldness appear, hair falls out mainly on the head. First, the quality of the hair decreases, they split, thin, thin. Why the process intensifies, bald areas appear. After treatment for syphilis, hair growth cannot be resumed.

Stages of syphilis

Today, having become infected with the disease, each person undergoes a quick diagnosis and receives adequate treatment, so only a few pass through all stages of the disease. If not treatedsyphilis, a person lives in terrible agony for 10 or 20 years, after which a fatal outcome occurs.

The disease begins with an incubation period that lasts an average of one month. At this time, there are no objective signs of the disease in the body.

If the infection penetrates into several places at once, then the incubation period is reduced to 1-2 weeks. If a person takes antibiotics for flu and sore throats, it can take much longer (for six months). Then the first symptoms appear - hard chancre and inflammation of the lymph nodes.

When the pathogen falls directly into the blood, the stage of primary syphilis does not manifest itself and the disease immediately passes to the secondary stage.

Stages of primary syphilis:

Name	Period	Description
Primary syphilis	From the onset of the chancre to the rash and inflammation of the lymph nodes	A syphilitic chancre is a hard formation that penetrates deep into the body, caused by an immune response to a pathogen. It can be recognized by its rounded shapes and well-defined edges. It is localized in the area of ​​​​infection. Painless, but causes serious concern and motivates to stop sexual intercourse and go to the doctor. At the end of the stage, multiple chancres may appear, lymph nodes become inflamed, malaise and fever body, dizziness
Headless	It is difficult to determine whether it begins when an infection enters the blood	There are no signs, the disease is asymptomatic and passes into the second or latent stage

The stages of secondary syphilis are divided into 4 stages. In the absence of treatment, the order of development is as follows:

Name	Time periods	Description
Early	From 60-70 days of invasion or 40-45 days after the onset of symptoms. Lasts from a few days to 1-2 weeks	External signs are expressed in rashes of three types, due to the response of the immune system and the production of endotoxins that fight infections. The nervous system, bones suffer, internal organs. The temperature rises to subfebrile figures. Accompanied by malaise, cough and runny nose. During this period, baldness is possible.
Hidden	From 60 days after the start of the primary stage or later	At certain points, the immune system blocks the infection that destroys the body. The rash stops. The infection does not leave the organs and tissues, lives in anticipation of a relapse
Age	After hidden phases	With any weakening of the immune system (colds, stress, skipping meals, trauma), a relapse occurs. Appears as a new rash with foci of hemorrhage. The symptoms characteristic of early syphilis are repeated. Often multiple chancres form on the genitals
Early neurosyphilis	Begins 2 years after infection	It is associated with damage to the vessels and neurons of the brain, organs, bones and joints. It manifests itself in the form of chronic meningitis, impaired pupillary response to light. Inside the vessel of the brain, miliary gunns are formed, which increase intracranial pressure which causes headaches and worsens general well-being. Many symptoms interfere with higher mental functions, such as attention, memory, coordination of movements. The changes are irreversible

The stages of tertiary syphilis are divided into 3 stages, in the absence of treatment, the order of progression is as follows:

Name	Time periods	Description
Latent chronic stage	From year 1 to 20 years	About 70-75% of patients without treatment live as carriers, moving from the asymptomatic phase of tertiary syphilis to relapse, sooner or later the body weakens, the patient moves on to the next stage, with highly likely disability or death
Tertiary syphilis	With the onset of symptoms	Launched syphilis. There is extensive damage to organs, tissues, bones and the nervous system. Gummas are formed - characteristic purulent tumors, which often bleed and are wet due to the large amount of lymph and pus. Often appear on the face. Heal hard, form strong scars. Sometimes infected with other bacteria that lead to gangrene
Late neurosyphilis	Final stage leading to death 10-20 years after the onset of the disease	Extensive damage to the central nervous system, which leads to loss of vision, paralysis, impaired cognitive function of the psyche

Brain diseases appear infectious nature- meningitis, gummas of bones and brain.

Neurosyphilis

Neurosyphilis begins at the end of the secondary syphilis stage. Manifested in the form of the following forms of the disease:

Name	Description
Asymptomatic neurosyphilis	There are no painful manifestations, tests will show inflammation and infection of the cerebrospinal fluid. This stage begins 12-188 months after infection
Gummy	It is accompanied by the formation of gums inside the spinal cord and brain. Feels like a large tumor, causes pain, causes increased intracranial pressure
Syphilitic meningitis	There is a lesion of the base of the brain in the region of the cranial vault. Accompanied by severe symptoms, including impaired thinking, attention, emotional sphere, memory
Dorsal dryness	Damage to the neurons of the spinal cord begins, with dysfunction and thinning. Leads to irreversible damage the ability to move in space. The gait is bent, the patient falls, having lost a sense of balance. Closing the eyes leads to disorientation in space
Meningovascular form of neurosyphilis	It becomes the cause of the destruction of the vessels of the brain, accompanied by meningitis. In the absence of therapy, it leads to headaches, impaired behavior, personality, sleep, convulsions. Eventually leads to stroke.
progressive paralysis	It provokes damage to the central nervous system: the personality is disturbed, behavior dangerous for society appears. Leads to complete paralysis of the body, atrophy optic nerve, visual impairment. First, vision deteriorates on one side, then the infection passes to the second optic nerve and leads to complete blindness. In the absence of treatment, the changes are permanent.
Late visceral syphilis	Damage to tissues and internal organs, mainly the heart and liver. Other organs are rarely affected. The patient complains of a deterioration in health, with exercise, heart murmurs appear, the aorta expands. With the localization of visceral syphilis in the heart, a heart attack can occur
Late syphilis of bones and joints	Provokes local expansion of bones and joints, accompanied by the formation of gums on the bones

Diagnostics

Laboratory diagnostics is carried out using 2 types of studies:

1. 1. Direct (non-treponemal)- methods are based on the recognition of the bacterium itself in fluids and tissues.
2. 2. Indirect (treponemal)- antibodies to the pathogen are detected in the cerebrospinal fluid and plasma.

Diagnosis is determined reliably by direct methods, these include:

• Detection of treponema by microscopy on dark background or immunofluorescence.
• PCR, the presence of fragments of DNA and RNA of the pathogen is determined.

Indirect methods include treponemal and non-treponemal tests.

Nontreponemal

The principle is that the substances (antibodies) that are in the patient's blood interact with the cardiolipin antigen, which is similar to the pathogen's antigen. Antibodies are detected 2 weeks after the onset of the first signs of pathology (ulcers).

Reactions determine the presence of antibodies in only 70-80% of those infected. On the late stage their sensitivity is reduced. The main disadvantage of this type of test is a large number of false positive reactions. The advantage is low cost and ease of implementation.

Non-treponemal tests are usually used when needed to diagnose at the same time a large number of of people. These reactions include:

• microprecipitation reaction (Wassermann reaction);
• plasma reagin test;
• venereal disease laboratory test and others.



Treponemal tests

In this case, a treponemal allergen is used. The sensitivity is much higher, reaching 70-100%. The number of false positives is less. They are used mainly in controversial and doubtful cases, when examining small groups of patients. Not used to monitor the dynamics of treatment, there are false positives in patients with autoimmune pathologies.

Kinds:

• linked immunosorbent assay;
• immunoblotting;
• immunochemiluminescence;
• immunochromatography;
• immunofluorescence reaction.

False positive reaction

Sometimes in people, even in the absence of the pathogen, tests show the presence of antibodies. There are 2 explanations for this: an incorrectly performed analysis or a special condition of the body. Acute reactions (when a positive result is determined up to six months) are found in the following situations:

• menstrual bleeding;
• pregnancy;
• time after vaccination;
• myocardial infarction;
• infectious diseases: chickenpox, influenza, HIV, acute respiratory disease,
• dermatosis.

Chronic false positive tests observed in the following cases:

• malignant tumors;
• diseases of the liver and gallbladder;
• autoimmune reactions;
• systemic connective tissue diseases;
• diseases of the heart, blood vessels, lungs, endocrine system;
• old age;
• drug use;
• endemic treponema.

Treatment

Therapy depends on the goals:

• specific - in order to destroy the pathogen;
• preventive - assigned to sexual partners;
• prophylactic - for pregnant women with the presence of a pathogen or, if these recommendations are not followed, for a newborn;
• a trial treatment is given if a disease is suspected, until the diagnosis is confirmed by a laboratory.

Treatment is carried out on an outpatient basis. Hospitalization is only necessary if tertiary disease, pregnant women, children, persons with complications of the course of the disease.



Main therapeutic drug is benzylpenicillin in the forms prolonged action. Semi-synthetic penicillins, macrolides, tetracyclines and cephalosporins are also effective.

In modern conditions, the disease is considered completely curable.

Syphilis (Syphilis)- a sexually transmitted infectious disease that occurs in a chronic form, in which the skin, mucous membranes, bones, many internal organs, as well as the immune and nervous systems are affected.

Other names for syphilis - Lues.

The main cause of syphilis is infection of the body with the bacterium Treponema pallidum (pallid treponema).

The main symptoms of syphilis are painless ulcerations on the skin (hard chancres), a specific rash on the skin and mucous membranes, general malaise, weakness.

How is syphilis transmitted? Infection with syphilis occurs mainly through sexual contact. However, infection can also occur through blood, kissing, household way or from mother to child (congenital disease).

Is there a cure for syphilis? Yes, modern medicine, with timely access to a doctor, can treat this disease. Of course, if a person does not respond to the disease and does not seek help, there is a high probability lethal outcome with multiple severe health problems.

Development of syphilis

The development of syphilis occurs during 4 periods (stages) - incubation, primary, secondary and tertiary. The pathogenesis of syphilis is based on the body's immune response to the presence of an infection and its metabolic products, which are toxins (poison).

Consider the stages of syphilis in more detail.

Stages of syphilis (periods)

Incubation period syphilis(from the moment of infection to the appearance of the first signs of the disease) is from 7 days to 6 weeks, and even 6 months. The first signs of the disease usually appear in the place where the bacterium entered the body. healthy person. During incubation, pale treponema rapidly increases its presence at the site of introduction. The prolongation of the incubation period may be associated with the intake of antibacterial drugs at this time by an infected person.

Stage 1 syphilis (primary syphilis)- lasts an average of 6 to 7 weeks and is characterized by the appearance at the site of contact of a healthy area of ​​\u200b\u200bthe skin or mucous membrane of a person with an infection of a hard chancre, usually painless. Chancre may have atypical forms - multiple chancre, chancre amygdalite, chancre panaritium. After a few days (by 7-10), near the site of infection, the lymph nodes increase in size, and sometimes the lymph nodes become inflamed (regional scleradenitis, lymphadenitis or lymphangitis).

Until the middle of the 80s of the 20th century. primary syphilis was divided into 2 periods - seronegative and seropositive. Seronegative syphilis was characterized by the absence of classic serological reactions(KSR) - Wasserman, Kahn, Kolmer and Sachs-Vitebsky reactions. Seropositive syphilis usually formed 3-4 weeks after the onset of primary syphiloma (the first hard chancre). This division was made to determine the timing of infection of the body, however, with the advent of such diagnostic methods as RIF, RIBT, ELISA and PCR, the designations “seronegative” and seropositive” have lost their significance.

The appearance of a specific rash on the skin and mucous membranes indicates the end of the primary stage of the disease.

Syphilis stage 2 (secondary syphilis)- is formed approximately 6-7 weeks after the first signs of the disease appear. During this period, the infection goes beyond the infectious focus and, having penetrated into the bloodstream, spreads throughout the body with blood flow. The appearance on the skin and mucous membranes of a specific rash ( syphilitic rash) is an immune response to the spread of infection and endotoxins secreted by bacteria throughout the body.

The syphilitic rash has a papular, pustular and roseolous character. Systemic lesion white treponema causes damage to many organs and systems, but primarily the liver, kidneys, bones, and nervous system suffer. After some time, the immune system limits the activity of endotoxins and the disease enters a latent phase, in which the rash disappears. And therefore, secondary syphilis is divided into 3 phases - fresh, or early (Lues secundaria recens), followed by recurrent, or recurrent (Lues secundaria recidiva, Lues secundaria reccurens) and ends with a latent period (Lues secundaria latens). However, due to the fact that immunity does not kill a bacterial infection on its own, when it is weakened, a relapse of the disease occurs, mainly visual sign which is the return of the syphilitic rash.

Syphilis stage 3 (tertiary syphilis)- is formed in the event that the patient has not received adequate treatment. It is characterized by a weakening of the immune system, due to which the infection begins to affect all organs and systems of the patient. One of the clear signs of tertiary syphilis is the appearance of syphilitic gums (gummy syphilis).

The end of the tertiary stage of the disease may be accompanied by neurosyphilis with paralysis, as well as syphilitic gonitis, uveitis, damage to the bones, heart valves, aorta, kidneys () and liver (,), and in the end - death.

When white treponema enters the body, the immune system produces three groups of antibodies - IgA (fluorescins), after the appearance of primary syphiloma - IgM (reagins), and after IgG (immobilisins). In addition, the main elements of immunity are involved in the fight against infection - T-lymphocytes, B-lymphocytes and macrophages.

Photos of secondary and tertiary syphilis can be viewed on the forum.

Syphilis Statistics

Syphilis is one of the most common sexually transmitted diseases (STDs).

Despite the ability of modern medicine to treat this disease, it is still officially found in 20-30% of people in developed countries.

In the territories former USSR The epidemiological situation is also deteriorating. So, in 1991, in Russia, out of 100,000 people, syphilis was diagnosed in 7, and in 2009 there were already 52 patients.

Syphilis - ICD

ICD-10: A50-A53;
ICD-9: 090-097.

Syphilis - symptoms

The symptoms of syphilis largely depend on the duration of contact with the infection, the state of human health and the stage of the disease, which we discussed above.

The first signs of syphilis (symptoms of primary syphilis)

The first symptoms of the disease (primary syphilis) appear a few days, and sometimes months after contact with the infection. Among them are:

• The appearance of a hard chancre (primary syphiloma);
• Enlarged lymph nodes (regional lymphadenitis, scleradenitis or lymphangitis);
• Indurative edema, which appears mainly in the genital area (due to the fact that it is here that the infection enters the body) and is a slight increase in the form of a bulge with a changed skin color, also painless, lasting from 1 week to 1 month during primary syphilis .
• The formation of a hard chancre, which is a practically painless deep dense sore, which looks like a hole with a smooth bottom of a rounded shape, without bleeding and a tendency to increase in diameter. Chancre can also be present on the body in the form of atypical forms - multiple chancre, chancre of amygdalitis (appears on one of the tonsils in the oropharynx, resembles signs), panaritium chancre (appears on 1-3 fingers of the right hand);
• Increased body temperature.

Symptoms of secondary syphilis

• The appearance of a generalized rash on the skin and mucous membranes (syphilitic rash);
• Hair falls out on the head in places, up to baldness;
• Enlarged lymph nodes, cold to the touch, without adhesions, painless or slightly painful (lymphadenitis);

In practice, the symptoms of the secondary stage of the disease resemble the symptoms of the usual one.

Symptoms of tertiary syphilis

Symptoms of tertiary syphilis in the first months, and sometimes decades, may be absent or minimal, and the patient remains a carrier of the infection.

After the disease worsens again, but already affects almost all organs and systems, which is expressed in the following destructive processes:

• Damage to the skin and mucous membranes;
• The formation of gums, which are initially soft tissue tumors, and then degenerate into fibrous scars;
• Vascular damage - syphilitic aortitis, syphilitic endarteritis;
• Brain damage - progressive paralysis;
• Damage to the musculoskeletal system;
• Damage to the nervous system - neurosyphilis.

Symptoms of neurosyphilis

At the end of the second stage, neurosyphilis begins to develop, the main symptoms of which are:

• Damage to the blood vessels (intimal hyperplasia, where milliary gums eventually form) and the membranes of the brain and spinal cord;
• The development of syphilitic in a chronic form;
• Symptom of Argyle-Robertson;
• Among other, but more rare signs, syphilitic and meningoencephalitis are distinguished;
• Paresis, paralysis, ataxia;
• The patient practically does not feel support under his feet;
• Dizziness, ;
• Violations of visual function;
• Mental disorders - forgetfulness, inattention, lethargy, etc.

Symptoms of congenital syphilis

It is transmitted from mother to baby during pregnancy, and due to the fact that at this time the child is only developing, after birth, some of the following symptoms are observed:

• Congenital lack of hearing (deafness);
• Parenchymal;
• Hypoplasia of dental tissues, or the so-called. "Hutchinson's Teeth".

After stopping the infection, congenital pathologies usually remain, which worsens the quality of life of the patient.

Complication of syphilis

• Paralysis;
• Syphilitic ecthymas, rupees, gummas;
• Optic nerve atrophy, blindness;
• hearing loss;
• Disability;
• Miscarriage;
• Diseases of cardio-vascular system: , vasculitis, ;
• Diseases of the musculoskeletal system - reactive osteitis;
• Fatal outcome.

Causes of syphilis

The causative agent of syphilis- the bacterium "pale treponema" (lat. Treponema pallidum), the infection of which is the cause of this.

Infection with syphilis occurs in the following ways:

• Through sexual intercourse with a carrier of the infection (the infection is found both in the blood and semen of the patient, even if the carrier has no obvious signs);
• Through kisses
• Through the placenta - from an infected mother to the fetus;
• Through breastfeeding - the infection enters the child's body with infected milk;
• Through the blood, which usually happens - with the infusion of an infected donated blood, using a syringe, razor, toothbrush, scissors and other items that the carrier of the infection has previously used;
• Body contact with open sores that are on the patient during the tertiary phase of the disease, or his bedding and household items for body care (including towels, bedding, spoons, dishes);
• When carrying out medical and diagnostic measures;
• At cosmetic procedures(manicure, pedicure), tattooing or dental services.

An exacerbation of the disease usually occurs against the background of a weakened immune system, which can be caused by -, lack of proper rest and sleep, rigid diets, insufficient intake of vitamins and (and), the presence of others.

According to WHO, about 30% of patients infected with white treponema with high immune reactivity recovered without the use of traditional methods therapy for this disease.

The classification of syphilis is as follows:

Primary syphilis (Syphilis I), which could be:

• Seronegative (Syphilis I seronegativa);
• Seropositive (Syphilis I seropositiva);
• Hidden, or latent (Syphilis I latens).

Secondary syphilis (Syphilis II), which could be:

• Early (Syphilis II recens);
• Recurrent (Syphilis II recidiva);
• Hidden (Syphilis II latens).

Tertiary syphilis (Syphilis III), which could be:

• Active (Syphilis III gummosa);
• Hidden (Syphilis III latens).

Congenital syphilis (Syphilis congenita), which could be:

• Early (Syphilis congenita praecox);
• Late (Syphilis congenita tarda);
• Hidden (Syphilis congenita latens).

In addition, there are special forms of syphilis, usually expressing special clinical manifestations:

• Syphilis of the nervous system (neurosyphilis);
• Progressive paralysis (Paralysis progressiva);
• Dorsal tabes (Tabes dorsalis);
• Syphilis of the brain (lues cerebri);
• Visceral syphilis;
• Syphilis, unspecified.

Diagnosis of syphilis

Diagnosis of syphilis includes:

• Visual examination, history;
• Examination of cerebrospinal fluid;
• Serodiagnostics;
• Polymerase chain reaction(PCR);
• enzyme immunoassay (ELISA);
• Cardiolipin test in combination with ELISA;
• Immunofluorescence reactions (RIF);
• Reactions of direct hemagglutination (RPHA);
• Treponema pallidum immobilization reactions (RIBT);
• Precipitation microreactions (MOR - microprecipitation reactions).

Syphilis - treatment

How to treat syphilis? Treatment for syphilis includes following methods therapy:

1. Medical treatment;
2. Physiotherapeutic procedures.

The primary stage of the disease is treated on an outpatient basis. Treatment in stationary conditions carried out in the presence of complications, or when the patient develops a secondary stage.

1. Drug treatment of syphilis

Important! Before using medications, be sure to consult your doctor!

1.1. Antibacterial therapy

As we already know, the causative agent of infection is the bacterium "white treponema". In this regard, antibiotic therapy is used to stop a bacterial infection.

The most popular antibacterial substances against white treponema are penicillin, and in case of an allergy to penicillin or with some resistance to it of another strain of bacteria, tetracycline and erythromycin are prescribed. Also against Treponema pallidum, more rarely, but still used cephalosporins. Sulfonamides against white treponema are not effective.

An interesting fact is the almost complete absence of resistance of white treponema to penicillin and its derivatives. However, syphilis continues to spread throughout the world, especially in developed countries.

Treatment of neurosyphilis is carried out with the help of the introduction of antibiotics - orally, intramuscularly and endolumbally. In addition, in order to achieve maximum efficiency, the patient's body temperature is artificially increased (pyrotherapy - "Pyrogenal"), which leads to an increase in the blood-brain barrier.

Treatment of tertiary syphilis is carried out not only with antibiotics, but also with good condition the patient - with the addition of preparations based on bismuth ("Biyoquinol") and arsenic ("Miarsenol", "Novarsenol"). However, it must be remembered that these substances are very toxic to the body.

Antibiotics for syphilis: penicillins ("Ampicillin", "Amoxicillin", "Oxacillin"), prolonged forms of penicillin ("Bicillin", "Retarpen", "Extencillin"), tetracyclines ("", "Doxycycline"), erythromycin ("", "Clarithromycin" ), cephalosporins ("Cefotaxime", "", "Cefepime").

To prevent the spread of infection to people around, all things and objects at the patient's place of residence must be disinfected - dishes, plumbing, clothes, linen, etc.

1.2. Detox Therapy

White treponema and its metabolic products, which are toxins (poisonous substances) for the body, complicate the course of the disease. In addition, after the use of antibiotics, dead bacteria also poison the body. To remove toxins from the body, detoxification therapy is used, which includes:

• Plentiful drink, preferably with the addition of vitamin C;
• Admission of sorbents: "Hemodez", "Atoxil", "Enterosgel", "Polysorb", "Smekta";
• Intravenous infusion of glucose-salt solutions, the dosage of which depends on the degree of intoxication;
• Hemosorption (blood purification);
• Plasmapheresis (purification of blood with the help of its collection, purification and reverse infusion);
• ILBI (blood purification using intravenous laser irradiation);
• UV blood (purification of blood using ultraviolet irradiation);
• Lymphosorption (lymph cleansing);
• Hemodialysis (purification of the blood in renal failure).

1.3. Strengthening the immune system

The high reactivity of the immune system, which performs the protective role of the body, contributes to a more rapid recovery of a patient with syphilis.

The following are used to stimulate the immune system: medications: "Laferon", "Timalin", "Timogen", "Methyluracil", "Likopid", "Imunofan", "Galavit", "Pantokrin", "Plasmol".

1.4. vitamin therapy

2. Physiotherapeutic procedures

To improve the patient's condition, maintain the functioning of organs and systems and accelerate recovery, the use of physiotherapy is prescribed, from the methods of which one can single out:

• Inductothermy;
• Magnetotherapy;
• UHF therapy;
• Laser therapy.

Important! Before using folk remedies against syphilis, be sure to consult your doctor!

Garlic, wine, jam and apple juice. Pour 1 cup of strawberry jam with half a cup of water, put the mixture on the fire and bring to a boil. After simmering for 3-4 minutes on low heat, remove the remedy from the stove and add 2 cups of warm red wine and 1 cup of apple juice. Mix everything thoroughly, cool. Then add another 6-7 cloves of ground powder to the product, mix everything again and set the mixture aside for 3 hours to infuse. Then strain and drink 100 ml per day.

Garlic, apples, hawthorn and wild rose. Grate 2 Antonovka apples and mix with them 1 cup of fruit, 1 cup of fruit and 7 chopped garlic cloves. Pour the mixture with 2 liters of boiling water, mix, cover the bowl and set aside for a couple of hours to infuse. Then strain the remedy and drink it in half a glass after meals, 3 times a day.

Sedge. Thoroughly clean and finely chop 20 g of sand sedge root, pour 600 ml of boiling water over it, put the mixture on a slow fire and simmer it until the amount of liquid is half as much. After that, set aside the product for a couple of hours to infuse and cool, strain and drink 3-4 times a day.

Yarutka field. Pour 1.5 tbsp. tablespoons of yarutka grass with a field glass of boiling water and set aside the remedy for 4 hours to infuse. After the infusion, strain and drink 1 teaspoon 5 times a day.

Burdock. 1 st. pour a spoonful of burdock root with a glass of boiling water, put the remedy on low heat, boil it for 20 minutes, then set it aside to cool, strain and drink 1 tbsp. spoon 4 times a day.

Hop. 2 tbsp. spoons of ordinary hops, pour 500 ml of boiling water, cover the container and let the product brew for 2.5 hours. After the remedy, you need to strain and drink half a glass 4 times a day.

Prevention of syphilis

Prevention of syphilis includes:

• Refusal of promiscuous sex life, especially with strangers;
• Instilling in children the awareness that extramarital relationships are a ban, not only from the moral, but also from the spiritual side, because. fornication is a sin—“Flee fornication; every sin a man commits is outside the body, but a fornicator sins against his own body” (1 Corinthians 6:18, Bible);
• Washing the genitals after intimacy with soapy water;
• The use of contraceptives, however, remember that contraceptives do not guarantee safety;
• Timely access to a doctor after the first signs of illness;
• Avoid visiting little-known beauty salons and dental clinics;
• Avoid tattoos on your body (by the way, according to the texts of Holy Scripture, tattoos on the body in ancient times were done for the sake of the dead);
• Compliance.

Which doctor should be consulted for syphilis?

• Syphilidologist.
• In some cases it may be necessary additional treatment in (women) and (men).

Syphilis - video

Today, many people are interested in questions about what the first symptoms of syphilis look like. After all, it is not a secret for anyone that with such a disease it is extremely important to start treatment on time - this the only way avoid severe complications.

Unfortunately, not all people are aware of what signs accompany the primary stage of syphilis. That is why the infected simply do not seek help from a specialist, which is considered the main problem in modern medical practice. After all, the patient is a source of infection for others.

A bit of history...

In fact, the disease syphilis has been accompanying mankind for hundreds of years. Until now, among scientists and researchers there are disputes about when such a disease appeared. And most of them are sure that syphilis is as old as humanity itself, although no mention of it has yet been found in the works of scientists from ancient civilizations.

Outbreaks of syphilis in Europe are associated with the campaigns of King Charles VIII to Italy. There is evidence that in those days the army accompanied and great amount women of easy virtue, who "awarded" the soldiers with this infection. Upon the return of the army home, the disease quickly spread, first in France, and then throughout Europe.

Of course, in those days, the disease had a different name - it was called "lues". It wasn't until 1500 that the symptoms of syphilis began to be separated from the signs of leprosy. And only in 1905, scientists for the first time managed to detect the causative agent of this disease. A year later, the famous scientist August von Wassermann developed a technique for blood testing. This analysis (today known to science as the "Wassermann test") still helps save lives today.

At one time, many became victims of the infection famous people, including monarchs, rulers and talented artists. It's no secret that such famous personalities as Beethoven, Vincent van Gogh, Napoleon, Guy de Maupassant, Lucrezia Borgia, Christopher Columbus, Leo Tolstoy, etc. suffered from syphilis.

The causative agent of syphilis and its features

The causative agent of this disease is a pale spirochete, or treponema (Treponema pallidum), which belongs to the family of spirochetes. The bacterial cell is characterized by a very small size - it cannot be seen through a conventional microscope, and also determined when stained with traditional laboratory dyes.

This microorganism is strict anaerobe, therefore, it grows well and actively reproduces in an environment with a deficiency or lack of oxygen. However, bacteria can survive in normal conditions- they can stay on various household items for about three days. Spirochetes also tolerate cold well and low temperatures can retain the ability to reproduce throughout the year. But the increase in temperature indicators has a detrimental effect on the microorganism - at 60 degrees Celsius, treponema dies. Bacteria are also sensitive to various disinfectants and antiseptics.

How is the infection transmitted?

Of course, the issue of the transmission of this infection is extremely relevant today. The easiest way for bacteria to spread is through unprotected intercourse. According to statistics, approximately 65 - 70% of patients become infected precisely from a sexual partner. By the way, the data of sociological surveys are also extremely disappointing. Over the past few years, the number of patients with syphilis in Russia has increased by almost 30 times. Outbreaks of the disease are also observed in many African countries, and in more developed countries this disease can hardly be considered a rarity. Moreover, young people aged 15 to 20 years are most often ill, which is associated with early start sexual life.

By the way, the use of a condom cannot guarantee complete safety - you can catch an infection even with an appropriate level of protection. In addition, bacteria can enter the body during oral or anal contact. Transmission through saliva during kissing is also possible, although less likely.

In modern medicine, there is such a thing as household syphilis. In this case we are talking not about a specific type of disease, but about the route of transmission of the infection. If one of the partners (or just people living in the same house) is infected, then there is always a chance to “pick up” a spirochete. After all, microorganisms can settle on household items. Sharing mugs, glasses, towels, toothbrushes, lipstick can all lead to infection. That is why household syphilis can hardly be considered a rarity.

In addition, infection with syphilis can occur through contact with the blood of a sick person (for example, during a transfusion, working in a laboratory, etc.). A child can pick up a spirochete from a sick mother during fetal development or childbirth.

Primary syphilis

Naturally, first of all, people are 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 consult a doctor and receive appropriate assistance.

In fact, there is a certain scheme according to which syphilis develops in most cases. The stages of the disease are as follows: primary, secondary and tertiary form of the disease, which follow one after the other. Moreover, each of these stages has a very characteristic clinical picture and is accompanied by unique set symptoms.

First, treponema enters 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 time that is the incubation period. At the site of the introduction of microorganisms, a so-called hard chancre is formed, which, as the disease develops, opens, forming a small sore. At the same time, pain practically does not bother a sick person.

Most often, the chancre appears in the vulva. For example, in men, it is often located on the head of the penis. Nevertheless, the sore can be found on the skin of the thighs, abdomen, sometimes next to anus. It is worth noting that sometimes a chancre is formed on the mucous membrane of the rectum, 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 enlargement of the lymph nodes next to the chancre - most often the infection takes root in the nodes located in the inguinal region. In most cases, the person himself can detect an enlarged node, which is usually hard to the touch. In some cases, due to a violation of the outflow of lymph, swelling of the labia appears, foreskin, scrotum, tonsils (depending on the site of infection).

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

Secondary form of the disease: the main symptoms of syphilis

This stage of the disease lasts about 2 to 5 years. It is characterized by an undulating course - the symptoms of syphilis either appear or disappear. The main signs at this stage include the appearance of a rash. Eruptions may form on different areas skin, including the area of ​​the trunk, legs, arms and even the face.

By the way, the rash in this case may be different. Most often, it looks like small spots of red or pink color with clear edges. It is also possible the formation of papules or pustules. Sometimes another bacterial infection joins syphilis - in such cases, pustules can form on the skin. In any case, the rash usually does not cause physical discomfort - there is no itching, no soreness, no fever. Therefore, sick people rarely seek help from a specialist, which, naturally, makes it possible for 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 on the body appears only at the initial stage - over the next years they do not show any visible signs of syphilis. At the same time, other patients suffer from relapses constantly - rashes appear and disappear. It is believed to provoke new outbreak diseases can weaken the immune system, frequent stress, hypothermia, exhaustion of the body, etc.

Tertiary syphilis

The third stage of the disease usually begins 3 to 10 years after infection. It is accompanied by the appearance of the 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 tissues, then a person develops arthritis, periostitis, or another disease. The defeat of the intra-abdominal lymph nodes leads to the development of mesadenitis, which is accompanied by a pronounced pain syndrome. 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.

congenital form of the disease

As already mentioned, infection can also occur during pregnancy, as bacteria can easily enter the tissues of the fetus through the placental circulation. As a rule, the transmission of the pathogen occurs after the end of the first trimester. That is why pregnant women are strongly advised to be tested for syphilis. The sooner the disease is detected, the easier it will be to eliminate the threat to the health of the child.

Of course, infection can lead to a violation normal development fetus - in some cases, doctors even convene a consultation about the termination of pregnancy. On the other hand, a child can 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 a 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, mental and physical retardation.
• The late form of congenital syphilis is characterized by the so-called Getchinson triad. These children have corneal lesions, dental pathology, and labyrinth deafness.

In some cases, syphilis in children causes extremely severe complications up to death. However, if the presence of infection is determined in time and adequate treatment is started, the prognosis for the child may be favorable. Therefore, in no case should you ignore the symptoms or self-medicate.

Other types of syphilis

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

• Latent syphilis is today considered one of the main problems in venereology. Why? The fact is that in some people, pale treponema after penetration into the body does not cause any visible symptoms. In 90% of cases given form syphilis is discovered quite 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 variety of the disease - this is seroresistant syphilis. A similar form is spoken of in cases where, after the course of treatment, treponema is still present in the analyzes. Patients with a similar diagnosis require an additional course of antibiotic therapy. Unfortunately, it is not always possible to cure a resistant form of infection. And in some cases, the status of an infected person remains with a person throughout his life.

Methods for diagnosing the disease

To date, 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 a visual examination, the venereologist will decide which tests will be needed.

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

Secondary and tertiary syphilis requires other studies. In particular, the Wasserman test (RW analysis) is the most popular - it is this test that is used in clinics for a 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 ruled out.

The most accurate method today is 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 get additional information the doctor directs the patient for a spinal cord puncture, after which samples of the cerebrospinal fluid 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 scheme of therapy is considered incorrect.

Drugs for the patient can only be selected by the attending physician. Moreover, a sick person is obliged to follow all the recommendations of a specialist and steadily follow the schedule of admission. In most cases, the presence of such an infection requires the intake of rather large doses of antibiotics - most often substances are used for this purpose. penicillin series(penicillin, erythromycin, tetracycline). Patients who are allergic to these antibiotics are given other antibiotics.

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

If syphilis is found in one of the sexual partners, the second is also required to be tested and undergo a full course of treatment. Even in the event that no signs of vital activity of pale treponema were detected in the body, the 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 a longer therapy, which often lasts more than a year.

Disease prevention

Unfortunately, there is currently no vaccine that can permanently protect against similar disease. People who have had syphilis can become infected with it again. Therefore, the only effective preventive measure is to prevent infection. This means that you should avoid promiscuous intercourse, especially without the use of condoms. If unprotected sex did take place, it is worth treating the genitals antiseptic solution and book 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, exclude the possibility of spreading the infection. In addition, the disease is much easier to cure in the early stages.

The symptoms of syphilis are all its manifestations and signs that can be found in an infected person. Syphilis - infectious disease, which in the human body causes a specific pathogen, pale treponema. Getting into human body, the microorganism gradually spreads to all tissues, internal organs, is especially actively concentrated in the lymphatic vessels and lymph nodes, spreads through the circulatory system to all systems, and can even affect the bone apparatus.

Modern medicine highlights different types and forms of syphilis, depending on how strongly the syphilitic lesion is developed, and what concentration of pathogens is present in the patient. Each form, type or stage has its own characteristic symptoms.

The main classification of forms of the disease

What can be syphilis in humans? It is generally accepted to divide the disease into primary, secondary and tertiary forms - this typology reflects the stages of the formation of the disease at different times.

Primary syphilis begins from the moment the pathogen enters the human body, and can last up to 5-7 weeks. Further, the symptoms of the disease change, and this means the onset of the secondary stage. Secondary syphilis is longer - its duration is from 2 to 5 years. During this time, the symptomatology of the lesion has a wave-like character, it alternately fades and becomes more active.

The tertiary stage of pathology - a rare event, which is the result of untreated primary and secondary syphilis, incorrectly or insufficiently selected treatment. It occurs 5-7 years after the initial infection, can last for decades and even lead to the death of the affected person.

Reviews and scientific publications of some medical specialists indicate the presence of the so-called fourth stage of syphilis - advanced syphilis, in which all systems and organs, the bone apparatus, and the vascular system are affected.

In addition, the disease can be congenital, latent (asymptomatic), while the latter type is early or late.

Symptoms of the incubation period and the primary stage of the disease

Primary Development external manifestations pathology is preceded by an incubation period - it begins from the moment when pale treponema enters the human body, and ends with the appearance of the first signs of syphilis. The incubation period lasts from a week to a month and a half. At this time, it is impossible to detect a lesion in the body by any sensations or manifestations - they simply do not exist. In addition, in the first few weeks after infection, primary syphilis is seronegative, that is, it does not appear in the results of serological tests.

The primary form, or stage 1, begins when the sick person discovers a hard chancre, which is otherwise called a syphilitic ulcer or primary syphiloma.

Chancres can be:

• single;
• multiple.

The formation of a chancre occurs at the site of penetration of the pathogen into the skin or mucous membranes. At first, it is designated as a red spot, gradually turning into a pronounced ulcer, at the base of which there is a solid infiltrative seal. The bottom of the ulcer looks like raw meat and has a bright red tint, and on top it is covered with a transparent shiny film. Usually a chancre of this type has the correct round shape, smooth edges. The seal at the base feels similar in structure to ear cartilage.

The chancre itself does not cause its wearer pain, and after some time the ulcer heals and epithelializes, even if treatment is not applied to it.

In men, the appearance of a chancre is indicated mainly in the genital area - on the penis, for example, on the head, on the prepuntal sac. Neoplasm can also be found on the hips, pubis, abdomen. Extra-genital ulcers in infected guys form somewhat less often - they are determined on the lip, fingers or tonsils.

The formation of a chancre in women usually occurs on the labia - external and internal, as well as on the cervix, pubis, thighs, abdomen. Especially dangerous is the penetration of treponema through the cervix - such a chancre cannot be detected in the early stages of the disease, since the site of the lesion cannot be seen on its own. Syphilitic wounds in girls and women also occur in the mouth - on the gums, palate, tongue, less often - in the throat. In some cases, a lesion in women can cause menstrual irregularities, but this syndrome is too nonspecific, so it is often associated with stress, travel, and physical exertion.

Primary syphilis in children can be formed only in the case of an acquired form of the disease, for example, if personal hygiene is not followed, if there is an infected person in the family, or when infected from a sick mother during or after childbirth. The signs of this stage of the lesion in children are similar to those in adults, and syphilis in them proceeds in the same way. A sick baby has a hard chancre, and after a while it passes.

On the initial stage the development of the disease, it is rather difficult to determine it in a person, since even such a specific sign as chancre, the patient cannot always detect in himself due to the fact that they do not hurt and do not manifest themselves in any way.

The end of the primary period of development of the pathology is indicated by the appearance of a febrile syndrome, which is expressed by headaches, a feeling of aching joints, fever, weakness, dizziness. It is these symptoms, combined with the formed chancre, that signal that a person has contracted syphilis.

The normal course of the disease is that primary manifestations are indicated in the affected person already 3-6 days after the treponema enters the body.

AT recent times doctors note some change in the characteristic primary symptoms, in particular, an increase in the number of chancres. If earlier, single chancres appeared in patients, now, during the period of primary syphilis, two or more ulcers are increasingly forming in the affected. In addition, the chancres themselves have become more difficult to identify by touch, as they can appear without seals.

Secondary form of syphilis: how to detect

The second stage of the formation of a syphilitic lesion is characterized by the presence of several periods:

• fresh;
• hidden;
• recurrent or repeated.

Fresh secondary syphilis is a direct consequence of the development of the primary form of pathology, the main manifestations of which are a characteristic skin rash and a healing hard chancre.

Latent syphilis stage 2 is the period when syphilitic manifestations subside, and the person does not feel the presence of the disease. At this time, a lesion can only be detected through serological tests.

The latent form of secondary syphilis is replaced by a recurrent one, when the symptoms of the disease again begin to remind of themselves.

The clinical manifestations of this form of lesion in men look like the flu - appears heat, intense headache, feeling of weakness. Myalgia and artria appear at night. Further, secondary lesions appear on the skin - a rash in the form of syphilis, the tissues of which contain a large number of treponemas, which is why such wounds pose a great danger to others. After epithelialization of these ulcers, no scars remain on the skin, and during healing they practically do not itch.

The appearance of secondary syphilides is often accompanied by baldness of some areas skin, and the hair falls out not only on the head, which is especially noticeable in men with intense hairline on the arms, back, legs. Patches of baldness look like lichen or alopecia, and may cover large areas, or be small.

In women, secondary syphilis appears 6-8 weeks after infection. The rashes are most pronounced in the genital area: on the labia, on the mucous tissue, a bright pink rash is found in the form of nodules, papules or roseola, the mucous tissue itself has a shiny, wet appearance.

In addition, in the genital area and on inner surface hips, syphilitic (wide) condylomas can form - they grow together and form large formations that look like warts.

Pimple-like pink papules can be found in the mouth and pharynx, on vocal cords, on the tongue, while the voice becomes hoarse.

Typically female manifestation disease in a secondary form is the "necklace of Venus" - pigmented syphilides on the neck, front and sides. The skin becomes discolored in the form of asymmetrical spots that wrap around the neck around, forming a kind of “necklace” - this can be seen especially well when studying photos of patients with secondary syphilis. "Necklace of Venus" appears in women about half a year after infection. In addition, leukoderma of syphilitic origin can be observed on the lower back, palms, and chest.

In children and adolescents, the transition of the disease to a secondary form is accompanied by the manifestation of an abundant rash in the form of papules. Such a sign allows you to reliably find out about the presence of untreated syphilis in a baby, if it has not been noticed before. During this stage, the blood of a sick child contains a high concentration of pale treponema. In response to an infection attack, the immune system will begin to intensively produce antibodies to it, and the rash will gradually disappear, but this does not mean the onset of a cure for syphilis.

A pustular rash is extremely rare in patients, and is characterized by an abundant content of pus with a specific odor in the rashes. Then they dry up and form a yellowish crust. Syphilitic pustules usually appear in drug addicts, people diagnosed with tuberculosis, and alcoholics. It should be noted that general pain, swelling, itching or atypical discharge at this stage of the disease, the patient is extremely rarely disturbed.

In patients with secondary syphilis with developing kidney damage, lipid nephrosis with severe proteinuria is noted, and the number of erythrocytes, leukocytes, and cylinders increases in the biochemical composition of urine.

Clinical picture of symptoms of the tertiary stage

Untreated syphilis, as well as a disease that has not been subjected to any medical treatment at all, passes into the tertiary stage of development.

The formation of the tertiary stage of the disease in men is accompanied by the appearance of syphilitic gums and tubercles. Small bumps appear in large numbers throughout the body: on the face, on the scalp, on the upper and lower extremities, in the genital area, back, hips, abdomen. Gummas, unlike tubercles, are large in size, and are usually located singly. Both types of neoplasms contain inside the affected tissues and fluid, the concentration of treponema in which is lower than in secondary syphilides therefore, tertiary syphilis is considered less contagious.

Like men, women with advanced syphilis develop bumps that look like pimples, as well as gummas. Over time, these affected areas of the skin turn into difficult-to-heal ulcers. In place of the ulcers, scars will later remain, which greatly deform the tissues, skin and mucous membranes. This is especially noticeable on the face, as well as in the genital area.

Tertiary syphilis in children and adolescents contributes to the formation of tertiary syphilis throughout the body, as well as on the internal organs. This also affects the musculoskeletal system and the nervous system.

The main danger of tertiary syphilis lies precisely in the fact that the tubercles, gummas and scars after them cause the destruction of the cartilage of the nose, nerve tissues, bones, skin, mucous membranes of the mouth and genital organs. The third stage of the disease can last for decades. During this time, the patient may develop blindness and deafness, mental insanity, paralysis of organs and limbs.

In this case, the affected person experiences mental changes - he begins to periodically panic, bouts of depression and baseless rage, he develops paranoia, which is replaced by periods of euphoria. Also, a person may suffer from the appearance of hallucinations as a result of the destruction of brain tissue.

Local destruction of various parts of the body may be accompanied by bouts of pain in the damaged areas.

Congenital syphilis: characteristic manifestations

The congenital type of syphilis, depending on how it proceeds, as well as on the stage at which its symptoms appear, can develop in four forms.

Fetal syphilis is formed at the stage of being in the womb of a pregnant woman, for a period of at least five months. Its signs are an increase and change in the structure of internal organs, especially the liver, pancreas, kidneys and spleen, as a result of the fact that they perform an infiltration function, passing through themselves significant amount infected content. The presence of infiltrates in the lungs is the cause of the formation of the so-called white pneumonia of the fetus.

It is possible to determine the presence of a congenital lesion in the fetus by conducting x-ray examination- its results will show the presence of specific osteochondrosis.

Congenital syphilis of the fetus is one of the causes of premature birth, late miscarriages, the birth of a dead or sick child.

An early type of pathology is determined in a baby under the age of 2 years. It can be divided into infant syphilis or early childhood syphilis. In infants, the first symptoms of the disease may appear as early as 1-2 months after birth. The child develops a skin lesion, syphilitic pemphigus forms on it. In addition, the newborn is tormented by a constant syphilitic rhinitis, and the concomitant infiltration of Gochsinger. The runny nose has a prolonged character, accompanied by a pronounced edema of the mucous membrane, as well as a large amount of mucus discharge. The child experiences a noticeable difficulty in nasal breathing. The consequences of a nose lesion can be irreversible - the patient's bone and cartilage structures are deformed, and a saddle nose can form. Infiltration according to Gohzinger is the formation of a dense infiltrate in the area of ​​​​the chin and lips, as well as on the buttocks, palms, and soles of the feet. The child has characteristically thickened lips, they crack, swell and bleed. Affected skin loses elasticity and thickens.

Ulcerative lesion of the larynx is accompanied by hoarseness of voice.

Especially noticeable in such children are lesions of the skeletal system, osteochondritis, periostitis. In addition, congenital syphilis may be accompanied by an extensive lesion somatic organs when an infected person develops hepatitis, pericarditis, hydrocephalus, diffuse pneumonia. Boys develop specific orchitis, in some cases - dropsy of the testicle.

The combination of all these birth defects quickly leads to the death of a child in early infancy.

In those babies who have already reached early childhood (older than a year), diseases of the organs of vision, lesions of the nervous system appear, and locally located large papules and wide condylomas can form on the skin. Congenital syphilis, which manifests itself in early childhood, is accompanied by a less pronounced lesion of the internal organs, and changes in the musculoskeletal system can only be determined by radiography.

late type congenital syphilis first makes itself felt after the child reaches two years, and most often this happens at the age of 14-15 years. The clinical picture of manifestations is similar to the symptoms of tertiary syphilis - gummas and tubercles form in a teenager, covering the entire body, including the nasal mucosa, hard palate. As a result, affected structures are destroyed.

In addition, saber-shaped shins, specific drives, dystrophic pathologies, or so-called stigmas can form in adolescents. Such stigmas are not specific, as they can accompany other infectious diseases.

Unlike stigmas, Hutchinson's triad is characteristic manifestation late congenital syphilis is a combination of diffuse keratitis, syphilitic labyrinthitis, Getchinson's teeth.

The latent form can be detected in children of any age, it is dangerous due to the complete absence of any clinical symptoms.

It is determined only as a result of serological studies.

Can syphilis be asymptomatic, and how to determine it

Latent syphilis is sometimes called chronic, since in this case there are no obvious symptoms the patient is not observed. From the moment of infection in the body, active reproduction of the infection begins, it gradually moves to all internal structures and organs, but the infected person himself does not feel it. Although the disease in this case is asymptomatic, the presence of syphilis can be established by positive results serological reactions of blood, even in the absence of clinical manifestations from the internal organs, skin, nervous and musculoskeletal systems.

Latent (latent) syphilis is most often detected during preventive examinations, since it is impossible to detect it at home. This form of the disease can be of three types - early, late and unspecified.

Early is more dangerous in terms of epidemiological factor, since after it manifests itself, the concentration of treponema in the secret and skin rashes of the patient will be very high. Sexual, and even household contact with such a patient can cause infection. The late one immediately takes shape as tertiary syphilis, with specific gums and tubercles, which are slightly contagious.

The early latent form of the disease corresponds to the period from primary to secondary recurrent syphilis.

An unspecified disease is a disease that is suddenly detected as a result of tests, when neither the duration of infection nor the route of infection into the body can be established.

The symptomatology of syphilis directly depends on what form the disease takes on over time, or because of the peculiarities of the reaction of the human body. In addition, the lesion can generally proceed without any external manifestations - in this case, it becomes even more dangerous for others.

Most specific symptoms has congenital form syphilis that develops in children. At the same time, other forms of damage are manifested by a skin rash typical of most venereal and skin diseases, for example, gonorrhea, inflammation of the lymph nodes, which can be observed with dozens of various diseases, signs of fever or flu (fever, chills, weakness). staging accurate diagnosis possible only after passing special serological tests.

Syphilis is a dangerous infectious disease that is transmitted sexually in 90% of cases. With untimely treatment, the pathology can progress and lead to serious consequences, chronic inflammatory processes of the reproductive and genital organs, as well as disturbances in the functioning of the nervous system. Signs and symptoms of syphilis depend on the stage of the disease and the sex of the patient. In men, the disease at any stage proceeds with bright severe symptoms, so there is usually no difficulty in diagnosing.

Treponema pale is the causative agent of syphilis. This type microorganisms are practically not adapted to life in external environment, therefore, the risk of infection by the household route is minimal, but still it cannot be completely ruled out. You can become infected using the personal belongings of a sick person (towel, Underwear, dishes). Baths and saunas, as well as public pools- one of the most popular sources of bacteria and microbes, therefore, when visiting them, men need to observe increased caution. Both men and women, infectious disease doctors and venereologists recommend not to sit on shelves or sofas without a towel or sheet, always put on rubber shoes on your feet and check with the administrator the schedule for planned disinfection of water and the sauna room.

Most infections occur during entry into intimate relationship with a person who has syphilis or is a carrier of the disease (during the incubation period). Even the use of a condom does not guarantee absolute protection, so it is necessary to approach your own health and the health of your partner very responsibly.

Another way that treponema can be transmitted is medical. It involves the transmission of the pathogen through the blood. If a man has received a transfusion of infected blood, the risk of developing syphilis will be almost 95%. You can become infected while visiting hairdressing salon or dental office. Even donating blood from a finger or vein can lead to infection if medical staff violate the rules of sterility and allow the reuse of syringes or needles (although such cases are almost never diagnosed).

How long is the incubation period?

The incubation period for treponema (a gram-negative bacterium of the genus spirochetes) is from 3 weeks to 1 month. During this period, active multiplication of treponema occurs, although the patient does not show clinical manifestations. Outwardly, the man looks completely healthy, but he is already a carrier of the infection and can be infectious for his partner.

Important! Even if outwardly there are no health problems with partners, it is always necessary to use means of protection against infectious diseases(condoms), since more than 3-4 weeks may pass from the moment of infection with syphilis until the first signs appear.

Doctors distinguish two age groups that most often get sick with syphilis:

• boys and young men aged 17 to 25;
• men over 40.

AT young age the frequency of infection is explained by an insufficiently responsible approach to one's own health and the choice of a sexual partner. Frequent change partners, promiscuity, neglect of protective equipment - all this increases the risk of sexually transmitted diseases several times.

In men older than 40 years, a similar picture is caused by an age-related decrease in immunity. The body cannot fully cope with bacteria and suppress their growth, so the risks of any infections also increase during this period. The situation is aggravated bad habits and chronic diseases, which also undermine health and reduce the activity of the immune system.

The frequency of infection in men of different ages

Stages of syphilis and their signs

In total, doctors distinguish three stages of the disease, which differ clinical course and symptoms. To make a correct diagnosis, a qualified venereologist needs only a visual examination and the collection of a medical history. Laboratory research in this case, they will be needed to confirm the type of pathogen and eliminate doubts about the chosen treatment tactics.

The first stage of syphilis begins with the formation of erosion or sores, which range in size from a few millimeters to several centimeters. In medicine, such rashes are called "hard chancre." This is the very first sign of syphilis, which will persist for 10-14 days.

Some men think that syphilis rashes cover only the surface of the penis or other genital organs (testicles, scrotum, etc.). This is not true. The sore may appear on the back, arms, palms, abdomen. In some cases, a hard chancre is formed on the surface of the mucous membranes, especially in the oral cavity, as it is an excellent breeding ground for the reproduction of any kind of bacteria and microorganisms.

The formation of a hard chancre is usually not accompanied by other symptoms, so many men do not go to a specialist at this stage of the disease. AT rare cases a man may experience weakness, malaise, loss of strength, but most often this is due to fatigue and other adverse factors. By the end of the second week after the formation of the sore, other symptoms of syphilis appear, which include:

• swollen lymph nodes in the groin, neck and armpits;
• mood changes (irritability, anxiety, aggression);
• appetite problems;
• pain in the joints;
• slight increase in temperature (up to 37.5 °).

In most cases, the formation of edema in the genital area is noted. With an abundant area of ​​​​edema, pain and discomfort during walking are possible.

Important! If the patient has not received treatment at the primary stage of syphilis, the disease becomes chronic, and the patient has a period of attenuation, which can last up to 2 months. After this period, the infection will proceed with periods of remission.

This stage can take up to several years, while the pathogen, while in the body, affects all organs and systems. male body. The heart and nervous system suffer the most, so a man with secondary syphilis is often diagnosed with the following symptoms:

• sudden attacks of fear and anxiety;
• sudden change of mood;
• dyspnea;
• angina;
• tachycardia;
• violation of the heart rhythm.

The main feature in the secondary stage is rash which can come and go on its own. This is the main danger of the disease - men often take such signs for an allergic reaction or manifestations skin dermatitis so they don't pay attention to them.

Important! The rash with syphilis is characterized by characteristic features, so it can be distinguished from dermatological diseases. Rashes in the period of relapses are brightly colored and symmetrical in shape (reminiscent of small nodules).

In some men, secondary syphilis may present with partial or complete alopecia (hair loss). Hair can fall out not only on the head - diffuse forms Baldness in men is diagnosed in the groin, under the armpits and on the surface of the legs. Only a qualified doctor can correctly determine the cause of alopecia, so you need to deal with this problem in a hospital, and not to cosmetologists.

Tertiary syphilis

The tertiary form of syphilis in men is extremely rare. It can occur several years after the penetration of the pathogen into the body. Rashes at this stage resemble hazelnuts in size, become dense and take the form of a ball. After the disappearance of the tubercles, syphilitic sores appear in their place.

The danger of this form of infection is that such ulcers can affect and destroy any tissue in the body, even as dense as the bones of the skull.

Why is syphilis dangerous for men?

It is necessary to treat syphilis immediately after the first signs are detected, since the disease can lead to serious complications. The causative agent of infection penetrates into the internal organs and destroys healthy tissue, resulting in necrosis (necrosis) of individual areas. Particularly often diagnosed is necrosis of the penis - a severe pathology that can result in the development of a purulent-inflammatory process and amputation of the organ.

The defeat of treponema strongly affects immune system men, therefore, the risks of secondary infection are significantly increased. The body is weakened and cannot fully fight against pathogenic microorganisms, which contributes to the addition of infections, including venereal ones.

Consolidation of the foreskin and swelling of the penis with syphilitic lesions are diagnosed in every third man. These complications are very painful, prevent a man from doing his usual activities and can cause discomfort while driving.

Syphilis is dangerous venereal disease, which affects not only the health of the genital organs, but also the work of the whole organism. If you do not consult a doctor for early stage pathology, there is a high probability of damage to vital organs. To avoid this, you need to know the signs and symptoms of the disease in men, as well as understand how the stages of infection differ from each other. Appeal for medical care at the initial stage, it increases the chances of successful treatment several times, so you should not delay it.

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