Syphilis early latent after treatment. Latent syphilis - how to quickly identify and effectively treat the disease? Is latent syphilis contagious?

A common sexually transmitted disease - syphilis - is caused by a microorganism - pale spirochete. It has several stages of development, as well as many clinical manifestations. In Russia, in the late 90s of the twentieth century, a real epidemic of this disease began, when out of 100,000 people fell ill per year, 277 people. Gradually, the incidence is decreasing, but the problem is still relevant.

In some cases, there is a latent form of syphilis, in which there are no external manifestations of the disease.

Why does latent syphilis occur?

The causative agent of the disease - pale spirochete - under normal conditions has a typical spiral shape. However, when adverse factors external environment it forms forms that promote survival - cysts and L-forms. These modified treponemas can persist for a long time in the lymph nodes of an infected person, his cerebrospinal fluid, without causing any signs of illness. Then they are activated, and there is a relapse of the disease. These forms are formed due to proper treatment antibiotics, the individual characteristics of the patient and other factors. Especially important is the self-treatment of patients for a disease that they consider gonorrhea, but in fact it is an early stage of syphilis.

The cyst form is the cause of latent syphilis. It also causes a lengthening of the incubation period. This form is resistant to many drugs used to treat this disease.

How is latent syphilis transmitted? In nine cases out of ten, the route of transmission is sexual. Much less common is the household route (for example, when using one spoon), transfusion (with the transfusion of infected blood and its components), and transplacental (from mother to fetus). This disease is detected most often during a blood test for the so-called Wasserman reaction, which is determined for each admitted to the hospital, as well as when registering with a antenatal clinic for pregnancy.

The source of infection is only a sick person, especially in the secondary period.

Latent period of syphilis

This is the time after infection of a person with treponema pallidum, when there are positive serological tests (blood tests are changed), but symptoms are not determined:

• rash on the skin and mucous membranes;
• changes in the heart, liver, thyroid gland and other organs;
• pathology of the nervous system and the musculoskeletal system, and others.

Usually changes in the blood appear two months after contact with the carrier. From this moment, the period of the disease is counted in a latent form.

Early latent syphilis occurs within two years of infection. It may not appear immediately, or it may be the result of a regression of early symptoms of the disease, when an apparent recovery occurs. There are no clinical symptoms of latent syphilis, it is characterized by a negative test of cerebrospinal fluid (cerebrospinal fluid). It is diagnosed using serological tests.

Latent late syphilis is characterized by a sudden activation of the process after a period of imaginary well-being. It can be accompanied by damage to organs and tissues, the nervous system. There are low-contagious elements of the skin rash.

What is latent unspecified syphilis?

In this case, neither the patient nor the doctor can determine when the infection occurred, since there were no clinical symptoms of the disease, and it was revealed, most likely, as a result of a blood test.

There is also the possibility of a false positive result of the Wasserman reaction. This happens in the presence of a chronic infection (sinusitis, caries, tonsillitis, pyelonephritis and others), malaria, liver diseases (hepatitis, cirrhosis), pulmonary tuberculosis, rheumatism. An acute false-positive reaction occurs in women during menstruation, in the third trimester of pregnancy, in the first week after childbirth, myocardial infarction, acute diseases, injuries and poisoning. These changes disappear on their own within 1-6 months.

If a positive reaction is detected, more specific tests are necessarily carried out, including a polymerase chain reaction that determines the antigen of pale treponema.

Early latent form

This form covers all forms by terms from primary seropositive (hard chancre) to secondary recurrent (skin rashes, then their disappearance - a secondary latent period, and relapses for two years), but there are no external signs of syphilis. Thus, the disease can be recorded in the period between the disappearance of the hard chancre (end of the primary period) until the onset of the formation of rashes (the beginning of the secondary period) or be observed at the moments of remission in secondary syphilis.

At any time, the latent course can be replaced by a clinically pronounced one.

Since all of the listed forms are contagious, due to the coincidence in time with them, the early latent variant is also considered dangerous for others and all the prescribed anti-epidemic measures (identification, diagnosis, treatment of contact persons) are carried out.

How to detect the disease:

• the most reliable evidence is contact with a patient with active syphilis during the previous 2 years, while the probability of infection reaches 100%;
• to find out the presence of unprotected sexual intercourse over the past two years, to clarify whether the patient had subtle symptoms, such as sores on the body or mucous membranes, hair loss, eyelashes, a rash of unknown origin;
• to clarify whether the patient did not go to the doctor at that time for any reason that worried him, whether he took antibiotics, whether he received blood or its components;
• examine the genitals in search of a scar left after a hard chancre, assess the condition of the peripheral lymph nodes;
• serological tests in high titer, but not necessarily, immunofluorescent analysis (ELISA), direct hemagglutination test (DPHA), immunofluorescence test (RIF) are positive.

late latent form

The disease is detected most often by chance, for example, during hospitalization for another reason, when a blood test is taken (“unknown syphilis”). Usually these are people aged 50 years and older, their sexual partners do not have syphilis. Thus, the late latent period is considered non-contagious. In terms of timing, it corresponds to the end of the secondary period and the entire Tertiary.

Confirmation of the diagnosis in this group of patients is more difficult, because they have concomitant diseases (rheumatoid arthritis and many others). These diseases are the cause of a false positive blood reaction.

To make a diagnosis, you should ask the patient all the same questions as with the early latent variant, only change the condition: all these events must have occurred more than two years ago. Serological tests help in the diagnosis: more often they are positive, the titer is low, and ELISA and RPHA are positive.

When confirming the diagnosis of latent syphilis, ELISA and RPHA are of decisive importance, because serological tests (rapid diagnostics) can be false positive.

Of these diagnostic methods, the confirmatory reaction is RPHA.

With latent syphilis, a puncture of the cerebrospinal fluid (CSF) is also indicated. As a result, latent syphilitic meningitis can be detected. Clinically, it does not manifest itself or is accompanied by minor headaches, hearing loss.

The study of cerebrospinal fluid is prescribed in the following cases:

• signs of changes in the nervous system or eyes;
• pathology of internal organs, the presence of gums;
• ineffectiveness of penicillin therapy;
• association with HIV infection.

What are the consequences of late latent syphilis?

Most often, syphilis has an undulating course with alternating remissions and exacerbations. However, sometimes its long course without symptoms is observed, ending several years after infection with syphilis of the brain, nerves, or internal tissues and organs. This option is associated with the presence in the blood of strong treponemostatic factors resembling antibodies.

How does the hidden late period manifest itself in this case:

• rash on the outer integument of the body in the form of tubercles and nodules, sometimes with the formation of ulcers;
• bone damage in the form of osteomyelitis (inflammation of the substance of the bone and bone marrow) or osteoperiostitis (inflammation of the periosteum and surrounding tissues);
• joint changes in the form of osteoarthritis or hydrarthrosis (fluid accumulation);
• mesaortitis, hepatitis, nephrosclerosis, pathology of the stomach, lungs, intestines;
• violation of the activity of the brain and peripheral nervous system.

Pain in the legs with latent late syphilis may result from damage to the bones, joints, or nerves.

Latent syphilis and pregnancy

If a woman has a positive serological reaction during pregnancy, but there are no clinical signs of the disease, she must definitely donate blood for ELISA and RPHA. If the diagnosis of "latent syphilis" is confirmed, she is prescribed treatment according to general schemes. Lack of therapy entails serious consequences for the child: congenital deformities, abortion and many others.

If the disease is cured before 20 weeks of pregnancy, childbirth proceeds as usual. If the treatment was started later, then the decision on natural or artificial delivery is made by doctors based on many concomitant factors.

Treatment

Specific treatment is prescribed only after confirmation of the diagnosis. in a laboratory way. The sexual partners of the patient are examined, if they have negative laboratory tests, then they are not prescribed treatment for the purpose of prevention.

Treatment of latent syphilis is carried out according to the same rules as its other forms.

Long-acting drugs are used - Benzathine penicillin, as well as Benzylpenicillin sodium salt.

Fever at the beginning of penicillin therapy is indirect evidence of a correctly established diagnosis. She accompanies mass death microorganisms and the release of their toxins into the blood. Then the state of health of patients is normalized. With a late form, such a reaction may be absent.

How to treat latent syphilis:

• in the early form, Benzathine penicillin G is injected at a dose of 2,400,000 units, two-stage, into the muscle once a day, only 3 injections;
• with a late form: Benzylpenicillin sodium salt is injected into the muscle at 600 thousand units. twice a day for 28 days, two weeks later, the same course is carried out for another 14 days.

In case of intolerance to these antibiotics, semi-synthetic penicillins (Oxacillin, Amoxicillin), tetracyclines (Doxycycline), macrolides (Erythromycin, Azithromycin), cephalosporins (Ceftriaxone) can be prescribed.

Latent syphilis during pregnancy is treated according to general rules, since the drugs of the penicillin group are not dangerous to the fetus.

Monitoring the effectiveness of treatment

After treatment of early latent syphilis, serological control (ELISA, RPHA) is carried out regularly until the indicators are completely normal, and then twice more with an interval of three months.

With late latent syphilis, if RPHA and ELISA remained positive, the follow-up period is 3 years. Tests are carried out every six months, the decision to deregister is made on the basis of a set of clinical and laboratory data. Usually, in the late period of the disease, the restoration of normal blood and cerebrospinal fluid is very slow.

At the end of the observation, a complete examination of the patient is carried out again, examination by a therapist, a neurologist, an otorhinolaryngologist and an oculist.

After the disappearance of all clinical and laboratory manifestations of the disease, patients can be allowed to work in children's institutions and public catering establishments. But once transferred and cured, the disease does not leave stable immunity, so re-infection is possible.

Latent syphilis: how to diagnose and treat, what is dangerous - all about diseases of the genital area, their diagnosis, operations, problems of infertility and pregnancy to the site

The female body can rightly be called another wonder of the world. This is the source of human life, its bearer, but is there a higher value on Earth? Therefore, it is so important for women to take care of their health, and above all - about the reproductive system. If it fails, there will be neither a full-fledged conception of a child, nor a calm pregnancy, nor a successful delivery. In order for the gene pool of our planet to improve, gynecology is needed - the oldest branch of medicine that studies and treats diseases that are characteristic exclusively for female body.

The word "gynecology" is derived from two Greek words: "γυναίκα", which means "woman" and "λόγος", which translates as "study"

Unfortunately, not everyone visits the "women's doctor" regularly and in a timely manner, even if there are some problems. Some don't have time, others are just shy. The result is serious disturbances in the functioning of the reproductive system, which negatively affect the reproductive function of the female body. The more you know about what is happening with your body, the calmer you will be about the processes taking place inside you. Thanks to the articles that you will find on the site, you will be able to:

• by some symptoms and signs to recognize various diseases relating to gynecology, and in time to seek help from doctors;
• understand the terminology used by gynecologists and not be afraid of these seemingly terrible words;
• know how to properly prepare for certain analyzes so that the results are more reliable;
• be able to read the results of their analyses.

And most importantly, what this project will teach all women is not to be afraid to visit gynecologists in a timely and regular manner. This will allow you to forget about problems, to be always cheerful and beautiful. After all, female youth is 90% dependent on the health of the reproductive system. Site site is ready to help provide the most useful information about this theme:

• about analyzes and diagnostics;
• about various female diseases;
• about the conception and bearing of a child;
• about childbirth;
• about medicinal products.

Do you want to be young and beautiful? In that case, take care of your women's health right now. Here you will find all the information you are interested in - detailed, reliable and accessible to your understanding. Do not be light-minded about what the life of all mankind depends on, because each of you is, first of all, a Mother.

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

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

To accurately determine the disease, photos from textbooks or the Internet are not suitable, because a novice chancre is easy to confuse with a large pimple or an allergic rash, and how soon you discover the disease in yourself depends on how the treatment process will go. We advise you to immediately consult a doctor at the first signs of illness, who can accurately diagnose.

Periods of syphilis

• Before choosing the right treatment for syphilis, you should know at what stage the disease develops.
• The disease itself has 4 stages of the course - we will consider them in more detail.
• Treatment of the disease is quite possible at each of its stages, with the exception of the last, when all organs and systems are affected and cannot be restored - the only difference is the duration and intensity of the course.

Incubation period

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

Syphilitic angina

One of the reasons for the development of angina - syphilis, or rather one of the external manifestations of infection of pale treponema, are symptoms characteristic of angina, but with certain differences.

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

• In addition, one of the first signs that it was treponemas that caused the patient's condition, similar to angina, is the duration of the disease course, which in this case lasts several times longer than ordinary angina.
• The first manifestations of syphilitic sore throat can only be observed in people who have oral sex, since, first of all, pale treponema manifests itself at the site of the entrance gate.
• Another way of infection is the use of personal belongings of the patient for oral hygiene.

The smell of syphilis

In women, such a sign of infection as an unpleasant smell of discharge can often be observed. This is especially true for the second period of the disease, when the amount of hostile microflora is greatest.

Therefore, if a woman's discharge began to have a pungent odor for no apparent reason, for example, non-compliance with basic personal hygiene, leading to mixing of the secretion of the sebaceous glands, uterine mucus and vaginal discharge, then herpes, mild chancre or syphilis begin to be suspected, that inflame tissues.

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

pain

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

• If we are talking about the pain of the musculoskeletal system, then the first manifestations can be observed in the primary period of infection in the form of aches at night and evening time, which people with rheumatism usually complain about.
• In the second period, bone damage may occur in the form of periostitis of the cranial or tibial obliques.
• The defeat of the same joints after infection, although it occurs, but it usually does not lead to pain.

A sign of infection in the second stage may be calcified growths on tubular bones at the roentgenogram, but only in case of repeated recurrent development of the disease. With primary infection, there are no such changes on x-rays.

Disease Definition

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

• Having appeared, the first signs may remain invisible, and may be mistaken for another disease.
• In the second case, self-treatment usually begins, the visible result of which is the disappearance of external signs of the disease, which should be associated not with healing, but with the body's immune response to pathogens.
• The person, being in full confidence that he was treated correctly, calms down, and when other signs appear after a while, they are no longer associated with a hard chancre.
• Therefore, you should not try to determine skin infections on your own, it is better to contact specialists immediately so as not to miss the onset of a serious infection.

Itching with syphilis

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

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

So, if a person has an itchy rash, you should think about whether syphilis itches?

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

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

Lymph nodes with syphilis

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

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

An increase in all lymph nodes or their soreness indicates a different type of infection, not associated with pale treponema.

Buboes or inflamed lymph nodes have been attributed to the main signs of syphilis since the Middle Ages, when it was believed that they simply could not exist without each other. However, in connection with the intake of various medications by people in the last decade, the number of cases in which the presence of pale treponema in the body was not accompanied by regional lymphodermatitis has increased.

Detection of syphilis

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

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

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

The following signs of primary syphilis can be distinguished:

Primary syphilis in the usual course manifests itself three to four days after treponema enters the body. This stage lasts an average of five to six weeks.

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

Primary

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 a unique set of 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 near the 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 is introduced into 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, foreskin, scrotum, tonsils appears (depending on the site of infection).

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

The first signs of secondary syphilis

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

• Fresh - this species syphilis is a consequence of the primary form. Symptoms - small polymorphic rash and hard chancre;
• Hidden- even the incubation period of syphilis does not manifest itself externally, but can be detected through serological studies;
• Recurrent- with this form of secondary syphilis, relapses alternate, during each relapse a rash appears on the body.

  But unlike fresh syphilis, the rash during relapses is less abundant, the spots are larger, and foci of rashes can be detected.

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. Rashes can form on various areas of the skin, including 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 that a weakening of the immune system, frequent stress, hypothermia, exhaustion of the body, etc. can provoke a new outbreak of the disease.

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 severe pain.
• No less dangerous are gummas in the central nervous system, since their appearance often leads to damage to certain parts of the brain and gradual degeneration of the personality.

If left untreated, syphilis is fatal.

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

Signs of tertiary syphilis:

• In men, tertiary syphilis is diagnosed through the appearance of tubercles and gums. The tubercles are quite small in size and quite a lot of them form on the body. Gummas are single, rather large and deep in the tissues. Inside these formations there is not such a large number of treponem, so the risk of infecting another person is much lower than with secondary syphilis.
• In the tertiary form, the first signs of syphilis in women are bumps and gums like in men. Both tubercles and gummas eventually turn into ulcers, from which scars will remain after healing. These scars adversely affect the state of organs and tissues, severely deforming them. Gradually, the functions of organs are violated, which can eventually lead to death. If infection with syphilis occurred from a sexual partner, then the rash will primarily be in the genital area (on the vagina, etc.).
• In children, tertiary syphilis affects the skin, internal organs and nervous system with special tubercles - syphilides. Syphilides are formed due to the development of hypersensitivity of the child's body to treponemas, which are found in excess in the child's body.

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

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

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

congenital form of the disease

As already mentioned, infection can also occur during pregnancy, 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, the infection can lead to a disruption in the normal development of the fetus - in some cases, doctors even convene a consultation about abortion. 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 of the 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, including 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.

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

Syphilis is quite diverse in its manifestations. It depends on a number of factors, ranging from the immune status of the person affected by treponema to the number of syphilis pathogens entering the body.

The following types of syphilis and their symptoms in men and women can be distinguished:

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

• The skin takes on a purple hue. Another sign of syphilis in men and women in an atypical form is a chancre panaritium, which can be found near the nail phalanx on the fingers.
• At the same time, the ulcer has uneven edges, painful sensations are created on the affected phalanx. At the same time, the lymph nodes in the elbows increase, but do not hurt. With the manifestation of a hard chancre on the tonsils, erosion and ulcers occur, the tonsil increases in size.
• Patients do not experience pain from sores on the tonsil. Paraphimosis in atypical syphilis is an inflammation of the preputial sac that develops when the head of the penis is exposed. Prolonged course of paraphimosis without proper treatment can lead to necrosis of the head.

congenital syphilis

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

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

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

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

Neurosyphilis manifests itself through the following symptoms:

• syphilitic meningitis - syphilis is accompanied by meningeal symptoms (severe headaches, dislike of light, nausea and vomiting, high fever);
• syphilitic meningoencephalitis - in fact, it is syphilitic meningitis, which is accompanied by mental disorders (hallucinations may occur);
• dorsal tabes - with this manifestation, neurosyphilis affects the spinal cord, so the patient loses the sensitivity of the limbs, sees poorly, feels problems with urination and defecation;
• progressive paralysis - with neurosyphilis, a patient with paralysis loses reading and writing skills, dementia develops and complete disintegration of the personality.

Latent syphilis

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

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

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

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

Household syphilis

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

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

impotencija.net

Other types of disease

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 syphilis, which 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, this form of syphilis is detected 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.

Diagnostic methods

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. Serological analysis for syphilis is considered no less accurate, during which the presence of a specific IgM immunoglobulin in the body can be detected. 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, in order to obtain additional information, the doctor refers the patient to 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 administration of rather large doses of antibiotics - most often, penicillin substances (penicillin, erythromycin, tetracycline) are used for this purpose. 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.

course of antibiotic treatment

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

The disease is sensitive to such groups of drugs:

• preparations containing penicillin.
• macrolides and the antibiotic ceftriaxone.

So antibiotics containing penicillin in their composition are very effective during treatment, adversely affecting the causative agent of the pathology. When diagnosing primary syphilis, they give excellent dynamics of treatment. Today, dermatovenereologists do not practice the method of the first loading dose of penicillin administration - the method of intramuscular injection of the drug every 3 hours is more effective, which ensures its constant concentration in the body.

PENICILLIN (MEDIUM FROM CERTAIN MOLDS)

So preparations containing penicillin perfectly help in the fight against the early stages of the course of neurosyphilis, but so far the nervous system has not undergone irreversible changes in its work, as well as in the congenital nature of syphilis damage to the body.

If the third stage of the course of syphilis is diagnosed, it is worth going through a 2-week therapy with drugs such as tetracycline or erythromycin before taking penicillin.

AZITHROMYCIN - A NEW GENERATION DRUG

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

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

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

If the doctor diagnoses hidden form the course of syphilis - the treatment regimen and drugs are similar, supplemented by a course of taking immunostimulants and physiotherapy procedures.

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

• First of all, it is necessary to exclude promiscuity with an unverified partner, especially without a condom. If there was such sex, immediately treat the genitals with an antiseptic and visit a doctor for a preventive examination and examination.

• It is enough to understand that not every person knows what he is on this moment acts as a carrier of the infection and, if the patient has a regular sexual life, doctors recommend regularly undergoing examinations by highly specialized doctors, being tested for STDs, thereby detecting the disease in the early stages of its course.tvojajbolit.ru

Disease prevention

Unfortunately, to date, there is no vaccine that can permanently protect against such a 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 with an antiseptic solution and making 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.
syl.ru

What is a hard chancre?

Chancre with syphilis is a specific local reaction of the body to the penetration of pale treponema. It all starts with a slight reddening with clear edges, in the place of which a painless scaly papule (nodule) appears, and later an erosion or ulcer (a deeper defect) is formed, this is the chancre (this is how ulcers were called in the old days).

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

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

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

Atypical forms of primary syphilomas

A hard chancre is a typical manifestation of syphilis. However, there are other clinical forms of primary syphiloma. These include:

1. Chancre panaritium - inflammation of the extreme phalanx of the finger.
2. Indurative edema - dense swelling of the genitals.
3. Chancre-amygdalite - an increase and compaction of one palatine tonsil, while there are no ulcers, erosions or deposits on the lymphatic formation.

These manifestations of syphilis are very similar to diseases of a completely different nature, so doctors have a hard time making the correct diagnosis. Leads them to the idea of ​​syphilis in such situations, regional lymphadenitis.

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

infmedserv.ru

How is syphilis transmitted?

You can get syphilis through direct contact with a syphilis sore during vaginal, anal, or oral sex. You may find sores on or around the penis, in the vagina, anus, rectum, or on the lips and mouth. Syphilis can be passed from an infected mother to her fetus.

Image of a primary syphilitic ulcer.

How does syphilis manifest itself?

Syphilis is divided into several stages (primary, secondary, latent, and tertiary) with different signs and symptoms associated with each stage. In a person with primary syphilis usually there is pain or ulceration at the original site of the infection. Ulcers usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. Ulcers are usually (but not always) hard, round, and painless. Symptoms secondary syphilis include skin rash, swollen lymph nodes, and fever. Signs and symptoms of primary and secondary syphilis may be subtle and unnoticeable. During latent stage no signs or symptoms. Tertiary syphilis associated with serious health problems. A doctor can usually diagnose tertiary syphilis with several tests. It can affect the functioning of the heart, brain, and other organs of the body.

What are the signs and symptoms of syphilis?

Symptoms of syphilis in adults vary depending on the stage:

primary stage

During the initial stage of syphilis, you may notice one or more sores. An ulcer is where the syphilis entered your body. Ulcers are usually (but not always) hard, round, and painless. Since the ulcer is painless, it is easy to miss it. An ulcer usually lasts 3 to 6 weeks and goes away whether or not you receive treatment.

Even after the ulcer is gone, you still need to be treated. This will stop your infection from progressing to the secondary stage.

secondary stage

During the secondary stage, you may develop a rash and/or mucosal lesions. Mucosal lesions are ulcers in the mouth, vagina, or anus. This stage usually begins with the appearance of a rash on one or more areas of the body. The rash may appear when the primary ulcer heals or several weeks after it has healed. The rash may appear as rough, red or reddish-brown patches on the palms of the hands and/or soles of the feet. Typically, the rash does not itch, and sometimes it is so mild that you may not notice it. Other symptoms you may experience include fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle pain, and fatigue. The symptoms of this stage will go away regardless of whether you receive treatment. But without proper treatment, the infectious disease will become latent, and possibly even late stage syphilis.

Syphilitic rash on the body in the secondary period.

hidden stage

The latent stage of syphilis is the period of time when there are no visible signs or symptoms of syphilis. If you go untreated, you can continue to have syphilis for years without any signs or symptoms.

Tertiary stage

In most people, untreated syphilis does not progress to the tertiary stage. However, when it does, it can affect many organ systems. These include the heart and blood vessels, as well as the brain and nervous system. Tertiary syphilis is very dangerous and can begin 10 to 30 years after infection. In the tertiary stage of syphilis, the disease affects the internal organs and can lead to the death of a person.

Neurosyphilis and syphilis of the eye

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (ocular syphilis). This can happen at any of the stages described above.

Symptoms of neurosyphilis include:

• severe headache;
• difficulty in coordinating muscle movements;
• paralysis (inability to move certain parts of the body);
• numbness; and
• dementia (mental disorder).

Symptoms of syphilis of the eye include blurred vision and even blindness.

Dark-field micrographic image of a pallidum spirochete ( Treponema pallidum).

Can syphilis be cured?

Yes, syphilis can be treated with antibiotics properly selected by your doctor. However, treatment may not correct the damage that the infection has already done.

https://www.cdc.gov/std/russian/stdfact-syphilis-russian.htm

Causes of primary syphilis

The causative agent of the disease is Treponema pallidum. The route of transmission of the infection is mainly sexual, with unprotected intercourse with a sick person or a carrier of the infection. The disease refers to sexually transmitted diseases or sexually transmitted infections. A hematogenous route of infection transmission is possible, during blood transfusion, also in injection drug addicts when using other people's syringes, when using other people's razors and toothbrushes in everyday life.

The household route of infection is very rare, as it requires close contact with a person with tertiary syphilis. Perhaps intrauterine infection and infection through mother's milk.

Symptoms of primary syphilis

The first symptoms appear 10–90 days after infection. A hard chancre appears at the site of infection, most often, its appearance is characteristic on the head of the penis in men, labia or on the mucous membrane of the cervix and vagina in women. There is also an extragenital location of the chancre, for example, on the thighs, fingers, abdomen, lips, on the mucous membrane of the anus, pubis, in the oral cavity.

Diagnosticsprimary syphilis

The doctor performs a survey and examination of the patient, analysis of the anamnesis of life and anamnesis of the disease. To confirm the diagnosis, a bacteriological examination of the detachable chancre is performed in order to detect the pathogen - pale treponema. Sometimes a biopsy of the lymph node is performed, and a number of serological tests are also performed (RIBT, RIF, RPR test).

Treatment of primary syphilis

Therapy must be carried out by both sexual partners at the same time, during the treatment period the possibility of any sexual contact is excluded. During drug treatment antibiotics of the penicillin series are prescribed. With the development of an allergy to penicillin, tetracycline or doxycycline is prescribed.

After the necessary treatment, all patients with seronegative primary syphilis are under mandatory dispensary observation for a period of 12 months, and with seropositive primary syphilis, they are under medical supervision for at least 3 years. The most common complications are: balanoposthitis, balanitis, phimosis, paraphimosis, gangrene.

Preventionprimary syphilis

In order to prevent infection, casual sexual contacts should be abandoned, if necessary, use barrier methods of contraception. General recommendations include compliance with the rules of intimate and personal hygiene, maintaining healthy lifestyle life.

https://www.obozrevatel.com/health/bolezni/pervichnyij-sifilis.htm

Update: December 2018

Syphilis (Lewis) is one of the few diseases that entails criminal liability when it infects a sexual partner or other people. As a rule, the first signs of syphilis in men and women do not appear immediately, but several weeks after the actual infection, which makes this disease even more dangerous.

Syphilis stands out among all socially significant diseases (threatening not only the health of the population, but also life) in that today the syphilis epidemic in Russia has a progressive trend. The incidence rate has increased fivefold in recent decades. If left untreated, this sexually transmitted disease can lead to infertility, both in women and men, during the pregnancy of a sick woman, infection of the fetus occurs in 70% of cases, which ends with the fetus dying or congenital syphilis in the baby.

Syphilis happens:

• by origin - congenital and acquired
• according to the stage of the disease - primary, secondary, tertiary
• in terms of occurrence - early and late

Diagnostics

The diagnosis of such a serious disease cannot be made to oneself "on the Internet" by reading about syphilis and its symptoms. The fact is that a rash and other changes can visually copy those in completely different diseases, which even doctors are periodically misled. For this reason, doctors diagnose syphilis with an examination, characteristic features and laboratory research:

• Examination by a dermatovenereologist. He asks the patient in detail about the course of the disease, examines the skin, genitals, lymph nodes.
• Detection of treponema or its DNA in the contents of gum, chancre, syphilides by dark-field microscopy, direct immunofluorescence reaction, PCR.
• Carrying out various serological tests: Non-treponemal - search for antibodies against treponemal membrane lipids and tissue phospholipids that are destroyed by the pathogen (Wasserman reaction, VDRL, rapid plasma reagin test). The result obtained may be false positive, i.e. show syphilis where there is none. Treponemal - search for antibodies to pale treponema (RIF, RPHA, ELISA, immunoblotting, RIBT).
• Instrumental research: search for gums using ultrasound, MRI, CT, x-rays, etc.

Exciter properties

The spirochete Treponema pallidum (pallid treponema) is recognized as the "culprit" of syphilis. In the human body, treponemas multiply rapidly, which leads to damage to internal organs. Among other things, there are many of them on the mucous membranes, so they are easily transmitted through sexual or close household contact, for example, through common dishes, some personal hygiene items (household syphilis). Pale treponema does not cause lasting immunity, so a cured partner can become infected again from his partner, who continues to get sick with Lewis.

Treponema does not tolerate desiccation and high temperatures(it dies almost instantly when boiled, and an increase in temperature to 55 0 C destroys treponema in 15 minutes). However, low temperatures and a humid environment contribute to the "survivability" of this spirochete:

• preservation of viability during the year when frozen to minus 78 0 С,
• survival on dishes with moisture residues up to several hours,
• even the corpse of a syphilitic patient is able to infect surrounding people for 4 days.

How is syphilis transmitted?

Syphilis is transmitted through:

• sexual contact (eg, vaginal, oral, anal sex)
• through blood (shared syringes for drug addicts, for blood transfusion, joint toothbrushes or shaving accessories in everyday life)
• through mother's milk (acquired syphilis in children)
• in utero (congenital syphilis of a child)
• through common utensils, if the patient has open sores, decaying gums (for example, a common towel, dishes)
• through saliva (infection occurs rarely in this way and mainly among dentists, if they do not work in protective gloves)
• Read more about the methods of transmission of infection in our article.

In case of accidental unprotected any kind of sexual contact, as an emergency prevention of syphilis, the following procedure can be performed (the sooner the better, no later than 2 hours after the act): first, thoroughly wash the genitals, inner thighs with soap, then treat the genitals with antiseptic solutions Chlorhexidine, (men should inject the solution into the urethra, women into the vagina).

However, this method only reduces the risk of infection by 70% and cannot be used continuously, condoms are the best way protection and even after using them with an unreliable partner, the genitals should be treated with an antiseptic. After accidental sexual contact, you should be examined by a venereologist for other infections, and in order to exclude syphilis, you should be examined after a few weeks, it does not make sense before

All external papules, erosions, ulcers with scanty discharge are extremely contagious. In the presence of microtraumas on the mucous membrane or skin in a healthy person, contact with the patient leads to infection. From the first to last day diseases, the blood of a patient with syphilis is contagious, and transmission is possible both during blood transfusion and when the skin or mucous membrane is injured with medical, cosmetic, instruments in pedicure and nail salons, which have been exposed to the blood of a patient with syphilis.

Incubation period

After entering the body, pale treponema is sent to the circulatory and lymphatic systems, spreading throughout the body. However, an outwardly infected person still feels healthy. From the time of infection to the period of onset of the initial symptoms of syphilis, it can take from 8 to 107 days, and on average 20–40 days.

That is, within 3 weeks and up to 1.5 months after infection, syphilis does not manifest itself in any way, neither with symptoms nor external signs, even blood tests give a negative result.

The duration of the incubation period is extended:

• old age
• high temperature conditions
• current treatment with antibiotics, corticosteroids, other drugs

The incubation period is shortened with massive infection, when a huge amount of treponema enters the body at the same time.

Already at the stage of the incubation period, a person becomes contagious, but during this period, infection of other people is possible only through the blood.

Syphilis Statistics

In the early stages, syphilis responds well to treatment, but despite this, it takes a confident 3rd place, inferior to trichomoniasis and chlamydia, among sexually transmitted diseases.

According to official statistics, 12 million new patients are registered in the world every year, but these figures are underestimated, since some people are treated themselves, about which there are no statistical data.

People aged 15-40 are more likely to become infected with syphilis, the peak incidence occurs in 20-30 years. Women have a higher risk of infection (micro-cracks of the vagina during intercourse) than men, however, the increase in the number of homosexuals in large cities in the US and the EU leads to a higher infection rate in these countries in men than in women.

The Ministry of Health of Russia reports that there is no unified record of patients with syphilis in our country. In 2008, 60 cases of the disease were registered per 100,000 people. Among those infected, there are often people without a permanent place of residence, without a stable income or with low-paid jobs, as well as many representatives of small businesses and service workers.

Most cases are registered in the Siberian, Far Eastern and Volga districts. In some regions, cases of neurosyphilis refractory to treatment are on the rise, rising from 0.12% to 1.1%.

The first signs of syphilis - primary syphilis

What are the first signs of syphilis? In the case of the classic variant of the Lewis current, this is a hard chancre and enlarged lymph nodes. By the end of the primary period, patients are concerned about the following symptoms:

• headache
• general malaise
• pain in muscles, bones, arthralgia
• heat
• decreased hemoglobin (anemia)
• increase in white blood cells

Chancre hard- A typical hard chancre is a smooth ulcer or erosion with rounded and slightly raised edges up to 1 cm in diameter, bluish-red in color, which may or may not hurt. On palpation, there is a dense infiltrate at the base of the chancre, due to which the chancre was called "hard". A hard chancre in men is found in the region of the head or on the foreskin, in women on the cervix or on the labia. It can also be on the rectal mucosa or near the anus, sometimes on the pubis, abdomen, thighs. In medical workers, it can be localized on the tongue, lips, on the fingers.

The chancre can be either a single or multiple defect on the mucosa or skin, and mainly appears at the site of infection. As a rule, a week after its occurrence, the lymph nodes increase, but sometimes patients notice the lymph nodes earlier than the chancre. After oral sex, the chancre and enlarged lymph nodes may resemble or, which may lead to the appointment of inadequate treatment. Also, the anal chancre can be misleading, since it resembles a fissure of the anal fold with an elongated outline, without infiltration.

Even without therapy, the hard chancre disappears after 4-6 weeks, and the dense infiltrate resolves. Often, the chancre does not leave changes on the skin, although giant forms can give dark brown or black pigment spots, and ulcerative chancres leave rounded scars surrounded by a pigment ring.

Usually, the appearance of such an unusual ulcer causes anxiety in a person, so syphilis is detected in time and timely treatment is carried out. But when the chancre remains unnoticed (on the cervix) or ignored by the patient (smeared with potassium permanganate, brilliant green), after a month when it disappears, the person calms down and forgets about it - this is the danger of the disease, it goes into secondary syphilis unnoticed.

Stages of syphilis - click to enlarge

Atypical chancres - In addition to the classic chancre, there are other varieties of it, which makes the recognition of syphilis difficult:

• Inductive edema. On the lower lip, foreskin or labia majora, a large seal of a pale pink or bluish-red hue occurs, extending beyond the boundaries of erosion or ulcers. Without adequate treatment, such a chancre persists for several months.
• Felon. Chancre in the form of ordinary inflammation of the nail bed outwardly almost does not differ from the usual panaritium: the finger is swollen, purple-red, painful. Often there is a rejection of the nail. Unlike the classic panaritium, it does not heal for several weeks.
• Amygdalitis. This is not just a hard chancre on the tonsil, but a swollen, reddened, hard tonsil that makes swallowing painful and difficult. Usually, like a typical sore throat, amygdalitis is accompanied by fever, general weakness, and malaise. Headaches (mainly in the back of the head) can also be observed. Syphilis may be indicated by a unilateral lesion of the tonsil and low effectiveness of the treatment received.
• Mixed chancre. This is a mixture of hard and soft chancre with parallel infection with these pathogens. In this case, a soft chancre ulcer appears first, since it has a shorter incubation period, and then induration occurs, and the picture of a typical hard chancre develops. Mixed chancre is characterized by a delay of 3-4 months of laboratory test data (for example, the Wasserman reaction) and the appearance of signs of secondary syphilis.

Lymph nodes - With primary syphilis, enlarged lymph nodes are observed (see). When the chancre is located on the cervix or in the rectum, enlarged lymph nodes remain unnoticed, as they increase in the small pelvis, and if syphiloma has formed in the mouth, then the chin and submandibular nodes, cervical or occipital, increase, when the chancre is found on the fingers, the lymph nodes increase in the area of ​​the elbow. One of the hallmarks of syphilis in men is a painless cord with thickenings that forms at the root of the penis - this is syphilitic lymphadenitis.

• Bubo (regional lymphadenitis). It is a firm, painless, mobile lymph node that is adjacent to a chancre, such as:
  • in the groin - chancre on the genitals
  • on the neck - chancre on the tonsils
  • under the arm - chancre on the nipple of the mammary gland

• Regional lymphangitis. It is a dense, painless and movable band under the skin between a hard chancre and an enlarged lymph node. The average thickness of this formation is 1–5 mm.
• Polyadenitis. By the end of the primary period of Lewis, there is an increase and compaction of all lymph nodes. In fact, from that moment on, we can talk about the onset of secondary syphilis.

Complications of primary syphilis - Most often, complications arise when an infection is added in the area of ​​​​a hard chancre or a decrease in the body's defenses. Develop:

• balanoposthitis
• inflammation of the vagina and vulva
• constriction of the foreskin
• paraphimosis
• phagedenization (gangrene that spreads deep and wide into a hard chancre - it can even lead to rejection of the entire organ or part of it).

Symptoms of secondary syphilis

Secondary syphilis begins to develop 3 months after infection, on average, the duration of the secondary period of syphilis is from 2 to 5 years. It is characterized by undulating rashes that disappear on their own in a month or two, leaving no marks on the skin. The patient is not bothered by either the rise in temperature. At the beginning, the symptoms of secondary syphilis are as follows:

Skin syphilis - Secondary syphilis is characterized by a variety of elements of the rash, but they are all similar:

• benign course and rapid disappearance with appropriate treatment of syphilis
• rashes last for several weeks and do not lead to fever
• different elements of the rash appear at different times
• the rash does not itch or hurt

Syphilis options:

• syphilitic roseola - rounded or irregular shape a pale pink spot, which is more often seen on the sides of the body;
• papular - many wet and dry papules, often combined with syphilitic roseola;
• miliary - pale pink, dense, cone-shaped, disappearing much later than other elements of the rash and subsequently leaving patchy pigmentation:
• seborrheic - formations covered with scales or fatty crusts in those areas where the activity of the sebaceous glands is increased (forehead skin, nasolabial folds, etc.), if such papules are located along the edge of hair growth, then they are called the "crown of Venus";
• pustular - multiple abscesses, which then ulcerate and scar;
• pigmented - leukoderma on the neck (white spots), called the "necklace of Venus".

Syphilis of the mucous membranes - First of all, it is angina and pharyngitis. Syphilides can spread to the vocal cords, pharynx, tonsils, tongues, and oral mucosa. The most common are:

• Erythematous angina. Syphilides are located on the soft palate, tonsils in the form of bluish-red erythema.
• Papular angina. In the area of ​​the pharynx, there are many papules that merge with each other, ulcerate and become covered with erosions.
• Pustular angina. Pustular lesion of the mucous membrane of the pharynx.
• Pharyngitis. With the development of syphilis in the region of the vocal folds, there may be hoarseness or complete disappearance of the voice.

Baldness - it can be focal, observed in the form of small rounded areas on the head, beard, mustache and even eyebrows. Or diffuse, in which case the hair falls out profusely all over the head. After the start of treatment, after 2-3 months, the hair grows again.

Complications of secondary syphilis- The most severe complication of secondary syphilis is the transition of the disease to the tertiary period, when neurosyphilis and related complications develop.

Tertiary syphilis

Years or decades after the secondary Lewis period, treponemas transform into L-forms and cysts and gradually begin to destroy internal organs and systems.

Syphilides of the skin of the third period - Tubercular is a painless and dense burgundy tubercle that lies in the skin. Sometimes these tubercles are grouped together and form garlands resembling scattered shot. After their disappearance, scars remain. Gummatous is a sedentary nodule the size of a nut or pigeon's egg, located deep under the skin. As it grows, the gumma ulcerates and gradually heals, leaving a scar. Without adequate treatment, such gummas can exist for several years.

Syphilis of the mucous membranes of the third period - First of all, these are various gummas, which, when ulcerated, destroy bones, cartilage, soft tissues and lead to permanent deformities and deformities.

• Nose gum. Destroys the bridge of the nose, causing deformation of the nose (it just falls through) or hard palate, followed by reflux of food into the nasal cavity.
• Gumma soft palate. Gumma forms in the thickness of the sky, which makes it immobile, dark red and dense. Then the gumma breaks through in several places at once, forming long-term non-healing ulcers.
• Gumma language. There are 2 main forms of tongue damage in tertiary syphilis: gummy glossitis - small ulcerations on the tongue , sclerosing glossitis - the tongue becomes dense and loses its mobility, then shrinks and atrophies (speech suffers, the ability to chew and swallow food).
• Gum throat. Difficulty swallowing, accompanied by painful sensations and disorders.

Complication of the third period Lewis are:

• The appearance of gum in the internal organs (liver, aorta, stomach, etc.) with the development of their severe insufficiency and even sudden death.
• Neurosyphilis, which is accompanied by paralysis, dementia and paresis.

Features of the symptoms of syphilis in women and men

There are practically no differences in the second and third periods. The difference in the symptoms of syphilis can be observed only with primary syphilis, when a hard chancre is located on the genitals:

• Chancre in the urethra - the first signs of syphilis in men are bloody discharge from the urethra, inguinal bubo and a dense penis.
• Gangrenous chancre on the penis- possible self-amputation of the distal part of the penis.
• Chancre on the cervix. When infected with syphilis, the signs in women with a hard chancre on the uterus are practically absent (the gynecologist discovers during the examination).

Atypical syphilis

Latent syphilis. It proceeds unnoticed by the patient himself and is diagnosed only on the basis of tests, although a person can infect others.

Today, venereologists are faced with an increase in the number of cases of latent syphilis, this is due to the widespread use of antibiotics, when the initial signs of syphilis remain undiagnosed in a person, and the patient begins self-treatment or antibiotics prescribed by a doctor for other diseases - tonsillitis, acute respiratory viral infections, stomatitis, as well as trichomoniasis, gonorrhea, chlamydia. As a result, syphilis is not cured, but acquires a latent course.

• Transfusion. It is characterized by the absence of a hard chancre and the primary period of syphilis, immediately starting with a secondary one 2-2.5 months after the transfusion of infected blood.
• Erased. The symptoms of the secondary period “fall out”, which in this case are almost imperceptible, and then asymptomatic meningitis and neurosyphilis.
• Malignant. Rapid course, accompanied by gangrene of the chancre, a decrease in hemoglobin and severe exhaustion.

congenital syphilis

A woman infected with syphilis is able to pass it on by inheritance even to her grandchildren and great-grandchildren.

• Early syphilis - deformity of the skull, continuous crying, severe exhaustion, sallow skin color of the baby.
• Late syphilis - Getchinson's triad: semilunar edges of teeth, symptoms of labyrinthitis (deafness, dizziness, etc.), keratitis.

How to treat syphilis?

Which doctor treats syphilis?

A dermatovenereologist is engaged in the treatment of patients with syphilis, you should contact the dermatovenereological dispensary.

How much to treat syphilis?

Syphilis is treated for quite a long time, if it is detected at the primary stage, continuous treatment is prescribed for 2-3 months, with the development of secondary syphilis, therapy can last over 2 years. During the treatment period, any sexual contact is prohibited while the infectious period lasts, and preventive treatment is shown to all family members and sexual partners.

Are there folk remedies for the treatment of syphilis?

Neither folk remedies nor self-treatment for syphilis are acceptable, it is not effective and dangerous in that it makes it difficult to diagnose in the future and lubricates the patient's clinical picture. Moreover, the cure and effectiveness of therapy is determined not by the disappearance of symptoms and signs of syphilis, but by the results of laboratory data, and in many cases treatment is indicated in a hospital rather than at home.

What drugs are used to treat syphilis?

The best and effective method treatment - the introduction of water-soluble penicillins in a hospital, this is done every 3 hours for 24 days. The causative agent of syphilis is quite sensitive to penicillin antibiotics, however, if therapy with these drugs is ineffective or if the patient is allergic, they can be prescribed drugs - fluoroquinolones, macrolides or teracyclines. In addition to antibiotics, syphilis shows immunostimulants, vitamins, natural immunity stimulants.

What should family members of the patient do to prevent syphilis?

Syphilis is a highly contagious infection, during sexual contact the risk of infection is very high, and if there are signs of syphilis in a man or woman on the skin, this risk increases significantly. Therefore, if there is a patient with syphilis in the house, the risk of domestic infection should be minimized - the patient should have personal utensils, hygiene products (towels, bed linen, soap, etc.), it is necessary to avoid any bodily contact with family members at the stage when the person is still contagious.

How to plan a pregnancy for a woman who has had syphilis?

To avoid congenital syphilis, pregnant women are examined several times during pregnancy. If a woman has been ill with syphilis, has been treated and has already been deregistered, only in this case it is possible to plan a pregnancy, but even so, it should be examined and preventive therapy should be carried out.

Syphilis without symptoms is a fairly common occurrence that characterizes certain stages of the course of the infectious process. Screening tests are used to diagnose the asymptomatic course of the disease.

They make it possible to detect the activity of certain antibodies in the blood.

Atypical asymptomatic course

To date, atypical clinical forms of syphilis are quite often recorded. In this case, the primary chancre may not appear, which is associated with certain changes in the properties of pale treponema.

Another factor is the individual characteristics of the human body (insufficient functional activity of the immune system).

Also, the course of the infectious process may be atypical after the implementation of other routes of infection:

• or anal intercourse with a sick person. Hard chancre often forms on the mucous membrane of the pharynx or rectum. Therefore, it is impossible to see it on its own.
• With parenteral infection, a latent course of secondary syphilis often immediately develops. Parenteral infection is possible after: the entry of bacteria into the internal environment of the body in case of transfusion infected blood; after invasive manipulations with non-sterile instruments.
• Transplacental infection of the fetus from a sick mother during pregnancy. After birth, the child develops neurosyphilis, which can be asymptomatic for a long time.

Such variants of the asymptomatic course of syphilis have recently become quite widespread.

We hope you got an answer to your question can there be syphilis without symptoms. It's possible. That's why better time from time to time to be checked by a doctor, passing tests. They will allow you to diagnose the infection even without clinical signs.

To avoid serious consequences in the case of an asymptomatic course of the disease, contact experienced venereologists.

Syphilis can also occur in a latent form.

This variant of the course of the disease is called latent syphilis. Latent syphilis from the moment of infection takes a latent course, is asymptomatic, but blood tests for syphilis are positive.

In venereological practice, it is customary to distinguish between early and late latent syphilis: if the patient became infected with syphilis less than 2 years ago, they speak of early latent syphilis, and if more than 2 years ago, then late.

If it is impossible to determine the type of latent syphilis, the venereologist makes a preliminary diagnosis of latent, unspecified syphilis, and the diagnosis can be clarified during the examination and treatment.

Ordinary syphilis develops when pale treponemas, the causative agents of this disease, enter the human body. During their activity, the patient develops symptoms of syphilis: rash, bumps, gummas, and so on.

At the same time, the patient's immunity does not stand aside: as with any infection, it secretes antibodies (protective proteins), and also sends cells of the immune system to the breeding sites of bacteria.

Thanks to these measures, the majority of pale treponemas die. However, the most tenacious bacteria remain, which change their shape so that the immune system no longer recognizes them.

In the cystic form, pale treponema cannot be active, but it can multiply

This type of "masked" pale treponema is called cystic forms or L-forms. In this form, pale treponema cannot be active, but it can multiply.

As a result, when the immune system "loses its vigilance", secretly bred bacteria enter the bloodstream and harm the body again.

The same thing happens with improper treatment of syphilis. If the antibiotic is chosen incorrectly or in the wrong dose, not all pale treponemas die - the survivors are masked and remain invisible until better times.

False-negative (false-negative) results occur at high antibody concentrations, which inhibit agglutination (the prozone effect), which can be avoided with serial dilutions
serum.

The average rate of false-negative non-treponemal tests (VDRL) in secondary syphilis is about 1%. False-negative results of non-treponemal tests must be distinguished from negative non-treponemal tests at various periods of the course of syphilis, when the body has not yet developed antibodies or when the amount of antibodies is significantly reduced due to a decrease in the amount of lipid antigen.

The frequency of negative non-treponemal tests in different periods of syphilis

Reasons for a false positive test

Bacteriology

Treponema pallidum subsp. pallidum is a spiral-shaped, Gram-negative, highly mobile bacterium. Three other human diseases that are caused by Treponema pallidum include yaws (subsp. pertenue), pinta (subsp. carateum), and bejel (subsp. endemicum).

Unlike the subspecies pallidum, they do not cause neurological disease. Man is the only known natural reservoir for the subspecies pallidum.

It cannot survive without a host for more than a few days. This is because its small genome (1.14 MDa) is unable to code for the metabolic pathways that are required to make most of its macronutrients.

It has a slow doubling time of over 30 hours.

This is the name of the presence of a positive reaction to syphilis according to a serological examination in the actual absence of the disease. Find out the reasons for the body's reaction to the test in this article. It is important to distinguish false positive syphilis from seroresistant and seropositive syphilis.

Is it possible to have a positive reaction in a blood test in the absence of syphilis?

Yes, you can get a false positive if you:

diabetes;

pregnancy;

oncological diseases;

tuberculosis;

alcoholism or drug addiction;

you have recently been vaccinated.

If you receive a positive blood test for syphilis, you should immediately undergo a detailed examination by a venereologist in order to start treatment as soon as possible.

False positive nontreponemal tests

The main reasons for biological false-positive reactions are related to the fact that when conducting non-treponemal tests, antibodies to cardiolipin are determined (the main component of mitochondrial lipids, especially the heart muscle - hence the name), which appears in the body when tissues are destroyed during
some diseases and conditions.

Thus, non-treponemal tests determine the so-called reagin antibodies, which the body has developed not against the causative agent of syphilis - pale treponema, but against the consequences of a syphilitic infection.

However, reaginic antibodies are produced not only to the lipids of destroyed tissues, but also to the membrane lipids of treponema pallidum, but more than 200 antigens have been identified that are similar in composition to the lipid antigen of treponema pallidum.

False positive treponemal
tests

The causes of false positive treponemal tests are unknown. Their percentage is very low.

It is noted that false positive treponemal tests are most common in systemic lupus erythematosus and in Lyme disease (borreliosis). Since antitreponemal antibodies are produced by immunological memory cells for quite a long time, there are hypotheses about a short-term contact of the body with pale treponema, which did not lead to infection with syphilis, but caused the production of antitreponemal
antibodies.

Undoubtedly, the appearance of positive non-treponemal and treponemal tests in non-venereal trepanematoses is not considered as a false positive biological reaction, but does not confirm the presence of syphilis.

Physicians who encounter various manifestations of disease point to biological false prerequisites. The proportion of people who received a false positive test for syphilis actually had lupus.

The same group includes bejel and relapsing fever, leptospirosis, leptospira. However, having received such a conclusion, the doctor cannot immediately ascertain the presence of the disease, if there are also no external signs.

A re-examination is required. The absence of symptoms a second time and a negative result only indicates that the person received an erroneous sentence.

It remains to find an alternative disease, which so far skillfully hides and does not allow itself to be detected visually.

The state of the body at the moment can also affect the receipt of a false positive result. LPR can result from a concussion, regular menstruation, significant trauma or gout.

Technical failures are also rare, but they cause a false positive analysis for syphilis. Lab technician errors or equipment failure will result in an incorrect result.

Non-recognition of serological false-positive reactions for syphilis can have negative prognostic and social consequences. Don't just trust your intuition. The diagnosis requires confirmation or competent refutation.

Decision makers may be due to technical errors and errors in the performance of research, as well as the quality of reagents. Despite the numerous advantages of diagnosticums for RPHA, ELISA and RIF and their modifications used for the diagnosis of syphilis, in some cases, unreliable test results are noted.

This may be due to both the insufficient level of qualification and professional responsibility of the personnel (the so-called non-biological or technical errors), and the characteristics of the tested samples (biological errors).

Classification of methods for laboratory diagnosis of the disease

The causative agents of endemic treponematoses (yaws, pinta, bejel) are treponemas that have genus-specific antigens similar to those of T.pallidum. In this regard, the antibodies formed against them are able to cross-react with the antigen of the causative agent of syphilis.

Biological false positive Wasserman reaction

• dark-field microscopy (detection of treponema on a dark background);
• RIT-test - infection of rabbits with the test material;
• polymerase chain reaction (PCR), which detects sections of the genetic material of a microorganism.

Nontreponemal:

• complement fixation reaction with cardiolipin antigen (RSKk);
• microprecipitation reaction (RMP);
• rapid plasma reagin test (RPR);
• test with toluidine red.

Treponemal:

• complement fixation reaction with treponemal antigen (RSKt);
• treponem immobilization reaction (RIT or RIBT);
• immunofluorescence reaction (RIF);
• passive hemagglutination reaction (RPHA);
• enzyme immunoassay (ELISA);
• immunoblotting.

In the initial stage, you can use the bacterioscopic method, based on the determination of the pathogen - pale treponema - under a microscope. In the future, serological tests based on the determination of microbial antigens and antibodies produced by the body in biological material are widely used.

Bacteriological research is not carried out, since the causative agent of syphilis grows very poorly on nutrient media under artificial conditions.

All methods for detecting treponema, that is, types of tests for syphilis, are divided into two large groups:

1. Direct, which directly detect the microbe itself:

2. Indirect (serological), based on the detection of antibodies to the microbe, which are produced by the body in response to infection.

Serological tests are divided into two groups

Nontreponemal:

Treponemal:

The methods of these analyzes are quite complex, so we will focus mainly on when they are carried out and how accurate information they give.

Let's say right away that the basis for diagnosing syphilis is serological methods. What is the name of the analysis for syphilis: in each case, the examination may include different methods. Below we will describe them in more detail.

False-positive reactions of treponemal and non-treponemal tests can be observed with infectious diseases, the causative agents of which have antigenic similarity with pale treponema.

These are relapsing fever, leptospirosis, tick-borne borreliosis, tropical treponematosis (yaws, bejel, pint), as well as inflammatory processes caused by saprophytic treponemes of the oral cavity and genitals.

The causative agents of endemic treponematoses (yaws, pinta, bejel) are treponemas that have genus-specific antigens similar to those of T.pallidum. In this regard, the antibodies formed against them are able to cross-react with the antigen of the causative agent of syphilis.

Russia is not a territory endemic for this group of diseases. These infections occur mainly in Africa, Latin America and South Asia, and cases are rare in the practice of medical institutions.

A patient with a positive serological test for syphilis coming from a country with endemic treponematoses should be tested for syphilis and given anti-syphilitic treatment if not previously given.