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How syphilis manifests itself and is transmitted, its stages, diagnosis and treatment. Unsuccessful sexual partner? What are the first signs of syphilis

Syphilis belongs to the group venereal diseases. In the vast majority of cases, the infection is transmitted sexually. The signs and symptoms of syphilis are numerous and varied, which is why the disease is diagnosed by doctors of different specialties. The disease occurs in waves and in stages, affecting the skin, mucous membranes, internal organs, osteoarticular and nervous systems. The infection from a sick mother is transmitted through the placenta to her baby.

Syphilis has been known since ancient times. Its signs and symptoms in different periods diseases are described in the works of Hippocrates, Galen, Celsus, Plutarch, Avicenna and other great scientists. The causative agent of syphilis is the bacterium Treponema pallidum.

Rice. 1. In the photo, chancre is the main sign of primary syphilis.

The role of Treponema pallidum in the development of syphilis

Syphilis is caused by a bacterium (Treponema pallidum). Mucous membranes and damaged skin are entry points for infection. Treponema pallidum quickly penetrates the lymphatic vessels, where they multiply vigorously and spread through the bloodstream throughout the body, settling in the tissues of internal organs, bones, joints and central tissues. nervous system. Damage to the skin and mucous membranes is specific to this disease. Bez goes through a number of stages in its development - the incubation period, the primary, secondary and tertiary periods.

In the early stages of the development of the disease in the patient’s tissues, Treponema pallidum has a great destructive ability. They are found extracellularly and actively reproduce. Patients during this period are active spreaders of infection. Over the years, in the case of untreated or insufficiently treated syphilis, the bacteria acquire the ability to hide from negative impact environmental factors (antibodies and antibacterial drugs, depletion of the nutrient medium, exposure to a number of physical and chemical factors) and transform into L-forms and cysts. In such forms, treponema can exist for a long time in the patient’s body without showing itself in any way, and then reverse (turn into active form), causing relapses of syphilis and its chronic course. In the later stages of syphilis, a minimal number of pathogens are recorded in the affected tissues, and patients become less infectious.

Rice. 2. Type of Treponema pallidum in electron microscope.

Incubation period for syphilis

Mucous membranes and even the most minor damage to the skin are the entrance gates for Treponema pallidum. Bacteria quickly penetrate the lymphatic tract, where they multiply intensively and penetrate into regional lymph nodes. After 5 days, Treponema pallidum enters the bloodstream and by the end of the incubation period they have spread throughout the body. The incubation period for syphilis lasts 3 - 4 weeks. Its duration extends to 2 - 3 months with uncontrolled antibiotic treatment of other diseases and with infection with cyst forms of the pathogen. A shortened incubation period is recorded in patients with the occurrence of several chancre.

The incubation period ends when primary signs syphilis - primary syphiloma (“hard” ulcer, chancre).

Rice. 3. Manifestations of syphilis in the primary period - chancre on the penis and tongue.

Stages of syphilis

The course of the disease is undulating and gradual. Specific signs of syphilis after the manifest course spontaneously disappear, and then reappear, changing their color.

Primary period of syphilis begins from the moment of appearance of primary syphiloma (hard chancre) and lasts until the moment of appearance - on average 6 - 7 weeks.

Secondary period characterized by the appearance of various rashes on the skin and mucous membranes, damage to internal organs, bones, joints and the central nervous system. The active period lasts from several weeks to several months. Then the rashes disappear without a trace even without treatment. The latent phase of the disease begins. It lasts from several weeks to several years. The undulating course of the disease is the most important sign of early syphilis.

After 3 - 4 years from the moment of infection, it develops (late syphilis), which is characterized by the appearance of gummas - late syphilides (nodes), irreversibly destroying the organs and tissues in which they are located. The disease often ends in severe disability and even death of the patient.

After 10 - 20 years it develops fourth period of syphilis. The central nervous system is affected - tabes dorsalis, progressive paralysis, or a combination thereof develops.

Rice. 4. Signs of secondary syphilis - papular syphilide (photo on the left) and syphilitic roseola (photo on the right).

Signs and symptoms of syphilis in the primary period

The primary period of syphilis begins from the moment of the first manifestation of the disease - the appearance of a small erosion or ulcer at the site of introduction of pale treponema, which is called a “hard” ulcer, chancre, primary syphiloma. Its edges are raised, smooth, the bottom is smooth and shiny. The ulcer is dark pink in color, painless, with a dense cartilaginous infiltrate at the base.
The full picture of the disease is preceded by septicemia - the entry of pale treponema into the blood. During this period, the patient is often bothered by malaise, headache, muscle-joint pain. There is a characteristic discrepancy between the completely satisfactory general condition of the patient and high temperature bodies.
A week after the appearance of chancre, regional lymph nodes enlarge. They are dense and mobile.
The duration of the primary period is from the moment the chancre appears until the appearance of the rash, which marks the beginning of the secondary period of syphilis (on average 6 - 7 weeks).
After 20 - 30 days, primary syphiloma heals. In some patients, it heals until rashes appear - the appearance of secondary syphilides; in other patients, healing is completed already in the second period of syphilis. When pale treponema enters directly into the blood, primary syphilomas are absent. Syphilis in this case is called “decapitated.”

Chancre, inflammation of the lymphatic vessels and enlargement of regional lymph nodes are the main signs and symptoms of syphilis in the primary period of the disease.

During traditional sex chancres are located in the genital area.

During oral sex chancrees appear on the mucous membrane of the lips, oral cavity, often on the tongue and the area of one of the tonsils, resembling or in the acute stage. Primary chancre on the tonsil can have an ulcerative, sore throat-like or mixed form. At the same time, the cervical and submandibular lymph nodes enlarge.

During anal sex chancres form in the anorectal area.

Chancre in women sometimes manifests itself in the form of inducing edema and resembles bartholinitis. Labia increases significantly and acquires a purplish-bluish color. The gynecologist’s doubts will be resolved by performing a simple and quick (within 20 minutes) test based on the microprecipitation reaction.

U medical workers Sometimes an atypical form of primary syphilis is recorded - chancre-felon. The disease is associated in this case with professional activity.

Rice. 5. Chancre, inflammation of the lymphatic vessels and enlargement of regional lymph nodes are the main symptoms of primary syphilis.

Rice. 6. In the photo there are multiple hard chancres on the genitals of a woman and a man.

Rice. 7. Hard chancre in the anorectal area (photo on the left) and hard chancre in the form of indurative edema (photo on the right).

Rice. 8. Hard chancre on the lips and in the oral cavity on the tongue.

Rice. 9. Medical workers sometimes report an atypical form of primary syphilis - chancroid felon (an occupational disease).

Signs and symptoms of secondary syphilis

The secondary period of syphilis begins with the generalization of the infectious process. Various rashes (secondary syphilides) appear on the skin and mucous membranes; internal organs, the nervous system, joints and bones are less commonly affected.

The duration of secondary syphilis is 3 - 4 years. Periods of a pronounced clinical picture are replaced by a hidden, latent course. Each new relapse is characterized by fewer and fewer rashes, each of which is larger and less intensely colored. At the end of the second stage of syphilis, monorelapses occur, when the clinical picture is limited to a single element. The patients' well-being suffers little.

Patients in the second period of the disease are the most contagious.

Syphilis rash

First generalized rash in a patient previously untreated for syphilis, it lasts 1.5 - 2 months. It is abundant, symmetrical, small in size, brightly colored, located on the skin of the chest, abdomen, covers the back, side surfaces of the body and rarely the face. Lymph nodes are always enlarged.

During the second wave of recurrent syphilis the rash is more limited, tends to group with the formation of arcs, garlands and rings. The number of elements is significantly less than during the initial rash and subsequently decreases even more with subsequent relapses.

The rash with syphilis has its own characteristics:

In the initial stage, the rash is bright, Pink colour, later she turns pale. Depending on the location, the rash of syphilis may have a cherry, copper-red, yellowish or bluish color.
There are no acute inflammatory phenomena.
The elements of the rash are not large, are not prone to radiance and peripheral growth, there is no peeling or itching.
Various other types of rashes are often reported simultaneously.
A benign course of secondary syphilides is noted.
After healing of secondary syphilides, no scars remain.
Elements of the rash with syphilis quickly disappear under the influence of specific treatment.

Secondary syphilides, especially in the form of erosions and ulcerations, are extremely contagious.

Syphilitic roseola or spotted syphilide

Syphilitic roseola occurs in 80% of patients with syphilis in the secondary period. The first “fresh” roseola appears 10 weeks from the moment of infection or 6 to 8 weeks after the appearance of chancre. It is most often pale pink in color. From 0.2 to 1.5 cm in diameter. In the same patient, roseola, due to evolutionary polymorphism, may have different shades of pink in saturation. The spots do not differ from the surrounding skin in either consistency or relief. There is no peeling.

Syphilitic roseola is hardly noticeable on the genitals. Roseola in the oral cavity are located in the area of the tonsils and soft palate, sometimes merge, forming continuous areas of hyperemia, sharply delimited from the normal mucous membrane. Often, simultaneously with secondary syphilis, papular and erosive-ulcerative syphilides appear in the oral cavity. Elevated, papular, exudative, follicular and confluent roseola are relatively rare.

Such diseases as spotted toxicoderma, pityriasis rosea, “marbled” skin, rubella and measles have a similar picture of rashes.

Rice. 10. Rash with syphilis of the second period - spotted syphilide (photo on the left) and papular syphilide (photo on the right).

Rice. 11. Erythematous sore throat with syphilis. Roseola in the oral cavity merge to form continuous areas of hyperemia, sharply demarcated from the normal mucous membrane (photo on the left) and papular syphilide (photo on the right).

Papular syphilide

Papular syphilide is a collection of cells in upper sections dermis (cellular infiltrate). Papules are round in shape, clearly demarcated along the periphery from the surrounding tissues, dense in consistency, pointed or hemispherical, located in isolation. Fresh papules are shiny and smooth, soft pink in color, but can be copper or bluish-red in color. After 1 - 2 months, the papules resolve. When papules resolve, their surface is sometimes covered with scales. After resorption, brownish pigmentation remains in place of the papules.

Unfavorable conditions lead to damage to the top layer of papules ( erosive papules). When infected with secondary flora, they form ulcerative papules. Sometimes papular syphilides hypertrophy and grow ( condylomas lata).

When located in the folds of the skin in case of irritation (increased humidity and sweating), papules tend to grow peripherally and merge. They are often subject to erosion and ulceration ( weeping papular syphilide). The genitals, perineum, anorectal area, interdigital spaces, armpits, in the folds of the neck and under the breasts in women are their favorite localizations. Weeping papular syphilide is the most contagious form of papular syphilis.

Papules have different sizes, which is why they are divided into miliary, lenticular, nummular (coin-shaped) And plaque-like papular syphilides.

Rice. 12. Papular rash with secondary syphilis.

Rice. 13. The photo shows symptoms of secondary syphilis - syphilide of the face and papules on the scalp.

Rice. 14. The photo shows symptoms of secondary syphilis - papular syphilide of the face.

Rice. 15. When papular syphilides grow, condylomas lata are formed.

Rice. 16. A sign of syphilis of the secondary period is psoriasiform syphilide (photo on the left) and nummular (coin-shaped) syphilide (photo on the right).

Papular plantar and palmar syphilides

In recent years, there has been an increase in cases of papular plantar and palmar syphilides. Syphilitic papules, due to the thick stratum corneum, are only visible through the skin. They have a red-brown color. On the feet they are most often located in the area of the arches, on the palms - in the center.

When the papules resolve, yellowish spots remain in their place, and scales of the epidermis appear along the periphery in the form of a corolla (Biette's collar) - a sign of syphilis. Sometimes papules on the soles and hands resemble calluses - formations sharply demarcated from healthy areas of the skin.

Rice. 17. Palmar syphilide.

Rice. 18. Plantar syphilide.

Papular syphilide of the mucous membranes

Papular syphilide of the mucous membrane of the cervix and vagina does not occur. Papules in patients with syphilis in the secondary period may appear on the oral mucosa. They are dense in consistency, round, whitish in color, with a smooth surface, painless.

Papular syphilides often appear on the lips along the line of closure of the teeth, soft and hard palate. Papules in the corners of the mouth often become crusty, crack, and resemble jams. Papules on the back of the tongue look oval, devoid of papillae, bright red formations (“mown meadow symptom”). When papules are located on the vocal cords, syphilitic dysphonia develops, rarely turning into complete aphonia. All elements of the rash with syphilis in the oral cavity are extremely contagious. Papular syphilide of the oral cavity poses a great danger to dentists.

Rice. 19. In the photo there is syphilis in the mouth - papular syphilide of the tongue.

Rice. 20. In the photo there is syphilis in the mouth: papular syphilide of the hard palate and tongue (photo on the left) and syphilitic syphilis (photo on the right).

Pustular syphilides

Pustular syphilides in secondary syphilis are rarely recorded and appear more often in weakened patients. Acne, impetiginous, smallpox-like, syphilitic ecthyma and rupee— the main types of pustular syphilides. In drug addicts and alcoholics, syphilides of the secondary period acquire a malignant course. Multiple ulcers appear on the skin of the face and torso, covered with purulent crusts, reminiscent of severe pyoderma.

An important criterion when carrying out differential diagnosis with other diseases is the presence of a clearly demarcated ridge of copper-red infiltrate along the periphery.

Rice. 21. Signs of syphilis of the secondary period - pustular syphilide - ecthyma.

Rice. 22. The photo shows impetiginous pustular syphilide of the face.

Rice. 23. In the photo, the symptoms of malignant syphilis of the secondary period are deep skin lesions - syphilitic ecthymas and rupees, multiple papules and acneiform syphilides.

Syphilide herpetiformis

Herpetiformis or vesicular syphilide is an extremely rare, severe manifestation of secondary syphilis. The disease is registered in weakened patients with chronic diseases and alcoholism.

Syphilitic alopecia

Hair loss due to syphilis can be diffuse, finely focal and mixed. Hair falls out quickly (overnight) or within 1 - 1.5 months. Eyelashes and eyebrows are often affected. For eyebrows with syphilis, small focal loss is typical. In place of the fallen eyelashes, they grow back, as a result of which they differ in different lengths (step-shaped eyelashes). The skin on the head does not become inflamed, there is no peeling or itching.

Similar signs are present with alopecia areata, superficial trichophytosis, microsporia, early baldness, lichen planus and lupus erythematosus.

Rice. 24. Alopecia is one of the signs of secondary syphilis.

Rice. 25. Alopecia in men.

Syphilitic leukoderma or pigment syphilide

One of the manifestations of secondary syphilis is leucoderma. Its appearance is associated with damage to the nervous system. Disorders of pigment formation in the form of hypo- and hyperpigmentation are caused by trophic disorders. Leukoderma is most often localized on the posterolateral areas of the neck (“necklace of Venus”), less often on the back, torso, lower back and limbs. Against the background of pale yellow hyperpigmentation, round spots of depigmentation appear. They can be isolated or merge, taking on the appearance of “lace”. Leucoderma does not peel off or become inflamed and lasts for months and years. Cases of disappearance of leukoderma within a few days have been described. There are no Treponema pallidums in the affected areas. Influenced specific therapy pigmentary syphilide does not disappear. Diseases such as pseudoleukoderma, vitiligo, plaque parapsoriasis and cicatricial atrophy have similar symptoms.

Rice. 26. A sign of secondary syphilis is leucoderma.

Visceral syphilis

Visceral syphilis (syphilitic damage to internal organs)

Internal organs with syphilis are affected already in the early stages of the disease, but are diagnosed much less frequently, since inflammation does not have specific signs. This circumstance leads to a large number of diagnostic errors.

Most often, syphilis affects the liver, stomach and kidneys. Defeat observed gastrointestinal tract in the form of syphilitic hyperplastic gastritis and enteritis, lungs - in the form of specific pneumonia, liver - in the form of syphilitic hepatitis, as well as the organs of vision.

Damage to bones and joints due to syphilis

Damage to bones and joints in syphilis begins at the end of the primary period, but obvious manifestations of the disease are recorded in the secondary period. Pain is the main symptom of syphilitic lesions osteoarticular system. The pain intensifies at night, more often appears in the long tubular bones of the legs, pain is noted in large joints - the knees and shoulders. Periostitis is rare.

Neurosyphilis of the secondary period

Neurosyphilis of the secondary period manifests itself mainly in the form of asymmetric meningitis, vascular lesions and autonomic dysfunctions.

Patients with syphilis in the secondary period are identified by doctors of various specialties. The Wasserman reaction will help to identify and treat the patient in a timely manner.

Signs and symptoms of tertiary syphilis

After infection, tertiary syphilis develops 3 to 4 years later (without treatment). In a small proportion of patients (3 - 5%), the disease occurs immediately after secondary syphilis. In most patients (95 - 97%) there is a latent period between the two periods, the duration of which ranges from several to tens of years.

It is believed that the cause of the development of tertiary syphilis is the local activation of Treponema pallidum, as evidenced by the proliferation of tubercular syphilides along the periphery.

Tertiary syphilis is characterized by the development of destructive processes in the skin, mucous membranes, internal organs, osteoarticular and nervous systems. Gummas (late syphilides) are formed in the skin and internal organs, which irreversibly destroy tissues in their locations. Irreversible morphological and functional disorders occur.

After 10 - 20 years from the onset of the disease, damage to the central nervous system develops - tabes dorsalis, progressive paralysis, or a combination of both.

Patients develop tubercular syphilides. After some time, they either resolve or ulcerate.
In the subcutaneous fatty tissue they develop gumma. When the gumma is opened, a gummous ulcer is formed that heals over several months.
Healing ends with the formation of a retracted star-shaped scar. Gummas contain a small amount of pale treponema. Patients in the tertiary period of syphilis are less infectious.

The tertiary period of syphilis has its own characteristics:

the course and regression of the disease is slowed down,
periods of exacerbations are replaced by remissions (latent syphilis),
there are no subjective sensations or acute inflammatory phenomena,
rashes are monomorphic and asymmetrical,
Rice. 30. The disintegration of gummas located in the bones of the back of the nose leads to deformation of the organ. A saddle nose is a sign of the tertiary period of syphilis.

Articles in the "Syphilis" sectionMost popular

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

According to 2014 data, 26 people per 100 thousand population of our country are sick with syphilis. The incidence of sexually transmitted diseases is decreasing at a slow pace, so the government is educating the population about STDs. Awareness about STD prevention helps to avoid serious health problems for both young people and adults.

Syphilitic infection symptoms

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person is unaware of the infection, as he has no signs of illness. Even most tests cannot detect the disease at this stage. Eat high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of his actions.
The first signs of the disease appear after the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (cutaneous syphilides) and on the mucous membranes - chancre in the mouth, on the genitals, rash on the mucous membranes (syphilides of the mucous membranes).

Symptoms of syphilitic infection in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). A hard chancre forms where the bacterium enters. Its appearance indicates the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of Treponema pallidum. It is localized in the mouth, in the area of the external and internal genital organs, and in the anus.

A chancre is a round inflammatory growth with a flat base. In the initial stages of its appearance there is practically no pain. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre. visible places body and mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a chancre. Ulcers often form on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, and in the anus. The symptoms and course of the disease are practically no different in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest in women?

The primary stage of sifak in women begins with the detection of hard chancre on the skin or mucous membranes. On initial stage it does not cause serious discomfort. Then a gradual inflammation of the chancre occurs, it takes on a red or bluish color, characteristic of a severe inflammatory process.
During the first week after the first symptoms appear, women begin to experience inflammation of the lymph nodes and vessels near the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of balls, forming significant edema and swelling around the chancre. If the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, making it difficult to swallow and breathe. The symptoms cause significant distress with verbal communication and eating. Scleradenitis in the genital area makes walking and defecation difficult.

Photo: Jarun Ontakrai/Shutterstock.com

The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern diagnostic methods make it possible to detect syphilism immediately after the first symptoms appear. The most commonly used are enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist at a clinic or a venereologist at a dermatovenereal dispensary. The average cost of analysis is 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. More early tests will not show anything other than a seronegative reaction, indicating the absence of Treponema pallidum in the body.

Symptoms of secondary syphilis

The skin around the chancre becomes covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and unite into large areas on the skin and mucous surfaces, causing the patient severe discomfort. There are three types of syphilitic rash.
Roseola rash - pink or red spots with clear or blurred boundaries 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
Papular rash - small conical growths of pink color. May peel off at the top of the cone. This kind of cheese looks extremely unpleasant.
Pustular rash - growths with purulent cavities.
Along with the appearance of a rash, damage to the nervous system may begin. Degradation of nervous tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, treatment of the disease will not lead to the restoration of lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
Signs of partial or complete baldness appear. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, becomes thinner, and thins out. Then the hair thinning intensifies and large bald patches of skin appear. After recovery from syphilis, hair growth does not renew.

Stages of syphilis

Nowadays, every person infected with Treponema pallidum can quickly and efficiently receive adequate and effective treatment. Only a few go through all stages of syphilis. Without treatment, a person lives in terrible agony for 10 or even 20 years, after which he dies.
Below is short description stages of syphilis.
Incubation stage

Stage name	Temporal boundaries	Description of symptoms
Incubation period	From the moment of infection to 189 days.	During this period, there are objectively no manifestations in the patient’s body. If the infection gets into several places in the body at once, this shortens the incubation period to 1-2 weeks. If an infected person takes antibiotics, for example, for the flu or for a sore throat, then the incubation period can last even six months. Ending of this period occurs with the appearance of the first symptom – chancre and inflammation of the lymph nodes. If the pathogen enters directly into the blood, then the stage of primary syphilis does not appear and the disease passes directly to the secondary stage.

Stage of primary syphilis

Stage name	Temporal boundaries	Description of symptoms
Stage of primary syphilis	From the moment hard chancre appears until the appearance of a rash and inflammation of the lymph nodes in the chancre area	A chancre is a single solid formation that penetrates slightly deeper, but does not fuse with the tissues, caused by immune reaction for Treponema pallidum. It has a rounded shape and clearly defined edges. Localized in the area of infection (Genitals, oral cavity, anal area, fingers). Does not cause pain, but should cause serious concern and motivate the patient to stop all sexual intercourse and immediately consult a doctor to begin treatment before a syphilitic rash appears. At the end of the primary stage, multiple chancre may appear. The second symptom is the appearance inflamed lymph nodes next to chancre. At the end of the stage of primary syphilis, malaise, dizziness, and body temperature rise. At this stage, atypical symptoms sometimes occur, which will be described below in the corresponding section of the article.
Headless syphilis	Boundaries are difficult to define	Observed when infected through blood. There are no symptoms, the disease goes directly into the secondary or latent stage, bypassing the primary one.

Stage of secondary syphilis. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Course of secondary syphilis	Temporal boundaries	symptoms of secondary syphilis
Early (Lues secundaria recens)	From 60-70 days after infection. From 40-50 days after the appearance of chancre. Lasts from several days to 1-2 weeks	There are three types of rashes caused by an active immune response and the production of endotoxins that fight infection. The nervous system, internal organs, and bones suffer. The temperature rises to 37-37.5 °C, accompanied by malaise, cough, runny nose, and conjunctivitis. Extensive inflammation of the lymph nodes without pain and discomfort, which feel hard and cool to the touch. Hair often falls out, and complete baldness is possible.
Hidden	From 60 days after the appearance of chancre or later	At a certain point, the immune system blocks the action of the infection that destroys the body. The rash stops. Of course, the infection does not leave the organs and tissues; the patient lives in anxious anticipation of a second relapse.
Recurrent (recurrent)	After the hidden phase	With any weakening of the immune system (stress, cold, skipping meals, injury), a relapse can occur. It manifests itself in the appearance of a new rash, more extensive, with areas of skin hemorrhage. All symptoms characteristic of early syphilis are repeated. Multiple genital chancre often forms.
Early neurosyphilis	Starting from 2 years from the moment of illness	Associated with inflammation and damage to blood vessels and neurons of the brain, internal organs (almost always the heart and liver), as well as bones and joints. It manifests itself in the form of chronic meningitis, a violation of the ability of the pupils to constrict when exposed to light. Miliary gummas are formed inside the brain vessels, which increase intracranial pressure, worsening general health and causing headaches. Many symptoms impair higher mental functions, such as attention, memory, and coordination of movements. The changes are irreversible.

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

Name of stage of tertiary syphilis	Temporal boundaries	Description of symptoms
Hidden chronic stage	Lasts from 1 year to 20 years	About 70% of patients in the absence of treatment live as carriers of the infection, moving from the latent phase of tertiary syphilis to the recurrent phase. However, sooner or later the immune system fails. A person moves to the next stage with a high probability of disability or death.
Tertiary syphilis	With the onset of corresponding symptoms	Extensive damage occurs to all organs and tissues, bones and the nervous system. Gummas are formed in the most merciless way in many places. Gummas are characteristic purulent tumors, often bleeding and moist with lymph and pus. Often appear on the face. They heal very hard, forming ugly scars. Often gummas become infected with other bacteria, leading to serious complications: abscess and gangrene.
Late neurosyphilis	The final stage, leading to disability and inevitable death. 10-15 years from the onset of the disease.	Extensive damage to the central nervous system, leading to loss of vision, paralysis, and impairment of cognitive functions of the psyche. Infectious diseases of the brain develop - meningitis, gumma of the brain and bones.

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

Atypical syphilis

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

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

Congenital syphilis

It is highly undesirable for a mother to suffer from illness during pregnancy. The fetus is exposed to Treponema pallidum, which leads to irreversible morphological consequences and disruption of intrauterine development.
Medicine knows three main symptoms:

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

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

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

The causative agent of syphilis

Treponema pallidum is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common venereal diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to quickly curing syphilis, and the way was also opened for them to invent methods early diagnosis diseases.

Properties of the pathogen

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

Incubation period

Entering the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Dividing at a rate of about once every 30 hours, it accumulates at the site of infection. There are no visible symptoms. After about a month, a hard chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of immunity varies from patient to patient, which makes the length of the initial period of infection vary widely. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases through sexual contact. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. Hard chancre forms where bacteria enter.

When caring for patients, infection is likely through contact with the patient's clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. This is one of the most painful symptoms in the stage of primary syphilis. Then hard chancre of the genital organs may appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when reusing a patient’s syringe, his razor, scissors, or utensils.

How to treat syphilis

Treatment should begin at the first signs of syphilis. This way the healing process will take place as quickly as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, drugs based on it are also used, since Treponema pallidum cannot adapt to this species antibiotics. Sufficient doses of penicillin effectively fight the disease. For the treatment of syphilis in patients with allergic reactions for penicillin, use erythromycin or tetracycline.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Pyrotherapy (artificial increase in body temperature) is added and intramuscular injection antibacterial drugs.

For tertiary syphilis, highly toxic bismuth-based drugs are used along with antibiotics. Treatment occurs strictly in a hospital with multi-level supportive therapy.

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

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bedding and underwear, clothing, etc.
Hospitalization in the initial stages of syphilis is not required, it is enough outpatient treatment. Only in severe forms, starting from the secondary stage, the patient is admitted to a hospital. Treatment of syphilis by compulsory medical insurance policy is free and anonymous.

It is highly not recommended to cope with the disease using folk remedies. Only well-designed treatment can defeat Treponema pallidum. Otherwise, there is a high probability of the disease progressing to more severe stages.

Which doctor treats sifak disease?

Since sifak is a disease transmitted primarily through sexual contact, treatment is carried out by a venereologist. The patient can contact a general practitioner and receive a referral to a venereologist. The option of direct contact with a skin and venereal disease clinic is possible.

After examination and receipt of test results, the patient is treated either by a venereologist himself, specializing in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

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

How long to treat syphilis

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

It is very important to know that under no circumstances should you interrupt the course of treatment. If treatment is not completed, the patient will soon experience a relapse. Therefore, treatment must be taken extremely seriously.

- an infectious venereal disease caused by the bacteria Treponema pallidum. It is transmitted through sexual contact with an infected partner, through blood transfusion and when the pathogen enters through wounds. Since the discovery of penicillin in the mid-20th century, the spread of the disease has been largely controlled, but efforts to eradicate the disease have not yet been successful.

Therapist: Azalia Solntseva ✓ Article checked by doctor

Syphilis in women - 4 stages

Without treatment, the disease progresses and goes through 4 stages: primary, secondary, latent and tertiary. It can be acquired or congenital (transmission route is in utero from an infected mother).

Syphilis manifests itself in a variety of ways and can mimic many other infections and immunological processes in later stages. That is why he earned the nickname “the great impostor.”

The causative agent of the disease, Treponema pallidum (treponema pallidum), can hardly survive outside the body. Transmission of the microbe requires direct contact with the carrier of the infection; the microorganism is exclusively a human pathogen.

Treponema does not withstand drying or exposure to disinfectants. Therefore, household transmission (for example, by sharing toilets) is practically impossible. Unprotected sex is a major risk factor for infection.

Syphilis remains common in many developing countries and in parts of North America, Asia and Europe, especially in the eastern part. Most new cases occur in women aged 20-29 years.

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How the disease manifests itself - signs

How does syphilis manifest in women? After the primary stage, the symptoms of which are the appearance of a painless ulcerating chancre (node) at the site of infection and enlargement of the lymph nodes, the next stage of the disease begins.

Secondary syphilis manifests itself in different ways. It usually presents as a skin rash that appears within 2-10 weeks of the primary chancroid. The rashes are most distinct 3-4 months after infection. Lesions can also be subtle: 25% of patients may not be aware of skin changes.

A localized or widespread mucous rash (usually non-pruritic and bilaterally symmetrical) with systemic mild enlargement of the lymph nodes is typical. Patchy baldness and condylomatosis may also occur.

Common symptoms of syphilis in women include malaise, migraines, anorexia, nausea, bone pain and fatigue, as well as fever and neck spasms. A small number of those infected develop acute syphilitic meningitis (inflammation of the meninges) and deafness.

Other less common manifestations include hepatitis, nephropathy, proctitis, arthritis, and optic neuritis.

The stage of latent syphilis in women, which follows the secondary phase, can last from several years (up to a maximum of 25). Patients can remember the symptoms of the primary and subsequent stages of the disease.

During the latent phase, there are no symptoms and the disease is detected only by serological tests. At the stage of late latent syphilis, women can transmit the disease in utero to the fetus.

During the tertiary phase, the disease progresses slowly and can spread throughout the body and affect any organ. At this stage, the disease is usually not considered infectious (capable of infecting others).

How the disease manifests itself:

chest pain, back pain, stridor (noisy and wheezing) or other symptoms associated with aortic aneurysms;
imbalance, sensitivity disorders (paresthesia), urinary incontinence;
neurological problems, including hearing loss and vision loss;
dementia.

Lesions usually develop within 3-10 years after infection. Symptoms of damage to the central nervous system depend on the affected area: headache, dizziness, psycho-emotional reactions in the form of mood swings, spasm of the neck muscles, blurred vision, weakness of the muscles of the shoulder girdle and limbs.

Some patients develop symptoms 10-20 years after infection. behavioral changes and other signs of dementia, indicating paresis.

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The first symptoms of syphilis on the genitals

How long does it take for syphilis to appear? The initial signs of syphilis in women occur 10-90 days after the bacteria enter the body. The first symptoms appear mainly on the vulva or cervix.

Ten percent of syphilitic lesions are found around the anus, in oral cavity, on the fingers, tongue, nipples or other non-genital organs. The invasion is followed by local, mild enlargement of the lymph nodes (lymphadenopathy).

Lesions (chancres) usually begin as solitary, raised, hard and red papules (nodules), up to several centimeters in diameter. They collapse, creating a crater with slightly raised edges around the central ulcer and a red border. It usually heals with rough scarring within 4-8 weeks, regardless of treatment.

Although genital chancre is often solitary, in some patients it may be multiple. Sometimes they appear as “kissing lesions” on opposite surfaces of the skin, such as the labia.

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How long does it take for the disease to appear?

After contact with the carrier and entry into the body, the bacteria quickly penetrate unaffected mucous membranes or microscopic skin abrasions and within a few hours end up in the lymphatic system and bloodstream, contributing to the development of a systemic infection.

The incubation time from exposure to the development of primary lesions that appear at the site where pathogens enter the body averages 3 weeks, but can vary from 10 to 90 days.

Research shows that spirochetes (an order of bacteria that includes Treponema) can be found in the lymphatic system as early as 30 minutes after initial entry. This indicates that syphilis is a systemic disease from the very beginning.

Primary syphilis in women is characterized by the development of a painless chancre (hard nodule) at the site of infection after 3-6 weeks of the incubation period.

The incubation period of the secondary stage, i.e. How long it takes for the disease to develop is 4-10 weeks after the initial lesion appears. During this stage, the spirochetes multiply and spread throughout the body.

The central nervous system (CNS) is infected by early stage infections; studies show that in the secondary stage, more than 30% of patients have abnormal findings in the cerebrospinal fluid. During the first 5-10 years after the onset of the disease, lesions of the meninges, tissue and blood vessels are detected, which leads to neurosyphilis.

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Discharge from this pathology

An atypical phenomenon for this disease. It is important to understand that female body in a normal state, secretes secretions from the genital tract, which are designed to maintain the constancy of the environment and flora of the genital organs, as well as to ensure the physiological functions of the body.

In the case of the location of the primary lesion (chancre), on the genitals, there is an unexpressed mucous discharge, transparent, without an unpleasant odor. A change in these parameters may indicate the addition of another infection, such as chlamydia or candidiasis.

With ulceration of a chancre located in an area rich in blood vessels, streaks of blood may appear.

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Rash in the fair sex

During the primary phase, one, painless node (papule) usually appears, which quickly collapses and becomes denser. The edge and base of the ulcer have a cartilaginous consistency to the touch.

Although classic chancre is not painful, it can cause discomfort if it becomes contaminated with bacteria or is located in the anal canal. Non-genital chancres occur most often over the neck, usually affecting the lips or oral cavity.

Secondary syphilis manifests itself differently in women, but usually involves a localized or diffuse mucous rash. Exanthema can be spotty, nodular or mixed.

Initial lesions are usually bilateral and symmetrical, pale red to pink in color (in fair-skinned individuals) or pigmented (in dark-skinned individuals).

The rash is separate, round, consists of uniformly colored spots with a diameter of 5-10 mm, distributed over the torso and limbs. After a few days or weeks, red nodular formations measuring 3-10 millimeters appear. The lesions become necrotic (purulent) and often spread to the palms and soles.

10-15% of patients with secondary syphilis develop painless superficial mucosal erosions on the palate, pharynx, larynx, vulva, or anal canal and rectum.

These spots are round, silver-gray defects with a red areola (edge). They are a reservoir of treponemes and a source of infection.

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Tests and diagnostics

Treponema pallidum cannot be cultured and is too small to be seen under a light microscope. Serological testing is considered the standard method for detecting all stages of the disease.

When acquired syphilis is suspected, the traditional approach is to first perform a nontreponemal syphilis test, or the more recently developed antigen test, followed by a specific test.

Distinctive feature laboratory diagnostics syphilis in a woman - no 100% results. The specificity of the development of microorganisms is cyclical; even with obvious symptoms, the test can give a negative result. Therefore, regular examination by a gynecologist and laboratory tests are recommended.

The sensitivity of the first analysis is 78-86% for detecting the primary phase, 100% for detecting the secondary and 95-98% for the tertiary process.

Specificity ranges from 85 to 99% and may be lower in people with vascular collagen ( connective tissue) diseases, pregnancy, intravenous drug use, tuberculosis and malaria. The test results become positive 1-2 weeks after the formation of the chancre.

Due to the possibility of receiving false positive results Confirmation of any positive or equivocal result of the above analysis should be accompanied by a treponemal test (eg fluorescent antibody uptake). Sensitivity is 84% for detecting primary infection and almost 100% for other stages.

Dark-field microscopy is a possible way to evaluate moist skin lesions such as chancre of primary syphilis or condyloma of secondary syphilis.

Patients with a confirmed diagnosis are tested for other sexually transmitted diseases, including HIV infection.

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How to treat the disease

Penicillin was created as effective remedy to fight syphilis. It remains the basis of treatment and the standard by which other therapies are evaluated.

How to treat syphilis in women using penicillin:

Primary or secondary syphilis - benzathine penicillin 2.4 million units intramuscularly in a single dose.
The early hidden stage is similar.
Late latent syphilis or unknown duration - benzathine penicillin 7.2 million units. It is administered in the form of 3 doses of 2.4 IU with an interval of 1 week.

The principles of treatment of the disease include the following:

Penicillin is the main drug for treating the disease.
Doxycycline is the best alternative in the treatment of early and late latent stages of the disease. Syphilis in women associated with HIV infection does not require any enhanced antimicrobial therapy.
When treating a late-stage disease with weekly injections, skipping a dose for 10-14 days does not require restarting the entire course of injections.
An interval of 7-9 days between medications may produce the best results.

Surgery is intended to treat complications of tertiary syphilis (eg, aortic valve replacement).

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Proper disease prevention

The main goal is to limit the spread of syphilis. This entails counseling people on safe sex practices and educating patients who abuse intravenous drugs. The latter should never share needles and must use clean syringes.

Identifying and treating sexual partners and drug abusers is of utmost importance. Prevention also involves special training for health care workers on precautions when treating such people.

One dose of benzathine penicillin 2.4 million units intramuscularly is recommended for all individuals who have had sexual contact with a partner who tested positive for primary, secondary, or early latent syphilis within the previous 90 days.

Circumcision does not help prevent transmission of the disease, although it may help reduce the spread of other sexually transmitted diseases such as HIV infection.

Syphilis is a serious disease that is characterized by damage to the skin, mucous membranes and internal organs of a person.

He is classified as classical diseases sexually transmitted. Unprotected sexual intercourse with an unreliable or casual sexual partner can cause syphilis.

The symptoms of syphilis are very diverse, and the manifestations of the disease largely depend on its period. Previously, this infection was considered incurable, but nowadays it can be successfully treated with antibiotics.

How is syphilis transmitted?

In most cases, syphilis is contracted through sexual contact in the vagina, mouth or rectum. Treponema enters the body through minor defects in the mucous membrane of the genital tract.

However, there are cases of infection by everyday means- the disease is transmitted from one partner to another through saliva during a kiss, through shared objects on which there is undried discharge containing pale treponema. Sometimes the cause of infection can be a transfusion of infected blood.

Pathogen

A mobile microorganism from the order of spirochetes, Treponema pallidum is the causative agent of syphilis in women and men. Discovered in 1905 by German microbiologists Fritz Schaudin (German Fritz Richard Schaudinn, 1871-1906) and Erich Hoffmann (German Erich Hoffmann, 1863-1959).

Incubation period

On average, it is 4-5 weeks, in some cases the incubation period of syphilis is shorter, sometimes longer (up to 3-4 months). It is usually asymptomatic.

The incubation period may increase if the patient took some antibiotics for other reasons. infectious diseases. During the incubation period, test results will show a negative result.

Symptoms of syphilis

The course of syphilis and its characteristic symptoms will depend on the stage of development at which it is located. However, symptoms in women and men can be very diverse.

In total, it is customary to distinguish 4 stages of the disease - starting from the incubation period and ending with tertiary syphilis.

The first signs of syphilis make themselves felt after the end of the incubation period (it occurs without symptoms) and the beginning of the first stage. It is called primary syphilis, which we will talk about below.

Primary syphilis

The formation of a painless hard chancre on the labia in women or the head of the penis in men is the first sign of syphilis. It has a dense base, smooth edges and a brown-red bottom.

Ulcers form at the site of penetration of the pathogen into the body, these can be other places, but most often chancres are formed precisely on the genital organs of a man or woman, since the main route of transmission of the disease is through sexual intercourse.

7-14 days after the appearance of hard chancre, the lymph nodes closest to it begin to enlarge. This is a sign that triponemes are spread throughout the body through the bloodstream and affect the internal organs and systems of a person. The ulcer heals on its own within 20-40 days after it appears. However, this cannot be regarded as a cure for the disease; in fact, the infection develops.

At the end of the primary period, specific symptoms may appear:

weakness, insomnia;
headache, loss of appetite;
low-grade fever;
pain in muscles and joints;

The primary period of the disease is divided into seronegative, when standard serological blood reactions are negative (the first three to four weeks after the onset of chancroid) and seropositive, when blood reactions are positive.

Secondary syphilis

After the end of the first phase of the disease, secondary syphilis begins. Symptoms that are characteristic at this moment are the appearance of symmetrical pale rash throughout the body, including the palms and soles. This doesn't cause any painful sensations. But it is the first sign of secondary syphilis, which occurs 8-11 weeks after the first ulcers appear on the patient’s body.

If the disease is not treated at this stage, then over time the rash disappears and syphilis develops into latent stage, which can last up to 4 years. Later certain period time the disease relapses.

At this stage, there are fewer rashes and they are more faded. The rash most often occurs in areas where the skin is exposed to mechanical stress - on the extensor surfaces, in the inguinal folds, under the mammary glands, in the intergluteal fold, on the mucous membranes. In this case, hair loss on the head is possible, as well as the appearance of flesh-colored growths on the genitals and in the anus.

Tertiary syphilis

Today, fortunately, infection at the third stage of development is rare.

However, if the disease is not treated in a timely manner, then after 3-5 or more years from the moment of infection, the tertiary period of syphilis begins. At this stage, the infection affects the internal organs, and foci (threshing floors) form on the skin, mucous membranes, heart, liver, brain, lungs, bones and eyes. The bridge of the nose may become sunken, and when eating, food gets into the nose.

Symptoms of tertiary syphilis are associated with the death of nerve cells in the brain and spinal cord; as a result, in the advanced third stage, dementia and progressive paralysis can occur. The Wasserman reaction and other tests may be weakly positive or negative.

Don't wait for development last stage disease, and at the first alarming symptoms, consult a doctor immediately.

Diagnostics

The diagnosis of syphilis will directly depend on the stage at which it is. It will be based on the patient’s symptoms and the tests obtained.

In the case of the primary stage, hard chancre and lymph nodes are subject to examination. At the next stage, the affected areas of the skin and papules of the mucous membranes are examined. In general, bacteriological, immunological, serological and other research methods are used to diagnose infection. It should be taken into account that at certain stages of the disease, test results for syphilis may be negative in the presence of the disease, which makes it difficult to diagnose the infection.

To confirm the diagnosis, a specific Wasserman reaction is performed, but it often gives false results analysis. Therefore, to diagnose syphilis, it is necessary to simultaneously use several types of tests - RIF, ELISA, RIBT, RPGA, microscopy method, PCR analysis.

Treatment of syphilis

In women and men, treatment of syphilis should be comprehensive and individual. This is one of the most dangerous venereal diseases, leading to serious consequences with improper treatment, so under no circumstances should you self-medicate at home.

The basis of treatment for syphilis is antibiotics, thanks to which the effectiveness of treatment is close to 100%. The patient can be treated on an outpatient basis, under the supervision of a doctor who prescribes comprehensive and individual treatment. Today, penicillin derivatives in sufficient doses (benzylpenicillin) are used for antisyphilitic therapy. Premature cessation of treatment is unacceptable; it is necessary to complete the full course of treatment.

At the discretion of the attending physician, treatment complementary to antibiotics may be prescribed - immunomodulators, vitamins, physiotherapy, etc. During treatment, any sexual intercourse and alcohol are strictly contraindicated for a man or woman. After completion of treatment, it is necessary to undergo control tests. These may be quantitative non-treponemal blood tests (for example, RW with cardiolipin antigen).

Consequences

The consequences of treated syphilis usually include decreased immunity, problems with endocrine system, chromosomal lesions of varying severity. In addition, after treatment of treponema pallidum, a trace reaction remains in the blood, which may not disappear until the end of life.

If syphilis is not detected and treated, it can progress to the tertiary (late) stage, which is the most destructive.

Late stage complications include:

Gummas, large ulcers inside the body or on the skin. Some of these gummas “resolve” without leaving traces; in place of the rest, syphilis ulcers are formed, leading to softening and destruction of tissue, including the bones of the skull. It turns out that the person is simply rotting alive.
Lesions of the nervous system (latent, acute generalized, subacute (basal), syphilitic hydrocephalus, early meningovascular syphilis, meningomyelitis, neuritis, tabes spinal cord, paralysis, etc.);
Neurosyphilis, which affects the brain or the membrane covering the brain.

If Treponema infection occurs during pregnancy, the consequences of the infection may appear in a child who receives Treponema pallidum through the mother’s placenta.

Prevention

The most reliable prevention of syphilis is the use of a condom. It is necessary to conduct timely examination in case of contact with infected people. It is also possible to use antiseptic drugs(hexicon, etc.).

If you discover an infection in yourself, it is important to inform all your sexual partners so that they also undergo appropriate examination.

Forecast

The prognosis of the disease is favorable in most cases. Timely diagnosis And adequate treatment leads to complete recovery. However, with a long-term chronic course and in cases of infection of the fetus in the womb, persistent irreversible changes develop, leading to disability.

Today, many people are interested in questions about what the first symptoms of syphilis look like. After all, it’s no secret that with such a disease it is extremely important to start treatment on time - this is the only way to avoid serious complications.

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

A little history...

In fact, the disease syphilis has accompanied humanity for hundreds of years. There is still debate among scientists and researchers about when such a disease appeared. And most of them are confident that syphilis is as old as humanity itself, although no mention of it has yet been found in the works of scientists from ancient civilizations.

Outbreaks of syphilis in Europe are associated with the campaigns of King Charles the Eighth in Italy. There is information that in those days the army was accompanied by a huge number of women of easy virtue, who “rewarded” the soldiers with this infection. When the army returned home, the disease quickly spread, first throughout France, and then throughout Europe.

Of course, in those days the disease had a different name - it was called “lues”. It was not until 1500 that the symptoms of syphilis began to be separated from those of leprosy. It was only in 1905 that scientists first managed to discover the causative agent of this disease. A year later, the famous scientist August von Wasserman developed a method for studying blood. This analysis (today known to science as the “Wassermann test”) still helps save lives.

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

The causative agent of syphilis and its features

The causative agent of this disease is the pale spirochete, or treponema (Treponema pallidum), which belongs to the family of spirochetes. A bacterial cell is characterized by a very small size - it cannot be seen through a regular microscope, nor can it be detected when stained with traditional laboratory dyes.

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

How is the infection transmitted?

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

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

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

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

Primary syphilis

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

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

First, treponema penetrates the body and migrates to the lymph nodes, where it begins to actively multiply. As a rule, the first manifestation of syphilis occurs four weeks after infection - this is the time when incubation period. At the site where microorganisms invade, a so-called chancre is formed, which opens as the disease progresses, forming a small ulcer. In this case, pain practically does not bother the sick person.

Most often, chancre appears in the area of the external genitalia. For example, in men it is often located on the head of the penis. However, the ulcer can be found on the skin of the thighs, abdomen, and sometimes near the anus. It is worth noting that sometimes chancre forms on the mucous membrane rectum, the cervix or even on the tonsils - in such places it is almost impossible to detect it on your own, so infected people simply do not go to the doctor.

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

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

Secondary form of the disease: main symptoms of syphilis

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

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

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

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

Tertiary syphilis

The third stage of the disease, as a rule, begins 3 to 10 years after infection. It is accompanied by the appearance of so-called gummas. These are infiltrative tubercles with clear boundaries, formed on the tissues of internal organs. They are prone to decay and scarring.

In fact, gummas can affect almost any organ system, leading to dangerous complications. For example, if such tubercles “grow” on bone tissue, then the person develops arthritis, periostitis or another disease. Damage to the intra-abdominal lymph nodes leads to the development of mesadenitis, which is accompanied by severe pain syndrome. No less dangerous are gummas in the central nervous system, since their appearance often leads to damage to certain parts of the brain and gradual degeneration of the personality. If left untreated, syphilis is fatal.

Congenital form of the disease

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

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

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

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

Other types of syphilis

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

Latent syphilis today is considered one of the main problems in venereology. Why? The fact is that in some people, treponema pallidum does not cause any visible symptoms after entering the body. In 90% of cases, this form of syphilis is discovered completely by accident, for example, when scheduled inspection 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 one, no less dangerous species The disease is seroresistant syphilis. ABOUT similar form they say in cases where, after a course of treatment, treponema is still present in the tests. Patients with a similar diagnosis require an additional course antibacterial therapy. Unfortunately, it is not always possible to cure the resistant form of infection. And in some cases, the infected status remains with the person throughout his life.

Methods for diagnosing the disease

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

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

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

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

Modern methods of therapy

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

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

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

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

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

Disease prevention

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

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