home Folk remedies The first symptoms of syphilis. How symptoms and signs of syphilis develop in women depending on the stage of the disease

The first symptoms of syphilis. How symptoms and signs of syphilis develop in women depending on the stage of the disease

An experienced doctor talks about an infectious venereal disease - syphilis. From the interview you will learn everything about syphilis - manifestations of the disease, how to diagnose it in time, and what therapy is used for treatment.

- Viktor Ivanovich, today we will talk about syphilis - an inherited disease modern world since the depths of the Middle Ages, and which has not yet lost its relevance. Although the incidence of infection has decreased in recent years, the statistics from the Ministry of Health are still frightening: per hundred thousand residents of our homeland, 26 people have syphilis. Tell me, is it not the awareness of our population that is to blame for this, or a simple devil-may-care attitude and confidence that this will not affect me?

- Yes, indeed, the statistics are frightening, but over the past ten years, cases of infection have decreased significantly, especially among the risk group - teenagers. This became possible thanks to special awareness programs with explanatory and preventive work. Lessons on reproductive health are regularly held in schools and universities. But cases of diseases have become more frequent in the 40-year-old age group, who, as you say, think that this will not affect them. And this is a simple lack of awareness of the population, since explanatory events are not often carried out in production.

— Your youngest and oldest patient?

— You can say from zero and above. The disease is susceptible to both infants, those infected in the womb or during childbirth, and elderly patients. But if we talk about those who came to the appointment on their own, the youngest is a 13-year-old teenager and the oldest is a man aged 80. So, all ages are susceptible to syphilis).

— Is there any relationship between disease outbreaks and seasons?

— Yes, the most productive time is the end of summer and beginning of autumn, when the vacation period ends and the realization comes that what have I done and whether I need to see a doctor)

—Who contacts you most often?

— There is no clear answer to this question. Among the patients there are both decent citizens and antisocial elements; this disease can affect anyone. But most often these are people with bad habits, I can’t say that all of them are drunkards, but nevertheless, after damage to the brain by alcohol, they begin to think in other parts of the body. This is where the danger lies.

Routes of infection

— From your hint about body parts, we can conclude that the most common route of infection is through sexual contact with an infected person?

— Yes, in 95% of cases, infection occurs this way.

— Tell us in more detail for our readers about the routes of transmission of infection and where the danger lies?

— As I already said, the main route of infection is sexual. The fact is that the favorite place of concentration of the pathogen in the body is all liquid media - sperm, vaginal secretions, blood and even saliva. During sexual intercourse, the greatest likelihood of infection is due to the exchange of sperm and vaginal fluid between partners.

— Before talking with you, I studied comments on the Internet about syphilis infection, and many times I came across advice that recommends interrupting sex before ejaculation. There is an opinion that this method protects against infection. Is it so?

- Definitely not. This is a deep misconception, precisely because of the very lack of awareness of the population. During sexual intercourse, there is contact between the mucous membranes of the genital organs, which contain a lubricant that is released during arousal, and this is also liquid sebum in which a large concentration of the pathogen is observed. If there is minimal damage to the mucous membranes, instant infection will occur.

— What is the probability of becoming infected after the first sexual contact with a patient?

— Very high, 30-40% of infections occur after the first and only time. I should note that infection can also occur through oral sex and the risk of contracting the disease is no less. With this method of sex, the same exchange of fluids and saliva contains no less pathogen than semen or vaginal fluid.

- What about anal sex?

— Statistics say that infections during anal sex occur no less frequently than during regular sex. It is homosexuals who are included in the risk group; the disease is much more common among them. The fact is that the pathogen penetrates through the smallest damage to the mucous membranes and skin, and micro cracks in the rectum are a common occurrence.

— From all of the above, the question arises: is it possible to become infected through a kiss?

— The probability is very low, but it does exist, since the activity and ability of the pathogen to reproduce remains in humid environments, which is what saliva is. If there is damage oral cavity infection occurs.

— What other ways is the infection transmitted?

— Infection is less likely to occur:

By everyday means. In this case, the risk is minimal, since the pathogenic microorganism is sensitive to environmental conditions, but nevertheless can remain active in a humid environment until it dries completely. For example, the cutlery of an infected person will be a source of infection until the saliva dries on it. Danger can arise when using common household items and personal hygiene products, while taking a bath with or after a patient, or when using a shared bed.
Infection of babies- a common problem and a painful topic for doctors, which requires separate and detailed consideration, because it is always difficult to look at newborns with symptoms of syphilis. In this case, infection occurs during pregnancy from a sick mother to a child, through the placenta or during labor activity during the passage of the child through the birth canal.

What is syphilis

— Viktor Ivanovich, let's get straight to the point. What kind of terrible beast is hidden under the name syphilis?

- This is an infectious lesion not only genitourinary system, as many believe due to the specific route of infection, the disease affects the entire body - bone and cartilage tissue, skin, all body systems, including the central nervous system, and internal organs. The causative agent of the disease is Treponema pallidum, a pathogenic microorganism that, when entering the body, is concentrated in the lymphatic system, and then through the walls of small vessels penetrates the bloodstream and spreads throughout the body.

— How long does it take for syphilis to be detected after infection?

— Incubation of the disease or asymptomatic period can last from 10 to 90 days and after this time the first symptoms of the disease appear. But on average, incubation lasts from 20 to 45 days.

— Why such ambiguous terms of manifestation of the disease?

— Yes, indeed, the time frame is very blurry and depends on many factors. The first symptoms will appear when the pathogen reaches a certain concentration in the body, and how soon this happens depends on the state of the immune system and some other components. For example, they increase incubation accompanying illnesses With elevated temperature body and taking antibacterial agents, and the time is reduced by weak immunity and the entry of a large amount of pathogen into the body.

— What are the signs of syphilis?

— It is worth dwelling on this issue in more detail, since this is a broad topic that requires detailed consideration. Syphilis is a very insidious disease with symptoms that may be present temporarily and then disappear completely, and this does not mean that the disease has receded, on the contrary, it progresses, affecting the body more and more. Depending on the degree of development, syphilis is divided into several stages.

Primary syphilis

The first stage of the disease manifests itself as a neoplasm in the area of infection. This is the so-called “entry gate” through which infection occurs. They can be located everywhere, from the genitals and oral cavity to any place on the skin. Neoplasm - chancre, primary symptom syphilis.

— In what least expected place have you ever discovered a chancre?

— An interesting question, it all depends on the fantasies of the infected. In my many years of practice, the first sign of syphilis occurred between the toes, in the area auricle, on the chest.

— What does chancre look like?

- This is a kind of ulcer or erosion with a diameter of up to 10 mm and a characteristic blue-red tint. Its distinctive feature is sudden appearance and further disappearance without any treatment. Two weeks after the appearance of syphiloma (chancre), an inflammatory process begins in the lymph nodes of the adjacent area. For example, if syphiloma on the genitals is an inflammation inguinal lymph nodes, when it is in the oral cavity - inflammation of the submandibular.

- What hurts with stage 1 syphilis?

“That’s the insidiousness of the disease, that the first stage very rarely manifests itself as pain. In very rare cases, chancroid responds with pain when subjected to mechanical action, and inflamed lymph nodes also do not cause discomfort. That's why, most of sick people do not seek help from doctors, attributing the symptoms to allergies and other diseases, especially since syphiloma disappears on its own.

— How else does primary syphilis manifest?

— As for the symptoms, at the first stage they are no longer there, only chancre can have an atypical shape:

indurative edema– pink subcutaneous compaction at the site of treponema penetration;
felon– syphiloma on nail plate, appears as a tumor on the finger with a burgundy tint;
amygdalitis– syphiloma affecting the tonsils with noticeable thickening and swelling (if it occurs, fever and weakness may occur)

At the end of the first stage, symptoms of upper respiratory tract diseases of ARVI may appear.

- Does this mean that with syphilis there is a runny nose and cough?

— Yes, cough, as a rule, is observed in later stages, and a runny nose with syphilis of the second stage is a common phenomenon, it is also called syphilitic runny nose. It occurs with the release of purulent and mucous discharge.

— Is there a fever with syphilis?

— At the first stage of the disease, there is no hyperthermic reaction at all, or the temperature rises to imperceptible levels of 37°-37.2°C before the onset of secondary syphilis and the appearance of skin rashes. The symptom lasts for several days until a rash appears on the skin, and then disappears.

— Does the body itch with syphilis?

- Definitely not.

Secondary syphilis

The second stage of syphilis is manifested by multiple skin rashes, which are characterized by a periodic course, that is, they appear and disappear after 30-60 days. With each new wave of the rash, it fades, losing its brightness and becoming less widespread throughout the body.

-What does the rash look like?

- Skin rashes or syphilides can manifest themselves in different ways.

Table No. 1. Types of rash with syphilis of the second stage:

Type of rash	Description
	The rash is irregular in shape, usually located along the body and has a pale pink tint.
	Skin rash in the form of papules with a wet and dry surface, a frequent companion of roseola.
	A spot with a dense structure and conical shape; skin pigmentation appears at the site of its disappearance.
	The main location is the area of the sebaceous glands. The surface is covered with small scales and crusts.
	Pustular lesion of the skin.
	The necklace of Venus with syphilis is a pigmented skin lesion in the neck area, which is called leucoderma. It looks like white spots, round or oval shape, which give the impression of lace.

— Because of such massive damage to the skin, the question arises: is there itching in stage 2 syphilis?

- Neither primary nor secondary syphilis has this symptom. If a patient with syphilis experiences itching, this is a concomitant disease against the background of weakened immunity by Treponema pallidum, which requires separate diagnosis and appropriate treatment. Further, after skin manifestations, inflammation occurs lymph nodes in all respects, since the lymph system is the first thing that treponema pallidum affects. An inflamed lymph node in syphilis is called a “syphilitic bubo.” Upon examination, it is elastic and mobile, with a dense structure.

— Do the lymph nodes hurt with syphilis?

— Inflammation in the lymph nodes during syphilis does not cause pain and goes unnoticed in most patients. Along with damage to the skin, syphilis also affects the mucous membranes; this manifests itself:

erythematous tonsillitis, which affects the soft palate and tonsils;
papular tonsillitis – manifestation in the form of papules in the pharynx area, which gradually transform into erosions;
pustular tonsillitis - purulent lesions of the mucous membrane of the pharynx;
pharyngitis - syphilides affecting the vocal cords (can lead to loss of voice).

The second stage is characterized by baldness of all hairs. Treponema pallidum is to blame for this, as it penetrates the skin and destroys hair follicles. Hair loss due to syphilis or syphilitic alopecia is divided into two types - finely focal and diffuse.

Table No. 2. Types of hair loss:

Type	Characteristics
	Characteristic features are areas of baldness with a diameter of no more than 1.5 cm, irregular in shape and without a regular location. The affected area undergoes partial hair loss, while there is an inflamed skin color and there is a complete absence of discomfort in the form of itching. Finely focal hair loss does not affect the hair except the scalp.
	This type of baldness affects not only the head, but also eyebrows, mustaches, and eyelashes. It is characterized by a sharp decrease in the number of hairs, while there are no lesions. Over time, there may be complete baldness, but more often it is hair loss, slightly more than normal, with a change in its structure. In this case, the hair will be brittle and lifeless.

— Is hair lost without restoration?

— No, with adequate therapy, the hair is completely restored.

— What other symptoms of secondary syphilis?

— This is where the clinical picture of the second period basically ends. Additional symptoms appear only in patients with weakened immunity due to poor lifestyle or chronic diseases. In these cases, syphilis becomes malignant and is characterized by weight loss and symptoms of general intoxication of the body.

Tertiary syphilis

The third stage of the disease causes very serious health problems. During this period, treponema pallidum affects the entire body, from bone and cartilage tissue to all systems and internal organs, and pathological changes in the body in most cases are irreversible. Tertiary syphilis no longer manifests itself as rashes on the skin, but has a completely different appearance.

— What do the external manifestations of syphilis look like at the third stage?

- Skin rash is replaced by cutaneous syphilides, which manifest themselves:

Tuberous formations- These are dense formations in the lower layers of the skin. They can have both group and single locations. In the area of the mound there is a characteristic burgundy tint, and when pressed, painful sensations.
Nodular formations- a dense, immobile nodule in the lower layers of the skin, has the size of a walnut and leaves scar tissue when it disappears.

Damage to the mucous membranes in tertiary syphilis is called syphilitic gumma - these are dense nodular formations that develop in the subcutaneous fatty tissue, which deform soft tissues and lead to deformities. On initial stage gummous syphilide does not appear on the skin and mucous membranes, but during development it forms a tumor protruding above the skin with a diameter of up to 4 cm.

Among mucous gummas there are:

gumma of the tongue - tissue compaction that leads to complete immobility and deformation:
gumma of the nose deforms the cartilage tissue, which leads to complete collapse of the nose;
gumma soft palate– formation in the deep layers of tissue, complication – complete immobility of the palate;
gumma of the pharynx, as in all previous cases, leads to complete immobility and makes swallowing difficult.

Syphilitic gummas affect not only the skin, but also internal organs, cartilage and bone tissue, blood vessels and muscles, leading to their complete destruction.

— Viktor Ivanovich, do joints hurt with syphilis if bones and joints are affected?

- Yes, sure. It should be mentioned that damage to joints and bones is typical for all stages of syphilis, but in the first two periods, inflammatory processes in the musculoskeletal system are asymptomatic. For syphilis there are:

Damage to bones and joints in the early stages occurs in only 15% of patients and is manifested by body aches and minor pain in the bones.
Lesions in secondary syphilis are more common and may manifest as mild swelling in the affected areas (usually the shoulder and knee joints), while there are no changes on the x-ray. In very rare cases, the patient may be plagued by severe pain and fever, but no pathologies form and the inflammation proceeds benignly, and with adequate treatment the condition returns to normal.
Damage to osteoarticular tissue in the tertiary period already has serious consequences. The patient is being pursued by a strong pain syndrome and the changes are pathological. There is damage to the periosteum, medulla and spongy substance.

- How does this manifest itself?

- This manifests itself:

Damage to the vertebrae – in severe cases, complete immobility and constant paroxysmal pain.
Damage to the bones of the skull and chest.
Damage to the nose and hard palate.

This is not a complete list of damage to the musculoskeletal system and bone tissue. All these pathological changes without proper treatment lead to disability. Along with bone tissue, all internal organs and systems are affected.

In connection with these, they distinguish:

Central nervous system lesions or neurosyphilis can occur at any stage of the disease, but is most common in tertiary syphilis. After treponema penetrates into the nervous tissue, damage to nerve cells and fibers begins, which is manifested by paralysis by the tabes dorsalis, atrophy of the optic nerve, etc.
Syphilitic damage to the gastrointestinal tract, which can be characterized by fairly broad symptoms, similar to other diseases of the digestive system - nausea, vomiting, loss of appetite. Oddly enough, even diarrhea with syphilis is quite a possible symptom, since digestion is impaired.
Liver damage can occur at all stages of the disease. With primary and secondary syphilis, it is not so critical and manifests itself as jaundice, which is cured after two to three weeks of therapy, only in rare cases can it turn into atrophy, accompanied by symptoms of severe intoxication and coma. At the third stage, the liver is affected by gummas and interstitial hepatitis is observed, as a result of which liver adhesions occur, its work is disrupted and liver failure, death is possible.
Lung damage is rare, but it does occur; this disease is called pulmonary syphilis. It is quite difficult to diagnose; there may be minor manifestations on the radiograph in the form of minimal darkening and changes in the area of the lung root.

— Tell me, what are the symptoms of lung damage? Can a cough occur with syphilis?

— The clinical picture of lung damage has no distinctive features and is similar to the manifestation of other diseases, but cough manifests itself in any case. Symptoms of shortness of breath, hyperthermia and the release of a small amount of mucus may be added.

- What consequences last stage syphilis without proper treatment?

— It must be said right away that tertiary syphilis is very rare, since modern diagnostics make it possible to recognize the disease in the early stages, but it is still present in the risk group - homeless people, drug addicts and alcoholics. Without proper timely therapy, the patient experiences mental insanity, loss of vision and hearing, cerebral paralysis, and the fourth stage—death.

— Viktor Ivanovich, tell me if there is fundamental differences male and female syphilis?

— Differences between male and female syphilis can only be at the first stage of the disease when the primary chancre appears and only with sexual infection. In men, erosion (hard chancre) is localized on the head of the penis or on the foreskin, in women on the labia, cervix or vaginal walls.

— Tell me, does the female body react in any special way to infection with Treponema pallidum? For example, how does menstruation occur with syphilis?

— Changes in the menstrual cycle should not be mistaken for symptoms of the disease, and even more so, you should not hope that normal cycle guarantees a completely healthy body. Not all diseases, including sexually transmitted diseases, affect this physiological state. Menstruation with syphilis, especially in the first stages, passes without changes and at the usual time, and only in later stages (tertiary) can it cause pain and occur with cycle disruption. The tertiary stage of syphilis can last up to ten years and, as a rule, finds a woman at the age of forty and changes in the cycle are attributed to menopause.

— Do women have divisions when infected?

- Yes, there is discharge. They differ from other STD diseases because they have a thick structure similar to pus and an unpleasant odor. Sometimes the discharge is accompanied by burning and discomfort in the genital area.

Syphilis and pregnancy

— Viktor Ivanovich, according to statistics, syphilis is not uncommon during pregnancy and our readers are interested in this topic. How dangerous is the disease for expectant mother and baby, what are the consequences of infection and what is congenital syphilis?

- Yes, to our deepest regret, such cases do occur, although not often, due to the fact that during pregnancy the list mandatory tests includes reactions to syphilis, sometimes up to three times in nine months.

— What to do if syphilis is discovered during pregnancy?

— Timely detected disease guarantees the unborn child health and birth without signs of syphilis. If the expectant mother does not pass timely treatment or therapy begins in the second and third trimester, the fetus is already affected by the pathogen and there is an almost 100% probability of congenital syphilis or even worse consequences - miscarriage and stillbirth. Congenital syphilis is distinguished between early and late.

Symptoms of early congenital syphilis appear immediately after birth:

skin damage;
syphilitic runny nose;
damage to bone tissue;
defeat internal organs and CNS.

Symptoms of late congenital syphilis appear during the first two years of life or up to 14 years:

damage to the optic nerve;
deafness;
tooth damage;
damage to all organs.

— How realistic is it for the expectant mother to cure the disease?

“Modern medicine is able to cope with the disease and minimize the risk to the child in almost one hundred percent of cases, but only if the disease is detected in time and treated in a timely manner. An infected woman undergoes two courses of treatment - the main one immediately after detection of the disease and the preventive one in later stages of pregnancy.

— Is abortion performed for syphilis and in what cases?

— There are no prerequisites for abortion during pregnancy. If syphilis is detected early, adequate therapy will exclude everything Negative consequences diseases. If the disease is detected in the later stages, especially, abortion is out of the question. In this case, treatment is prescribed that affects not only the mother, but also the child through the placenta. Modern medicine has medications that are effective at any stage of the disease, so not a single qualified doctor will recommend termination of pregnancy.

— How to plan a pregnancy after treated syphilis?

- First of all, go to the doctor and get tested necessary tests. If adequate therapy for the disease has been carried out and more than two years have passed, the risk of infection of the fetus is minimal. For treatment that has lasted less than two years, at the discretion of the doctor, preventive therapy may be prescribed (after the 20th week of pregnancy), which will prevent infection.

Diagnosis of the disease

— Viktor Ivanovich, how is the disease diagnosed?

— First of all, this is taking an anamnesis, although in most cases this does not bring results, since most patients hide the details of their intimate life. Next comes a series of laboratory tests to confirm the diagnosis:

An examination that reveals external signs of the disease - chancre, inflammation in the lymph nodes and a rash on the body.
Polymerase chain reaction or PCR is a sensitive diagnostic method that determines the presence of Treponema pallidum DNA in the body with almost 100% results. For the study, body fluids are taken - amniotic fluid, cerebrospinal fluid. A puncture for syphilis to examine the cerebrospinal fluid is indicated only for latent disease.
Serological diagnosis identifies the presence of antibodies to the pathogen. For the study, blood serum is used - serum.
Wasserman reaction - RV. The material being tested is blood from a vein. If the disease is present, RV gives a positive result. When performing the analysis, different concentrations of serum are used for qualitative and quantitative testing, and the reagin titer is determined based on the maximum dilution. Titers for syphilis are indicated by a ratio from 1:2 to 1:800
Immunofluorescence reaction - RIF.
Treponema pallidum immobilization reaction – RIBT
RPGA – passive agglutination reaction.

— What are titers for syphilis?

— Antibody titer is the dilution of blood serum at which the activity of antibodies to the infectious agent is detected. When their concentration is low, the disease is not confirmed, but when their number increases, we can talk about a possible disease. The titer is also used to monitor the dynamics of treatment if it decreases.

— What is a serological scar for syphilis?

— A serological scar or scar is the presence of antibodies to pathogens in the blood. This means that a person who has recovered from the disease has developed immunity to the disease in the form of antibodies. An experienced doctor uses this indicator to determine the duration of the infection.

- Tell me, without specific tests can the disease be detected? At general analysis blood will leukocytes be elevated with syphilis?

— Syphilis requires special diagnosis and the reading of leukocytes, both in urine and in blood, remains within normal limits.

— Very often there are statements about false positive and false negative test results. Why can a syphilis test be false negative and false positive?

— Each of the laboratory diagnostics can give erroneous results. This occurs in the presence of concomitant diseases (tuberculosis, lupus, etc.). Therefore, in order to avoid a false diagnosis, a combination of several laboratory research and based on this, they confirm or refute the disease. If the doctor's results are in doubt, additional tests are prescribed.

Table No. 3. The most common combinations of tests for syphilis and interpretation of the results:

Research method			What does a combination of results mean?
RW	REEF	RPGA
+	—	—	False positive RW result, the disease is not confirmed.
+	+	—	The initial stage of the disease is assumed. To clarify the diagnosis, additional studies are prescribed: RIBT, ELISA
+	+	+	The disease has been confirmed.
+	—	+	The first stage of the disease was diagnosed.
—	+	+	Stage late syphilis or a disease that has been treated for a long time.

— Viktor Ivanovich, very often in the comments readers complain about doctors who confuse syphilis with other diseases. Is this possible?

- Yes, in some cases this is possible. Syphilis in its symptoms is very similar to many other diseases and not necessarily sexually transmitted ones. Let me give just a few examples:

urologists confuse herpes with syphilis of the first stage, when chancre appears;
upon examination, the therapist may mistake roseola of secondary syphilis for rubella or dermatitis;
When erosions appear on the genitals, gynecologists diagnose thrush or trichomoniasis;
ENT doctors confuse stomatitis, with syphilis of the second stage, with syphilitic lesions of the oral cavity (ulcers, pustular rashes).

Separately, it is worth mentioning the diagnosis of syphilitic gummas, which are very often confused with:

cancerous ulcers, their difference from gummas, metastases, which are not present with gummas, as well as irregular shape and tuberous bottom;
tuberculous ulcers, the differences are fistulas, at the bottom of a tuberculous ulcer there are bleeding granulations and the absence of a gummous core.

Treatment of the disease

— Viktor Ivanovich, let’s move on to treating the disease. What methods and medications are used to treat syphilis and is it possible to completely get rid of the disease?

— Modern medicine has a wide range of methods and medicines against Treponema pallidum, although treatment takes a long period of time. For example, primary syphilis can be treated for up to two months, and secondary syphilis up to two years. The success of therapy will depend on the stage of the disease and the timeliness of treatment. Therapy for each patient is prescribed individually, with a specific scheme drawn up and under the constant supervision of a venereologist.

— Where is syphilis treated?

— Depending on the stage of the disease and prescribed medications, therapy can be either outpatient or inpatient.

— Help me understand the medications and tell me what drugs are used against syphilis?

— The main effect on Treponema pallidum is the administration of antibacterial agents, mainly from the penicillin group, to which it is most sensitive. But if the patient has allergic reactions and penicillin is ineffective (in some cases), drugs from other groups are prescribed.

Table No. 4. Drugs of choice for the treatment of syphilis:

A drug	Description
	Penicillin for syphilis is most effective against Treponema pallidum, but is prescribed with caution, as it causes frequent allergic reactions. Before prescribing the drug, a mandatory allergy test for the effect of the drug is indicated. Penicillin is quickly absorbed into the blood, but is also excreted after a short period of time. Therefore, to maintain a constant therapeutic dose, it is administered every three hours. An antibiotic is treated only in a hospital setting, even if outpatient treatment is allowed due to frequent injections. The price of the drug and its effectiveness against Treponema pallidum play a huge role in its popularity and widespread use.
	The drug is widely used to treat syphilis. Available in different concentrations, this allows you to select a drug depending on the clinical picture and condition of the patient. Depending on the concentration of the active substance, it is administered at different intervals. Bicillin 5 – one injection supports therapeutic dose in tissues for 4 days, Bicillin 1 - administered daily
	Amoxicillin for syphilis is a semi-synthetic drug adequate replacement penicillin series, it reduces the synthesis of the cell wall of the pathogen and stops its reproduction. Due to increased acid resistance, it is used orally, which is very convenient for outpatient treatment. The maximum concentration of the active substance in tissues is achieved within an hour after administration.
	Cefazolin acts like penicillin for syphilis - it destroys the synthesis of the wall of the microorganism and stops the spread of infection. This is a semi-synthetic antibiotic from the cephalosporin group; the maximum therapeutic dose of the drug in the body is achieved within an hour after intramuscular administration and almost immediately after injection into a vein.
	Azithromycin for syphilis is an antibacterial agent of the latest generation. Active against most pathogens, including Treponema pallidum. Compared to penicillin, it has minimal negative impact on the body.
	Erythromycin for syphilis is prescribed for intolerance to penicillins, since it is similar in action to this group. But unlike penicillins, it is less effective, therefore it is used in combination with other drugs of the antibacterial group and for initial stages diseases. Advantages of the drug - minimal side effects on the body
	Doxycycline is one of the main drugs for syphilis, but is not used for outpatient treatment, as it requires frequent administration (it is quickly eliminated from the body and is not able to maintain the required therapeutic dose). The instructions for the drug exclude exposure to the sun during treatment.
	Tetracycline for syphilis began to be used relatively recently, due to the development of immunity to penicillins by treponema. This drug is prescribed mainly in the early stages (primary and secondary). The drug can be used to treat outpatient setting, since the tablet form is released. Side effects of the drug include increased sensitivity of the skin to ultraviolet radiation (it is necessary to limit exposure to the sun).
	Sumamed for syphilis, the action of the drug is aimed at inhibiting protein synthesis in pathogen cells. The drug is most effective in the early stages of the disease. For more advanced forms of the disease, it is used rarely or in combination, as additional remedy to other antibiotics.
	Vilprafen for syphilis is most often used during pregnancy, as it has no side effects on the body.
	Rocephin for syphilis. therapeutic effectiveness has been proven only for fresh syphilis and preventive treatment. It is not used as the main treatment for treponema.
	Ciprofloxacin for syphilis has an antibacterial and bactericidal effect on the body. The action is aimed at stopping DNA biosynthesis, growth and reproduction of bacteria. It is used both during the period of pathogen activity and during the resting period.

— What is the dosage of doxycycline for syphilis and the duration of treatment?

— It is impossible to say the exact dosage of Doxycylin and other drugs. For each patient, an individual treatment regimen and an individual drug are selected, in some cases none, it all depends on:

— If the disease occurs against the background of other chronic diseases and surgery is required, is it possible to have surgery for syphilis?

— During the period of treatment for syphilis, any surgical intervention is contraindicated until complete recovery. Exceptions are emergency operations, without which death may occur.

— The first and most basic recommendation is not to delay treatment of the disease and immediately seek help. The first two stages of the disease can be completely cured with adequate and timely therapy, but the third stage is characterized by pathological irreversible consequences, and therapy can only maintain the patient’s condition. Also follows:

Do not interrupt taking antibacterial drugs and do so according to a strict regimen prescribed by your doctor. This is necessary to maintain a constant therapeutic concentration of the drug in the body. Otherwise, the pathogen develops immunity to the drug and the disease is difficult to treat.
Examine all sexual partners for syphilis infection. When a patient is diagnosed with primary syphilis, all partners over the past three months are checked; if the disease is in the second stage, everyone who has been in contact with the patient over the past year is checked.
Refrain from sexual intercourse.
Maintain personal hygiene to avoid infecting others.

The video in this article is about laboratory diagnosis of the disease.

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 last up to six months or be shortened to 2 weeks otherwise.

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

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

Periods of syphilis

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

Incubation period

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

Syphilitic sore throat

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

For example, against the background of a sore throat, enlarged tonsils, lymph nodes and dry mouth, patients will experience the following signs of infection: an inflammatory process in only one tonsil, the manifestation of erosions followed by transition to small red wounds, absence of temperature, painlessness of the lymph nodes , gray coating 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 treponema that caused the patient’s condition, similar to a sore throat, is the duration of the disease, which in this case lasts several times longer than a regular sore throat.
The first manifestations of syphilitic sore throat can only be observed in people involved in oral sex, since treponema pallidum first manifests itself at the site of the entrance gate.
Another method of infection is the use of the patient’s personal belongings for oral hygiene.

The smell of syphilis

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

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

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

Pain

Pain is rare, especially in the initial 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 spirochete infection. In later stages of infection, pain is usually associated with damage to the musculoskeletal system and ulceration of the gumma on the skin and mucous membranes of internal organs.

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

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

Definition of disease

The severity of the disease depends on how much time passes 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 infection, as well as the tendency of many citizens to self-medicate instead of seeing a doctor. It is easier to identify other diseases, but infection with Treponema pallidum is not so simple.

Once the first signs appear, they may remain invisible or may be mistaken for another disease.
In the second case, self-medication usually begins, visible result which disappears external signs diseases, which should be associated not with healing, but with the body’s immune response to pathogens.
The person, being fully confident that he was treated correctly, calms down, and when after some time other signs appear, they are no longer associated with chancroid.
Therefore, you should not try to identify skin infections on your own; it is better to immediately contact a specialist 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 spirochete infection. For example, if, based on a “diagnosis” made independently using a reference book or after an authoritative statement from “Nyura’s neighbor,” it was established that the cause of the rash is secondary syphilis, you should not rush to your suitcases in a panic and pack your things to the venereal dispensary. The first thing you need to do is contact a specialist, answer his questions and, if necessary, take the appropriate tests.

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

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

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

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

Lymph nodes with syphilis

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

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

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

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

Detection of syphilis

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

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

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

The following signs of primary syphilis can be distinguished:

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

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

Primary

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

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

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

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

The first signs of syphilis of the secondary form

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

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

Secondary form of the disease: main symptoms of syphilis

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 another bacterial infection is associated with syphilis - in such cases, pustules can form on the skin.
In any case, the rashes, as a rule, do not cause physical discomfort - there is no itching, no pain, no fever.
Therefore, sick people rarely seek help from a specialist, which, naturally, allows the disease to progress further.

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

By the way, in some patients a rash appears on the body only at the initial stage - within 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 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 a person develops arthritis, periostitis or another disease.
Damage to the intra-abdominal lymph nodes leads to the development of mesadenitis, which is accompanied by severe pain.
No less dangerous are gummas in the central nervous system, since their appearance often leads to damage to certain parts of the brain and gradual degeneration of the personality.

If left untreated, syphilis is fatal.

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

Signs of tertiary syphilis:

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

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

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

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

Congenital form of the disease

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

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

Early form 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 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 can be favorable. Therefore, you should never ignore symptoms or self-medicate.

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

Syphilis is quite diverse in its manifestations. This depends on a number of factors, ranging from the state of immunity of the person affected by treponema, and ending with the number of syphilis pathogens penetrating 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 chancre. These may be indurative edema, chancrapanaricium, chancre on the tonsils and paraphimosis. Indurative edema is characterized by development in the area of the labia and preputial sac, and such edema is not accompanied by pain. The chancre looks like a rather large ulcer, dense when palpated.

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

Congenital syphilis

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

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

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

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

Neurosyphilis manifests itself through the following symptoms:

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

Hidden syphilis

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

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

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

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

Household syphilis

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

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

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Other types of disease

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

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

Diagnostic methods

Today, there are many studies in which it is possible to determine the presence of treponema in the human body. When the first symptoms appear, you should go to the doctor. After 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 additional information The doctor refers the patient for a spinal tap, after which cerebrospinal fluid samples are sent to the laboratory.

Modern methods of therapy

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

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

Since the doses of drugs in this case are really large, it is extremely important that treatment of syphilis takes place in 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.

Course of antibiotic treatment

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

The disease is sensitive to the following groups of drugs:

drugs containing penicillin.
macrolides and the antibiotic ceftriaxone.

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

PENICILLIN (A REMEDY FROM SOME TYPES OF MOLD)

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

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

AZITHROMYCIN – A NEW GENERATION DRUG

Syphilis and its treatment with azithromycin, a new generation drug (antibiotic), and macrolides also show good results, being as effective as antibiotics of the penicillin group. At the same time, the side effects and negative effects from the drug are minimal.

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

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

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

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

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

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 did occur, it is worth treating the genitals antiseptic solution and make an appointment with a doctor.

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

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

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

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

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

Atypical forms of primary syphilomas

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

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

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

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

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

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

What is syphilis?

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

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

The disease is highly contagious even during the incubation period

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

Classification

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

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

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

According to typical symptoms, syphilis is divided into:

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

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

Primary syphilis

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

Secondary stage

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

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

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

Tertiary stage

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

Congenital form

Congenital syphilis can be divided into several types:

The early form of the disease, as a rule, manifests itself already in the first two months of the baby’s life. The first signs of syphilis are the formation of a papular rash, as well as damage to the nasal mucosa. More serious complications include partial or complete destruction 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.

Incubation period

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

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

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

It lengthens due to the following factors:

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

How syphilis manifests itself: the first signs

The appearance of a syphilitic rash on the hands

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

The first signs you need to pay attention to:

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

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

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

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

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

Causes

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

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

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

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

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

How is syphilis transmitted?

Syphilis is transmitted in the following ways:

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

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

Symptoms of syphilis

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

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

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

What does syphilis look like on human skin: photo

This is what the rash on the palms looks like

Signs of the primary form of syphilis

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

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

Symptoms of secondary syphilis

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

Most often the rash occurs:

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

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

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

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

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

Symptoms at the tertiary stage

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

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

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

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

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

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

Complications

The most serious consequences of syphilis are:

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

Diagnostics

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

Laboratory diagnostic methods include:

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

Treatment

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

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

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

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

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

The most commonly used tablets are:

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

Prevention

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

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

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

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

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

- 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 the main 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.

At 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 the mouth, 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 are detected meninges, tissue and blood vessels, leading to neurosyphilis.

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Discharge from this pathology

An atypical phenomenon for this disease. It is important to understand that the female body is in good condition 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.

A distinctive feature of the laboratory diagnosis of syphilis in a woman is the absence of 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.

Because of the possibility of false-positive results, confirmation of any positive or equivocal result from the above-described test should be followed by a treponemal test (eg, fluorescent antibody absorption). Sensitivity is 84% for detecting primary infection and almost 100% for other stages.

Dark field microscopy is possible way assessment of moist skin lesions such as chancre of primary syphilis or condyloma of secondary.

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 an effective remedy to combat 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.

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 on visible parts of the body and on 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. At the initial stage, this 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 methods diagnostics 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. Earlier 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. The end 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 of inflamed lymph nodes next to the 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. With absence 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 form 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 at this stage of syphilis does not provide information about the true cause of the 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.
It may appear in people caring for patients with syphilis: medical personnel, relatives. Affects the thumb, index finger and middle fingers hands. 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 common consequence for the eye is decreased visual acuity. Keratitis is accompanied by blurred vision, acute pain, 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 is 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 the mother is infected with syphilis, breast-feeding the child should be stopped immediately, as 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 for early diagnosis of the disease.

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 discovered that under favorable conditions (it should only be a human or animal body), Treponema pallidum divides every 30 hours. The weak point of 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 does not know how to adapt to this type of antibiotics. Sufficient doses of penicillin effectively fight the disease. To treat syphilis in patients with allergic reactions to penicillin, erythromycin or tetracycline is used.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Pyrotherapy (artificial increase in body temperature) and intramuscular administration of antibacterial drugs are added.

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.

Coping with illness folk remedies highly not recommended. 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 most effective dosages of 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 of the 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.