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STDs Syphilis belongs to a group of infectious diseases with a predominantly sexual transmission. It is characterized by a chronic undulating course with gradual damage to all organs and systems.

Classical syphilis includes 4 periods: incubation (3-6 weeks), primary syphilis (6-7 weeks), secondary forms of the disease (2-4 years), tertiary period (many years after infection).

The disease is caused by pale treponema - a microbe of a spiral shape, capable of active movement and well preserved in a humid environment at room temperature.

The source of infection is a person who has symptoms of syphilis at any stage, while all the patient's biological fluids - saliva, blood, urine, semen - are dangerous.

The most common route of infection for women is considered to be sexual contact with a sick partner, but infection is possible through kissing, sharing hygiene items, dishes and toiletries, and smoking the same cigarette or hookah.

A sick woman can infect her child in utero or while caring for him, while breastfeeding.

The first signs of syphilis infection

When infected with syphilis in women, the first signs appear at the site of introduction of treponema into the body: a hard chancre appears on the walls of the vagina, cervix, nipples, mouth or rectum, which looks like a dense rounded ulcerative skin defect.

Chancre does not cause any subjective discomfort (no pain, burning or weeping). Vaginal discharge in women with syphilis may become thicker, viscous, with an unpleasant odor.

Sometimes lymph nodes can increase, body temperature rises slightly, general malaise appears.

All of these symptoms disappear on their own without treatment, but this cannot be considered a recovery, this is the transition of the disease from the primary to the next stage.

The secondary period of the disease is characterized by the cyclic appearance of syphilides (various rashes in the form of spots, nodules, pustules) on the skin throughout the body and an increase in lymph nodes. The rash lasts for several weeks, then spontaneously disappears.

Episodes of rashes for several years alternate with an asymptomatic stage.

The fresh process is manifested by a bright, small, symmetrical, abundant rash without peeling. With recurrence, syphilides are darker, larger, asymmetrical, prone to merge with the formation of patterns on the skin, with signs of peeling along the edges.

A frequent sign of the 2nd stage is the appearance of pigmented syphilis in the form of a "necklace of Venus", after the disappearance of which white rounded spots remain. Rashes in secondary syphilis contain a large number of active treponemas, therefore, during this period, patients are very contagious.

Manifestations of tertiary syphilis

Approximately 4 years from infection, 40% of cases develop signs of tertiary syphilis.

For this stage, the characteristic symptoms are syphilitic tubercles and nodes (gummas), which are located in the deep layers of the skin and internal organs.

During their decay, gummas deform tissues, form poorly healing ulcers and large star-shaped scars that impair the functioning of organs.

Tertiary syphilides contain few treponemas, so such patients are little contagious to others.

Complications of the disease

A syphilitic infection without treatment has a long-term course and leads to destructive processes in various organs.

Neurosyphilis ends with paresis and paralysis, partial or complete loss of vision, damage to the meninges with the development of meningitis.

When the joints are damaged, there is a violation of the motor function of the limbs. Syphilides can form on all major vital internal organs, which leads to death.

Diagnosis of syphilis

To conduct an examination for syphilis, you need to contact a doctor - gynecologists and dermatovenereologists are well aware of how syphilis manifests itself on the genitals, so a diagnosis is often possible already at the stage of a clinical examination.

Scraping is taken from suspicious skin elements, which is then examined under a microscope in a dark field and sown on special media to determine the sensitivity of the microbe to antibiotics.

by the most modern diagnostic method it is considered that allows you to identify the disease at any stage, but it is not available in all medical institutions.

Therefore, the first place in the mass diagnosis of syphilis belongs to the detection of antibodies to syphilis in the blood (Wassermann reaction - RW), which becomes positive at 3-4 weeks from the onset of the disease.

Syphilis in pregnant women

For the timely detection of syphilis in pregnant women, a three-time blood test for RW is provided: at 8-12, 30 and 38-40 weeks. Infection at any stage of pregnancy is not considered an indication for termination, but if an infection is detected, treatment should be started as soon as possible.

The course of antibiotic therapy for the initial forms of syphilis in the 1-2 trimester allows you to completely prevent infection of the child.

The presence of a tertiary form in a pregnant woman or infection in the last trimester cannot guarantee the safety of the fetus: even after successful treatment, such children should be under medical supervision in the first years of life for the timely detection of various manifestations of the congenital form of the disease.

Preparations for the treatment of syphilis in pregnant women cannot be considered completely harmless, but their selection is based on the least toxicity to the fetus (cephalosporins and macrolides are recommended).

Without treatment, only 1 in 10 children of mothers with syphilis will be relatively healthy. In the rest, after the fourth month of intrauterine development, symptoms of infection appear: changes occur in the liver, kidneys, skeletal system, and mucous membranes.

Severe damage to the internal organs leads to the non-viability of the fetus, and such a pregnancy ends in a late miscarriage or stillbirth.

Each specific situation should be considered separately, taking into account the form of the disease, the severity, the amount of treatment performed, and the duration of the process.

Ideally, a woman should come to a gynecologist at the stage of conception, so that the doctor evaluates all the features of the body and the disease and decides whether it is possible for the patient to give birth to a healthy child after syphilis.

Statistics show that women who have been successfully treated for primary and secondary syphilis before pregnancy give birth to completely healthy children.

After treatment of tertiary syphilis, several years must pass before the moment of conception, and health monitoring is necessary to exclude reactivation of the infection.

When good results are obtained within 3-4 years, doctors usually give the go-ahead for pregnancy, since there is no risk of infection of the fetus.

Treatment of syphilis in women and men

Early periods of the disease can be treated on an outpatient basis - within 1 month, patients receive injections of bicillin (this is a long-acting penicillin antibiotic) several times a week.

In stationary conditions, the standard treatment regimen for syphilis (primary and secondary forms) includes intramuscular injections of penicillin 6 r / day for 14-28 days in combination with bicillin, antihistamines.

In the presence of local elements, their treatment with antiseptic solutions is indicated.

In late or latent forms of the disease, preparation is first carried out using bismuth preparations (biyoquinol) for 10-14 days, then they are prescribed penicillin therapy (at least 28 days) and drugs to maintain the normal function of internal organs affected by pale treponema (hepatoprotectors, cardiotonics , nootropics).

The course of treatment of syphilis at any stage ends with the appointment of immunostimulants (retarpen, aloe, extencillin, splenin) to increase the body's own defenses.

After treatment, patients are under medical supervision for 3-6 months. (with primary syphilis) up to three years (with complicated forms).

Modern qualified therapy for syphilis makes in most cases the prognosis for this disease is very favorable, so you should not self-medicate and be embarrassed to contact doctors about being examined for this disease.

Content

If a man or woman is suspected of having the first signs of syphilis, you need to pay attention to whether there is a rash on the body and other symptoms of the disease. A disease detected in time must be diagnosed and treated before it becomes incurable or leads to death. Familiarize yourself with the characteristic signs of the disease in men and women, learn how to identify them.

What is syphilis

Infectious dangerous sexually transmitted disease is syphilis. Of the pathogens, pale treponema is a bacteria that affects the skin, mucous membranes, internal organs, bones and the nervous system. You can become infected with the disease through sexual intercourse - vaginal, oral and anal sex. There is also household syphilis, when bacteria penetrates through small cracks, injuries on the skin. Late congenital syphilis leads to infection of the fetus during pregnancy. Another way to become infected with an infectious agent is through a blood transfusion from a carrier of the disease.

How does syphilis manifest itself?

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

Symptoms

Allocate skin manifestations of syphilis and internal lesions. Typical symptoms are:

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

Among women

The appearance of chancres and syphilides in women occurs on the cervix or labia - the site of penetration of a sexually transmitted infection into the body. The base contains a dense infiltrate. Another location for the formation can be the mucous membrane of the rectum, pubis, abdomen, thighs, anus. Inductive edema in girls appears on the labia majora, has a pale pink or bluish tint.

Discharge from syphilis

A characteristic symptom of syphilis infection in women is the appearance of discharge. The discharge is thick in consistency, the internal and external genitals itch and a burning sensation is felt. In appearance and consistency, the discharge resembles pus, has a sharp unpleasant odor.

In men

Syphilis on the skin in men is also manifested by a hard chancre located in the region of the glans penis or foreskin. Sometimes the position of a saucer-shaped ulcer of meat-colored cartilage-like consistency shifts to the region of the mucous membrane of the rectum, the fold of the anus, the pubis. The chancre is covered with a white greasy coating, equal in size to a five-kopeck coin. Indurative edema appears on the foreskin. After oral contact with the patient, ulcers appear on the tongue, gums, cheeks, hard palate or palatine tonsils.

Spots

After 3-4 weeks of the incubation period and the appearance of a hard chancre, other skin rashes appear that do not cause itching, are painless, have a dark red color, dense texture, smooth edges without peeling. Characteristic rash:

• roseolous - oval or round spots 1-1.5 cm in size, distributed throughout the body, localized on the trunk and limbs, the borders are not sharp, do not merge and do not rise above the skin;
• papular - a rounded shape of the skin rash, pale pink color, size 1 cm, smooth shiny surface, peeling; localization: on the palms, soles of the feet, genitals;
• condylomas - papules connected together, covered with ulcers;
• leukoderma - white spots against the background of darkening of the skin, acquiring a brown-yellow hue, localization - neck, armpits, chest, arms;
• erythematous tonsillitis - rashes on the oral mucosa, near the pharynx, on the hard palate, treponemas are inside the papules;
• alopecia - on the scalp, miliary rashes with a diameter of 1-2 mm, on which hair falls out.

signs

In the incubation period, there are no clinical signs of the disease, the primary signs of syphilis are characterized by a hard chancre, the secondary ones (lasting 3-5 years) - spots on the skin. The tertiary active stage of the disease is the most severe, with untimely treatment leads to death. The patient's bone tissue is destroyed, the nose "falls in", the limbs are deformed.

Primary signs

After a few weeks from the moment of infection, the first symptoms of syphilis appear, which include signs:

• specific rounded ulcers - chancres;
• chancres disappear after a few weeks, but this does not mean a cure, but the penetration of bacteria into the body;
• characteristic lesion of the lymph nodes;
• primary syphilis affects internal organs and systems.

Signs of secondary syphilis

At 11 weeks of infection, clinical symptoms of secondary syphilis occur. This is characterized by the appearance of syphilitic infections in the form of spots, rashes, abscesses, nodes on the skin. These formations are painless, in the absence of treatment they disappear, the disease passes into a latent stage. Over time, secondary recurrent syphilis occurs, characterized by manifestations repeatedly. The stage lasts up to four years, accompanied by a deterioration in the condition.

Signs of tertiary syphilis

Five years after infection, tertiary signs appear. This is already a severe form, there are lesions of internal organs, the formation of foci (threshing floor) on the skin, mucous membranes, heart, liver, brain, lungs, bones and eyes. Often the disease affects the nasal mucosa, which can lead to the destruction of the nasal septum. At this stage, dementia, progressive paralysis is manifested. She is not being treated.

Diagnostics

How to recognize syphilis at different active and chronic stages, the doctor knows. If you suspect a disease, you should contact a dermatovenereologist. At the first examination, a hard chancre, lymph nodes are examined, at a secondary examination - the affected areas of the skin, papules of the mucous membranes. For the diagnosis of syphilis, bacteriological, immunological, positive serological and other tests are used. For confirmation, a specific Wassermann reaction is carried out, which reveals a 100% result of infection. False-positive reactions to syphilides are not excluded.

For long-term treatment, drugs with the antibiotic penicillin and others from this group are used. The therapy is carried out on an outpatient basis, under the supervision of a physician. After the diagnosis has been made, treatment begins not only of the person who applied, but of his sexual partners, plus the risk of infection with the household type of illness of relatives and others is excluded. A recovered person does not receive immunity, there are cases of recurrent syphilis.

After treatment, there is a risk of re-infection, so prevention of syphilis and its consequences is important: contraception of sexual partners, absence of promiscuity, personal hygiene. The main way of transmission is social and domestic, so you need to monitor your contacts, do not use other people's things. Self-medication should not be allowed so as not to prolong the incubation period.

22.06.2017

One in 20 girls exposes themselves daily to a sexually transmitted infection or STI, such as chlamydia, gonorrhea and, of course, syphilis.

Neglecting their health, sexual partners become victims of their frivolous attitude to life.

Every year, the rate of people with STIs reaches 357 million, of which 5.6 million people acquire male and female syphilis. And, if in men the first manifestations of a sexually transmitted disease occur after 3-4 weeks, then the first signs of syphilis in women can be recognized no earlier than 1-1.5 months. The asymptomatic course significantly complicates timely diagnosis and impedes the speedy recovery of patients.

What is syphilis

A systemic bacterial disease that belongs to the group of sexually transmitted infections. Gram-negative spirochete, anaerobic treponema pallidum or Treponema pallidum, is the only causative agent of syphilis. It does not require access of oxygen for development and vital activity in the human body. The breeding process takes place at a temperature of 37 ° C once every 1.5 days. A pathogenic bacterium affects cells, tissues and organs, the heart, blood vessels, the central nervous and digestive systems, the musculoskeletal system and the spinal cord.

Infection with syphilis occurs during promiscuous and casual sexual relationships. The risk is significantly reduced when using barrier methods of contraception, but they do not guarantee that the partner is safe. Infection with syphilis occurs in the presence of wounds, damage to the genitals of a woman or an inflammatory process of the pelvic organs, violation of the integrity of the condom during sex. Even microcracks on the lips of a girl contribute to the penetration of pale treponema into the body.

The intentional or accidental use of the same syringes, which is often observed in people with drug addiction, causes syphilis to be transmitted through the blood. The same danger is exposed to inexperienced medical personnel when taking tests and conducting droppers, intravenous and intramuscular injections to the patient.

Without sufficient information about how STDs are transmitted, many underestimate household syphilis.

Shared items of common use and personal hygiene items touched by a sick person with pronounced ulcers are dangerous to others. Spirochete is stored in warm, damp linen for 2-3 days.

The first signs of syphilis in women

The optimal favorable conditions for the development of gram-negative bacteria are the lymph nodes and mucous membranes. Until the moment when it will be possible to identify the first symptoms of syphilis in a woman, at least 21-30 days will pass. During this time, anaerobic treponema spreads throughout the body and multiplies. It is difficult to determine the incubation period for the course of the disease, even in laboratory conditions. The primary manifestations of syphilis usually last 6-8 weeks:

• hard chancre, a small ulcer with a dense infiltrate inside on the mammary gland, pubis, labia, around the anus, in the vagina and on the cervix. Dissolves without treatment. In its place, scars or age spots form;
• atypical erosion with swelling of a pale pink or bluish tint on the lips, in the genital area;
• suppuration of soft tissues in the area of ​​​​the fingers on the hands;
• significant enlargement of the tonsils. Accompanied by temperature;
• inflammation of the lymph nodes. It manifests itself in the small pelvis, elbow bend, on the neck and back of the head, chin.

A characteristic feature in women is fetid thick discharge with syphilis, which is accompanied by burning, itching in the perineum and skin around. Very often, patients note a violation of the menstrual cycle, painful bleeding and an increase in blood volume.

Secondary manifestation of syphilis

A feature of an infectious disease is a periodic acute manifestation followed by a temporary absence of symptoms. This alternation of relapses and their frequency are interrelated with the response of the immune system to bacteria. Secondary symptoms of syphilis in women are usually observed after 2-4 months from the date of infection. They can last for several years, both in a latent and in a pronounced form.

Secondary rashes, syphilides, differ from those that were at the beginning of the infection. Occur everywhere, affect the skin and mucous membranes are no longer single ulcers, but red roseola, mother-of-pearl papules and purulent pustules. They disappear without the formation of scars characteristic of the chancre.

An infected woman develops seizures in the corners of the lips, spots on the face in the form of pigmentation, the so-called "necklace of Venus" develops in the neck, which is a lot of small lightened discolored areas of the skin. Hair begins to thin out, multiple hair loss occurs in the temporal and parietal region, eyelashes and eyebrows lose their density.

Almost the entire body is affected by syphilis, including the hematopoietic and digestive organs, joints and bones, the nervous and cardiovascular systems.

Possibly impaired vision and hearing. Often, patients have fever, fever up to 38 ° C, migraine, sleep disturbance and lack of appetite.

Tertiary syphilis - the last stage

Insufficiently qualified treatment or its absence due to the woman’s unwillingness to be healthy becomes the cause of the tertiary neglected form, in which there is a violation of the functional work of all systems and organs, and the likelihood of disability and death increases. Here is how syphilis manifests itself in women in the last stage of the disease:

• gummous syphilis. Granuloma that destroys tissue. Damages the skin and subcutaneous tissue, bones, cartilage, internal organs;
• neurosyphilis. CNS dysfunction and brain damage. It provokes a weak transmission of nerve impulses. The result is paralysis, dementia, neuralgia, epilepsy.

Severe consequences of the tertiary period of syphilis cause partial or complete loss of vision and hearing, kidney failure, syphilitic hepatitis, myocarditis, arthritis. Naturally, a woman is deprived of her main function: procreation.

syphilis during pregnancy

Statistics show that syphilis in pregnant women is not so rare. More than 900 thousand expectant mothers are infected, intrauterine infections affect the fetus, and then the newborn child in 30-40%. And only in 20% of cases it is possible to have a healthy baby without developmental pathologies.

Syphilis affects the eyes, ears, bone marrow, and heart of the fetus, and therefore increases the likelihood of a stillbirth or spontaneous pathological termination of pregnancy.

In surviving babies, the bacterium may not express itself for more than 2 years, and the disease may proceed in a latent asymptomatic form.

After a confirmed diagnosis and the presence of an infection for the treatment of syphilis during pregnancy, it is prescribed to take "Penicillin", which provokes dizziness, false contractions, migraine and muscle pain. It is strictly forbidden to have sexual intercourse during the treatment period. The patient is under the constant supervision of an obstetrician-gynecologist within the hospital.

Diagnosis of syphilis in women

Conducting clinical laboratory studies will help to recognize and detect bacteria such as pale treponema. If a sexually transmitted disease is suspected and in order to confirm the diagnosis of syphilis, after the initial examination, the attending gynecologist must prescribe an examination.

RPR test. Provides for the reaction of IgG and IgM antibodies to specific cardiolipin antigens, the appearance in the body of which is characteristic of syphilis. The effectiveness of the implementation depends on the duration of the course of the disease. A 100% result can only be guaranteed if the gram-negative spirochete has been in the body for more than 5 weeks. A titer of 1:2 or more indicates the presence of bacteria and the need for immediate treatment.

bacteriological research. To study and search for a microorganism, biological material, excretions are taken from the patient, followed by placing it in a special nutrient medium. A positive test result is observed with the growth of bacteria and an increase in their number.

PCR diagnostics gives about 98% reliable data. To be tested for syphilis, blood samples are taken from a woman, skin areas affected by chancres, pustules and erosions, scrapings. During pregnancy, it will be enough to donate breast milk. After determining the bacterial DNA, the result is compared with previously obtained materials.

Transvaginal ultrasound. The specialist has the opportunity to assess the condition and structural changes of the uterus, fallopian tubes and ovaries using a specially equipped sensor with a light diode, to identify pathologies and their development.

Colposcopy. Procedure for a thorough examination of the cervix. A binocular microscope allows you to obtain the necessary information about the condition of the vagina, find foci of infection, and conduct a biopsy.

Treatment regimen for syphilis

Based on the received accurate data after laboratory and hardware researcha woman is offered to undergo specific drug treatment, for which special drugs against primary and secondary syphilis are used:

• "Bicillin". Antibacterial agent for intramuscular injection from 2.4 to 4.8 million units. Course duration - 1 week. The drug is also effective for the treatment of tertiary syphilis. In the running form, the duration of administration is 3-5 weeks. In a week, the amount of the active substance should not exceed 2.4 million units twice;
• Benzylpenicillin novocaine salt. Biosynthetic penicillin for intramuscular injection with 0.9% sodium chloride solution. Dosage - 300 thousand units twice a day;
• "Extencillin". Natural bactericide. It acts on the cell wall of the microorganism and disrupts its synthesis. The introduction is mandatory in different buttocks. A single dose is 2.4 million units. Re-injection is carried out after 7 days.

If the patient has concomitant infections that have arisen against the background of the disease, tablets are additionally prescribed: Azithromycin, Sumamed, Doxycycline. The treatment regimen for tertiary syphilis involves the use of more potent drugs.

Bioquinol. Preliminary preparation for the upcoming antibiotic therapy. Every 2-3 days, intramuscular injection of 2-3 ml of the drug is necessary, followed by an increase in dosage to 25 ml per day.

"Penicillin". Use only once every 2 days. An exemplary scheme is drawn up with a subsequent increase in the administration of the drug. 1 time - 50 thousand units, 2 times - 100 thousand units, 3 times - 200 thousand units, 4 times - 400 thousand units.

"Oletetrin". Combined antibacterial agent. Prescribed in tablets, it acts against most gram-negative microorganisms. Daily dosage - 0.25 grams 4 times.

Medicinal electrophoresis under the action of current strength contributes to the rapid introduction and distribution of drugs throughout the body. To eliminate skin deformation in the form of scars, adhesive processes, Lidaza is used, the analgesic effect is provided by Novocain, calcium is provided for women with vascular and heart diseases.

To restore women's health and activate the immune system, it is recommended to take vitamins A and group B, calcium, ascorbic, nicotinic acid, riboflavin, aloe extract, "Aevit".

It is imperative that drug therapy be carried out in partners at the same time. During treatment, sexual intercourse and alcohol intake should be excluded.