who has syphilis. Syphilis symptoms and treatment prevention photo: syphilis rash. This disease is spread in the following ways

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

- Viktor Ivanovich, today we will talk about syphilis - a disease inherited by the modern world from the depths of the Middle Ages, and which still has not lost its relevance. Although cases of infection have decreased in recent years, the statistics of the Ministry of Health are still frightening, for one hundred thousand inhabitants of our country, 26 people are sick with syphilis. Tell me, is it the fault of the lack of awareness of our population or a simple disregard 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 - adolescents. This became possible thanks to special programs for informing 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 age category of 40 years, who, as you say, think that this will not affect them. And this is a banal lack of awareness among the population, since explanatory events are not often held at the production facilities.

— Your smallest and most adult patient?

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

- Is there any relationship between disease outbreaks and seasons?

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

- Who contacts you most often?

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

Ways of infection

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

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

- Tell us in more detail, for our readers, about the ways of transmission of the infection and where the danger lies?

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

- Before talking with you, I studied the comments on the Internet for syphilis infection, and many times I met advice in which it is recommended to interrupt sex before ejaculation. There is an opinion that this method protects against infection. Is it so?

- Definitely not. This is a deep delusion, just because of the very lack of awareness of the population. During sexual contact, contact occurs between the mucous membranes of the genital organs, which contain a lubricant that is released during arousal, and this, too, is a liquid gray in which a large concentration of the pathogen is observed. In the presence of minimal damage to the mucous membranes, instant infection will occur.

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

- Very high, 30-40% of infections occur after the first and only time. I should note that infection can also occur during oral sex and the risk of catching 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 infection during anal sex occurs at least as often as during normal sex. It is homosexuals who are included in the risk group, they have the disease much more often. 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 thing.

- From all of the above, the question arises, is it possible to get infected with a kiss?

- The probability is very low, but it takes place, since the activity and ability of the pathogen to reproduce is preserved in humid environments, which is what saliva is. In the presence of damage to the oral cavity, infection occurs.

- What other ways is the infection transmitted?

- Less likely to be infected:

1. Household way. In this case, the risk is minimal, since the pathogen is sensitive to environmental conditions, but nevertheless can remain active in a humid environment until completely dry. For example, the cutlery of an infected person will be a source of infection until saliva dries on it. Danger may lie in wait when using common household items and personal hygiene products, while taking a bath together with the patient or after it, when using a shared bed.
2. Infection of babies- a common problem and a painful topic for physicians, which requires a 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 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 hiding under the name of syphilis?

- This is an infectious lesion not only of the 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 pale treponema, a pathogenic microorganism that, when entering the body, concentrates in the lymph flow, and then penetrates the bloodstream through the walls of small vessels and spreads throughout the body.

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

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

- And why such ambiguous terms of manifestation of the disease?

- Yes, indeed, the time frame is very blurred and depends on many factors. The first symptomatology will appear when the pathogen reaches a certain concentration in the body, and how soon this happens depends on the state of immunity and on some other components. For example, concomitant diseases with elevated body temperature and the use of antibacterial agents increase the incubation, and reduce the time - weak immunity and the ingestion of a large amount of the pathogen.

What are the signs of syphilis?

- It is worth dwelling on this issue in more detail, since this is an extensive 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 more and more affecting the body. 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 "entrance gate" through which infection occurs. They can be located everywhere, from the genitals and oral cavity to any place on the skin. A neoplasm is a hard chancre, the primary sign of syphilis.

- In what least expected place have you ever found a hard chancre?

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

What does a hard 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 the 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 area adjacent to it. For example, if syphiloma on the genitals is inflammation of the inguinal lymph nodes, when it is in the oral cavity, it is inflammation of the submandibular.

- What hurts with syphilis of the first stage?

- That's the insidiousness of the disease, that the first stage very rarely manifests itself as pain. In very rare cases, a hard chancre responds with pain during mechanical action and inflamed lymph nodes also do not cause discomfort. Therefore, most of the sick do not seek medical help, attributing symptoms to allergies and other diseases, especially since syphiloma disappears on its own.

- How else is primary syphilis manifested?

- As for the symptoms, then at the first stage it is no longer there, only a hard chancre can have an atypical form:

• indurated edema- subcutaneous compaction of a pink hue at the site of penetration of treponema;
• felon- syphiloma on the nail plate, manifests itself as a tumor on the finger with a burgundy tint;
• amygdalitis- syphiloma affecting the tonsils with noticeable hardening and swelling (if it occurs, fever and weakness may occur)

At the end of the first stage, symptoms of diseases of the upper respiratory tract of SARS may join.

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

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

- Is there a temperature 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 pales, losing its brightness and is less widespread throughout the body.

- What does the rash look like?

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

Table number 1. Types of rash with syphilis of the second stage:

- Because of such a massive lesion of the skin, the question arises, is there itching with second-stage syphilis?

- Neither in primary nor in secondary syphilis, this symptom is absent. If a patient with syphilis has itching, this is a concomitant disease against the background of a weakened immune system with pale treponema, which requires separate diagnosis and appropriate treatment. Further, after skin manifestations, inflammation of the lymph nodes occurs throughout, since the lymph system is the first thing that affects pale treponema. An inflamed lymph node with syphilis is called a "syphilitic bubo". On examination, it is elastic and mobile, with a dense structure.

Do lymph nodes hurt with syphilis?

- Inflammation in the lymph nodes with syphilis does not cause pain and in most patients go unnoticed. Along with the defeat of the skin, syphilis also affects the mucous membranes, this manifests itself:

• erythematous angina, which affects the soft palate and tonsils;
• papular tonsillitis - a manifestation in the form of papules in the pharynx, which gradually transform into erosion;
• pustular tonsillitis - purulent lesions of the pharyngeal mucosa;
• pharyngitis - syphilides that affect the vocal cords (may lead to loss of voice).

The second stage is characterized by baldness of all hairline. Pale treponema is to blame for this, which penetrates the skin and destroys the hair follicles. Hair loss with syphilis or syphilitic alopecia is divided into two types - small-focal and diffuse.

Table number 2. Hair loss types:

- Hairline is lost without restoration?

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

- What are the other symptoms of secondary syphilis?

- This is where the clinical picture of the second period basically ends. Additional symptoms appear only in patients with a weakened immune system due to an unhealthy lifestyle or chronic diseases. In these cases, syphilis acquires a malignant course 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, pale treponema affects the entire body, from bone and cartilage tissue to all systems and internal organs, and pathological changes in the body are in most cases irreversible. Tertiary syphilis is no longer manifested by rashes on the skin, but has a completely different appearance.

- And what do the external manifestations of syphilis look like in the third stage?

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

1. Tubercular formations- These are dense formations in the lower layers of the skin. They can have both group and single arrangement. In the region of the tubercle, there is a characteristic burgundy hue, and when pressed, painful sensations occur.
2. Nodular formations- a dense, immovable knot in the lower layers of the skin, has the size of a walnut and leaves scar tissue when it disappears.

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

Among the gums of the mucous membranes, there are:

• gummu tongue - thickening of the tissue, which leads to complete immobility and deformation:
• nasal gum deforms cartilaginous tissue, which leads to a complete collapse of the nose;
• gumma of the 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 tissues, blood vessels and muscles, leading to their complete destruction.

- Viktor Ivanovich, do the joints hurt with syphilis if the bones and joints are damaged?

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

1. Damage to the bones and joints in the early stages is manifested in only 15% of patients and is manifested by body aches and minor pain in the bones.
2. Lesions in secondary syphilis are more common and may present with mild swelling in the affected areas (often the shoulder and knee joints), with no x-ray changes. In very rare cases, the patient may be pursued by severe pain and fever, while no pathologies are formed and the inflammation proceeds benignly, and with adequate treatment, the condition returns to normal.
3. The defeat of the bone-articular tissue in the tertiary period already has serious consequences. The patient is pursued by a strong pain syndrome and pathological changes. There is a lesion of the periosteum, brain and spongy substance.

- How does it manifest itself?

- This manifests itself:

1. Damage to the vertebrae - in a severe case, complete immobility and constant paroxysmal pain.
2. Damage to the bones of the skull and chest.
3. Damage to the nose and hard palate.

This is not the whole 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, there are:

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

- Tell me, what are the symptoms of lung damage? Can coughing occur with syphilis?

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

- What are the consequences of the last stage of 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 - these are homeless people, drug addicts and alcoholics. Without proper timely therapy, the patient develops mental insanity, loss of sight and hearing, paralysis of the brain and the fourth stage - death.

- Viktor Ivanovich, tell me if there are any fundamental differences between male and female syphilis?

- Differences between male and female syphilis can only be in the first stage of the disease with the appearance of a primary chancre 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 somehow especially react to infection with pale treponema? For example, how does menstruation proceed with syphilis?

- You should not take changes in the menstrual cycle as symptoms of the disease, and even more so, you should not hope that a normal cycle guarantees a completely healthy body. Not all diseases, including sexually transmitted diseases, affect this physiological state. Monthly with syphilis, especially in the first stages, pass without changes and at the usual time, and only at later (tertiary) can cause pain and pass with a violation of the cycle. 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 you have divisions in women when infected?

- Yes, there are exceptions. They differ from other STD diseases in 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. What is the danger of the disease for the expectant mother and baby, what are the consequences of infection and what is congenital syphilis?

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

What to do if syphilis is discovered during pregnancy?

- A disease detected in time guarantees the unborn child health and birth without signs of syphilis. If the expectant mother does not receive 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% chance of congenital syphilis or even worse consequences - miscarriage and stillbirth. Congenital syphilis is distinguished early and late.

Symptoms of early congenital syphilis appear immediately after birth:

• damage to the skin;
• syphilitic runny nose;
• bone tissue damage;
• damage to internal organs and the central nervous system.

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

• damage to the optic nerve;
• deafness;
• damage to the teeth;
• damage to all organs.

- How realistic is the cure of the future mother from 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 and treated in time. An infected woman undergoes two courses of treatment - the main one immediately after the detection of the disease and prophylactic at later stages of pregnancy.

- Do they have an abortion for syphilis and in what cases?

- There are no prerequisites for abortion during pregnancy. If syphilis is detected early, adequate therapy will eliminate all the negative consequences of the disease. If the disease is detected at a later date, all the more so, abortion is out of the question. In this case, a treatment is prescribed that affects not only the mother, but also the child through the placenta. Modern medicine has drugs that are effective at any stage of the disease, so no qualified doctor will advise abortion.

- How to plan a pregnancy after treated syphilis?

- First of all, consult a doctor and pass the necessary tests. If adequate therapy of the disease has been carried out and more than two years have passed, the risk of infection of the fetus is minimal. With treatment that has passed less than two years, at the discretion of the doctor, preventive therapy may be prescribed (after the 20th week of pregnancy), which will exclude infection.

Diagnosis of the disease

— Viktor Ivanovich, how is the disease diagnosed?

- First of all, this is an anamnesis, although in most cases this does not bring results, since most patients hide the details of their intimate life. The following is a series of laboratory measures to confirm the diagnosis:

1. An examination that reveals external signs of the disease - hard chancres, inflammatory processes in the lymph nodes and a rash on the body.
2. Polymerase chain reaction or PCR is a sensitive diagnostic method that determines the presence of treponema pallidum DNA in the body with almost 100% result. For research, they take the liquid media of the body - amniotic fluid, cerebrospinal fluid. A puncture for syphilis for the study of cerebrospinal fluid is indicated only with a latent course of the disease.
3. Serological diagnosis identifies the presence of antibodies to the pathogen. Serum is used for research.
4. Wasserman's reaction - RV. The studied material is blood from a vein. In the presence of the disease, RV gives a positive result. When carrying out the analysis, different concentrations of serum are used for qualitative and quantitative formulation, and the titer of reagins is determined based on the maximum dilution. Titers for syphilis are indicated by a ratio from 1:2 to 1:800
5. Immunofluorescence reaction - RIF.
6. Treponema pallidum immobilization reaction -RIBT
7. RPHA - passive agglutination reaction.

What are titers for syphilis?

- Antibody titer - dilution of blood serum at which the activity of antibodies to the infectious agent is detected. With their low concentration, the disease is not confirmed, and with an increase in their number, we can talk about a possible disease. Also, the titer is used to control the dynamics of treatment, with its decrease.

What is a serological scar in syphilis?

- A serological scar or scar is the presence of antibodies to pathogens in the blood. This means that a person who has been ill has developed immunity to the disease in the form of antibodies. An experienced doctor on this indicator determines the duration of the infection.

- Tell me, can a disease be detected without specific tests? With a general blood test, will leukocytes be elevated with syphilis?

- Syphilis requires special diagnostics and the readings of leukocytes, both in the urine and in the blood, remain within the normal range.

- Very often there are statements 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 tests is used and, on the basis of this, the disease is confirmed or refuted. If the results of the doctor are in doubt, additional studies are prescribed.

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

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

Yes, in some cases it is possible. Syphilis in its symptoms is very similar to many other diseases and not necessarily venereal. I will give just a few examples:

• urologists confuse herpes, with syphilis of the first stage, when a hard chancre appears;
• on examination, the therapist may take the roseola of secondary syphilis for rubella or dermatitis;
• gynecologists with the appearance of erosion on the genitals diagnose thrush or trichomoniasis;
• ENT doctors stomatitis, with syphilis of the second stage, is confused with a syphilitic lesion of the oral cavity (ulcers, purulent rashes).

Separately, it should be said about the diagnosis of syphilitic gums, which are very often confused with:

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

Therapy of the disease

- Viktor Ivanovich, let's move on to the treatment of the disease. What methods and drugs 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 drugs against pale treponema, although treatment takes a long period of time. For example, primary syphilis is treated up to two months, and secondary 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 the preparation of a specific scheme and under the constant supervision of a venereologist.

Where is syphilis treated?

- Depending on the stage of the disease and the drugs prescribed, therapy can be both outpatient and inpatient.

- Help me understand the medicines and tell me what drugs are used against syphilis?

- The main effect on pale treponema is the appointment of antibacterial agents, mainly from the group of penicillins, to which it is most sensitive. But with allergic reactions of the patient and the ineffectiveness of penicillin (in some cases), drugs from other groups are prescribed.

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

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

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

• stage of the disease;
• the form in which the disease proceeds;
• the age of the patient;
• the presence of concomitant STDs;
• the presence of chronic diseases;
• individual response to drugs.

- If the disease occurs against the background of other chronic diseases and surgical intervention is necessary, is it possible to do surgery for syphilis?

- During the period of syphilis therapy, any surgical intervention is contraindicated, until the moment of complete recovery. Exceptions are emergency operations, without which a fatal outcome can occur.

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

• Do not stop taking antibacterial drugs and do it according to the strict scheme prescribed by the 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. When diagnosing primary syphilis in a patient, all partners are checked for the last three months, if the disease is in the second stage - everyone who has been in contact with the patient over the past year.
• Refrain from sexual intercourse.
• Observe personal hygiene to avoid infecting others.

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

Venereal diseases are in the first place in terms of prevalence. These diseases affect mainly the reproductive part of the population. However, not all diseases are equally known. What is syphilis, many patients learn only when faced with it.

What is syphilis and how is it transmitted?

Syphilis is a systemic venereal disease of a chronic nature. Pathology has an infectious origin - it is caused by pathogens. With the development of the disease, the skin, mucous membranes, internal organs, the nervous system and the musculoskeletal system are affected. The disease is characterized by a long course with periods of exacerbation and remission.

The main route of transmission of the infection is sexual. Infection of more than 90% of patients occurs during unprotected intercourse. At the same time, the patients themselves learn about the disease only after some time - the disease has. Its duration is determined by the state of the immune system, the presence of other chronic infectious and inflammatory processes in the body.

Syphilis is the causative agent

To understand what syphilis is, it is necessary to consider the cause of the disease. The causative agent of the disease is pale treponema. This microorganism belongs to spirochetes. Inside the human body, it can exist for a long time. With reproduction, an increase in the concentration of the pathogen, a characteristic clinical picture appears. The pathogen quickly affects the internal organs, the spread in most cases begins with the mucous membranes. With the flow of lymph, the pathogen penetrates into the respiratory, excretory, and supporting systems of the body.

Pale treponemas do not tolerate drying, exposure to high temperatures. They quickly die when boiled. However, the microorganism is resistant to low temperatures and freezing. It was found that treponemas were active for a year after freezing and storage at a temperature of -780 degrees. After entering the body, a persistent immune response is not formed against a pathogen. This explains the possibility of re-infection with treponema, relapse of syphilis.

How is syphilis transmitted?

As noted above, syphilis is transmitted mainly through sexual contact. During unprotected contact, the pathogen from the mucous membranes of the sick partner enters the genital tract of a healthy one. The use of condoms as a means of protection reduces the risk of the disease, but does not eliminate it. There are other ways of transmission of this sexual infection, including:

• hemotransfusion - blood transfusion of a carrier to a healthy patient;
• vertical path - from an infected mother to a child during childbirth;
• with saliva;
• through personal hygiene products (rarely);
• through household items (extremely rare).

Primary syphilis

When an infection with syphilis has occurred, most patients find it difficult to answer. This is due to the presence of an incubation period. After entering the body, treponema for a long time may not make itself felt. According to the observations of venereologists, this period can last 2-4 weeks. At this time, the pathogen is actively spreading throughout the body through the circulatory and lymphatic systems.

At the end of the incubation period, at the site of the introduction of the pathogen into the body, a solid painless formation is formed, an ulcer - a hard chancre - the first manifestation of syphilis. From this moment, the countdown of the period of primary syphilis begins. After 10 days, treponema from the ulcer penetrates into the nearest lymph nodes in the manner described above. As a result, an inflammatory process develops, and a strand from an ulcer in the lymph node appears on the patient's body. A hard chancre (ulcer), an inflamed lymph node, a cord from a lymphatic vessel persists for 6–7 weeks (duration of the primary period).

Secondary syphilis

All periods of syphilis are characterized by their clinical picture. So, a distinctive feature of the secondary form is the appearance. Hard chancre disappears after 1-2 weeks from the moment of its appearance. A characteristic feature of the rash is its prevalence throughout the body. At the same time, the nature of the elements of the rashes themselves can be different: spots, abscesses, nodules.

These elements do not disappear even under the action of local anti-inflammatory agents (ointments, creams). The period of rashes with syphilis lasts up to 2 months. The rash may disappear for a while, but then reappear. Telling what secondary syphilis is, doctors pay attention to the duration of this period. It can last 2-4 years, depending on the effectiveness of the treatment.

Latent syphilis

If many people know what syphilis is, then not everyone has heard about the latent form of the disease. This variant of the development of a syphilitic infection is characterized by a complete absence of a clinical picture. Sexual syphilis in this case is detected only during laboratory diagnostics. A blood test for syphilis shows the presence of traces of the pathogen. The diagnosis is based on:

• history data;
• results of specific reactions to syphilis (RIBT, RPR-test).

Syphilis - symptoms

It is difficult to say unequivocally what syphilis looks like, what are its manifestations: the disease can change or not give symptoms at all. In addition, signs of syphilis appear several weeks after infection. However, many patients do not give them much attention. Most learn about the presence of the disease during the formation of a hard chancre, which appears after the development of the primary form of infection.

When conducting laboratory tests, changes in the blood formula (growth of leukocytes, decrease in hemoglobin) can be observed already in the early stages. These phenomena are of a general nature, and it is impossible to identify syphilis from them. By the end of the primary period, patients complain of:

• headache;
• weakness and malaise;
• pain in muscles and joints;
• increase in body temperature up to 38 degrees.

The first signs of syphilis

When syphilis develops, the chancre is one of the first symptoms of the infection. This formation is a sore of small diameter. It is formed directly at the site of introduction of treponema into the body: in women - in the area of ​​the labia or on the cervix, in men - in the area of ​​the glans penis. The formation can hurt, but often does not cause pain. There is a solid infiltrate at the base of the chancre, which is why it got its name. Other early manifestations of syphilis include:

1. Indurated edema- education in the area of ​​the labia or foreskin. In most cases, it has a bluish or pinkish tint.
2. Amygladalite- defeat of syphilis of the tonsils by a carrier of treponema. Occurs as a result of oral intercourse. There is pain when swallowing, high body temperature, weakness, severe headache.

Stages of syphilis

Depending on how syphilis manifests itself, what symptoms are observed, doctors can distinguish the stage of the disease:

1. First stage (primary syphilis)- begins with infection, includes an incubation period when symptoms are absent. The duration of this stage is up to 7 weeks. It is characterized by the formation of a chancre described above, an increase in lymph nodes.
2. Second stage (secondary syphilis)- characterized by rashes all over the body, which periodically disappear and reappear.
3. Third stage- develops several years after infection in the absence of proper therapy, treatment to a doctor. Recently, tertiary syphilis is becoming more widespread due to the latent course.

Why is syphilis dangerous?

If syphilis is left untreated for a long time, the consequences of the disease can adversely affect health. The list of possible complications is long, and it is not always possible to establish exactly what was the result of the presence of treponema in the human body. Among the most common consequences of the transferred disease:

• infertility;
• narrowing of the foreskin;
• disorders of the motor apparatus;
• CNS lesions - neurosyphilis;
• brain damage;
• death.

Syphilis - diagnosis

Having dealt with what syphilis is, how it manifests itself, it is necessary to find out how the disease can be diagnosed. It is difficult to identify the pathology on your own - often the disease proceeds in a latent form, it is detected during an accidental preventive examination. The basis of diagnosis is laboratory methods. Improvement of existing methods makes it possible to detect the presence of a pathogen in the body in the absence of external manifestations. The material for research is blood. Analysis for syphilis can be carried out according to one of the methods:

• rw();
• RIF (enzymatic immunoassay);
• passive agglutination reactions;

Syphilis - treatment

Treatment of syphilis is carried out in a hospital. The course of therapy is selected individually and is determined by the stage of the disease, the presence of concomitant pathologies, the patient's condition. Antibacterial drugs form the basis of treatment. Pale is sensitive to antibiotics of the penicillin series. However, these drugs have an increased allergenicity. As substitutes can be used:

• (Azithromycin, Erythromycin);
• tetracyclines (doxycycline, tetracycline);
• (Levofloxacin, Sparfloxacin).

As part of the complex treatment of syphilis, other groups of drugs are often used:

• immunostimulants (Immunal, Immunomax);
• anti-inflammatory (Naproxen, Surgam);
• vitamins (B6, B12, ascorbic acid).

Can syphilis be cured?

This question is often asked by those placentas in which syphilis developed again after treatment. As noted above, immunity to this pathogen in the human body is not developed, as a result, some time after the end of the course of treatment, the symptoms of syphilis may appear again. However, timely therapy, full compliance with medical prescriptions and recommendations from the patient are a guarantee of complete recovery. Statistics regarding how syphilis is treated are shown in the table below.

Syphilis - drugs

In each individual case, how to treat syphilis is determined by a venereologist. Therapy depends entirely on the form, stage of the disease. At the same time, the effect of treatment largely depends on the correct selection of the therapy regimen. There are several generally accepted schemes that guide physicians in the treatment of syphilis. The main international standards for the treatment of this sexually transmitted disease, indicating drugs and dosages, are shown in the table below.

Syphilis - prevention

Prevention of sexually transmitted infections is aimed at eliminating the transmission of the disease.

The first signs of syphilis appear in patients a month after infection. Prior to this, pale treponema does not manifest itself in any way and is not detected in the analyzes. Then the signs of syphilis manifest themselves at the site of the entrance gate of infection. The first signs of syphilis usually occur on the genitals or oral mucosa. A sign of syphilis at this stage of the development of the disease is a hard chancre and inflammation of the lymph nodes in the zone of ulcer formation. The chancre looks like a small painless erosion of a rounded or rampant shape, the edges of which are slightly raised. Signs of syphilis in the form of a chancre in men usually appear on the head of the penis, and in women - on the labia, cervix, anus and rectal mucosa. Sometimes external signs of syphilis are found on other parts of the body, mainly on the fingers (of laboratory assistants, gynecologists and dentists), on the lips, tonsils and tongue of oral sex lovers.

Sometimes the chancre, located in the rectum, remains invisible or the cause of its occurrence is in doubt. In this case, they are guided by other signs of syphilis, such as regional inflammation of the lymph nodes. At the same time, no painful sensations are observed, which, combined with the property of the chancre to disappear on its own without the help of any treatment, leads to the fact that many do not pay attention to the first signs of syphilis, the photos and pictures of which are so meager in their diversity.

What signs of syphilis, in addition to chancre and inflammation of the lymph nodes, occur in the patient, depends on the stage of the course of the disease, the site of infection, and how quickly the correct treatment was started. Do not forget that this disease is often called the "great imitator" for the variety of clinical manifestations. That is, the signs of syphilis infection may look like typical manifestations of other diseases with a slight difference. For example, the absence of temperature or inflammation of the regional lymph nodes.

Syphilitic angina

One of the reasons for the development of angina - syphilis, or rather one of the external manifestations of infection with pale treponema, are symptoms characteristic of angina, but with certain differences. So, for example, against the background of sore throat, enlarged tonsils, lymph nodes and dry mouth, patients will experience the following signs of infection: an inflammatory process on only one tonsil, the manifestation of erosion followed by a transition to medium-sized red wounds, lack of temperature, painlessness of the lymph nodes , gray plaque in the oral cavity and the presence of one or more large ulcers with smooth edges. In addition, one of the first signs that it was treponemas that caused the patient's condition, similar to angina, is the duration of the disease course, which in this case lasts several times longer than ordinary angina.

The first manifestations of syphilitic sore throat can only be observed in people who have oral sex, since, first of all, pale treponema manifests itself at the site of the entrance gate. Another way of infection is the use of personal belongings of the patient for oral hygiene.

The smell of syphilis

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

Therefore, if a woman's discharge began to have a pungent odor for no apparent reason, for example, non-compliance with basic personal hygiene, leading to mixing of the secretion of the sebaceous glands, uterine mucus and vaginal discharge, then herpes, mild chancre or syphilis begin to be suspected, that inflame tissues. In this case, in addition to the unpleasant odor, there will also be a change in the consistency of the discharge itself, a change in their color. Such discharge can cause pain, burning and herpes. However, infection with treponemas does not always lead to a combination of all these external manifestations of the disease, so no matter what signs, in addition to an unpleasant odor, are observed, it is worth contacting a gynecologist or virologist for advice and timely detection of infection.

pain

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

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

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

Disease Definition

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

Having appeared, the first signs may remain invisible, and may be mistaken for another disease. In the second case, self-treatment usually begins, the visible result of which is the disappearance of external signs of the disease, which should be associated not with healing, but with the body's immune response to pathogens. The person, being in full confidence that he was treated correctly, calms down, and when other signs appear after a while, they are no longer associated with a hard chancre.

Therefore, you should not try to determine skin infections on your own, it is better to contact specialists immediately so as not to miss the onset of a serious infection.

Itching with syphilis

It is also worth considering what signs are not characteristic of infection with spirochetes. For example, if on the basis of a “diagnosis” made independently with the help of a reference book or after an authoritative statement by “Nyura’s neighbor”, it was established that the cause of the rash is secondary syphilis, you should not rush to your suitcases in a panic and collect things in a venereal dispensary. The first thing to do is to contact a specialist, answer his questions and, if necessary, pass the appropriate tests. And before that, you can calm down and think whether all the manifestations and their nature correspond to infection with spirochetes. So, if a person has an itchy rash, you should think about whether syphilis itches? And having searched for more detailed information on this issue, find out that the rashes caused by spirochetes cannot be accompanied by itching, which means that itching is a clear sign of the absence of pale treponema in the body. Therefore, if “syphilis itches”, then this is not syphilis and you can calm down.

Lymph nodes with syphilis

The first signs of syphilis are not limited to the formation of a hard chancre at the site of the entrance gate. Following this, regional inflammation of the lymph nodes should appear. Lymph nodes in this case almost always become inflamed and enlarged, while remaining mobile and painless. Their size can reach a large walnut. As the first signs of syphilis, photos of inflamed lymph nodes will show a person with a large bump, not far from the site of infection, while the skin in the area above the nodes will not change its color. Such changes in the lymph nodes are associated with foci of reproduction of spirochetes in them.

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

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

Detection of syphilis

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

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

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

The course of syphilis is undulating, with alternating periods of exacerbation and subsidence of the symptoms of the disease. In severe cases, the disease leads to damage to the internal organs, osteoarticular and nervous system.

Etiology and routes of infection

The causative agent of syphilis is pale treponema, it is so called because it remains invisible through a light microscope when stained with conventional dyes.

In most cases, infection occurs sexually through contact with an open focus of infection (hard chancre, syphilitic gum). Transmission of the pathogen is also possible by household means (for example, when using common dishes), through blood products, and also from mother to fetus (in this case, they speak of congenital syphilis). Through the entrance gate of infection (microtraumas on the skin of the inguinal region, trunk, oral mucosa, genital organs), the pathogen enters the lymph nodes, and then into the systemic circulation.

Symptoms

The incubation period averages about 3-6 weeks. The first sign of the disease is the formation at the site of contact of a hard chancre of a painless dense rounded ulcer with a diameter of 0.5-2 cm, with a smooth, shiny bottom. These ulcers usually do not bleed and do not tend to coalesce. During the first week after the appearance of a hard chancre, the lymph nodes of the affected area increase (regional occurs). This period of illness is called primary syphilis. Sometimes there may be no primary lesions at all, or they are located on the internal genital organs (for example, on the vaginal wall in women), which makes diagnosis much more difficult.

A syphilitic ulcer can become secondarily infected. This process is accompanied by severe swelling, redness in the area of ​​the chancre, pus can be separated from the surface of the ulcer. When analyzing discharge from the ulcer area, it is not always possible to isolate pale treponema, which can erroneously conclude that there is no syphilis.

After about 2-3 months from the moment of infection, when a generalized rash appears on the skin and mucous membranes, we can talk about the transition of the disease to the secondary period. By this time, the primary foci, as a rule, disappear, leaving behind cicatricial changes. Skin manifestations of secondary syphilis are due to vascular changes in the deep layers of the skin. The rash is localized on the trunk, limbs, on the face, as well as on the palms and soles. The rash may be patchy, vesicular, or pustular and dark red in color, which fades over time. Rashes are formed on an unchanged background, individual elements are not prone to merging. Rarely, the rash is accompanied by itching.

When analyzing scrapings from secondary syphilides, pale treponema is detected, which indicates their contagiousness. In 10% of cases, there is an overgrowth of elements on the mucous membranes, under the mammary glands, in the area of ​​\u200b\u200bthe armpits, anus; then they start to get wet. These are the so-called wide warts, which are characterized by a high degree of contagiousness.

The appearance of a rash is sometimes accompanied by a slight malaise, a slight increase in temperature. The duration of the secondary period of the disease is several days. Without treatment, the disease becomes latent (asymptomatic) form.

A patient with a latent form of syphilis remains contagious, and transmission of infection from mother to fetus is also possible. During this period, which can last several years or even a lifetime, antibodies to the pathogen are found in the blood.

In about 30% of patients, the disease passes into the tertiary period, which is characterized by severe destructive damage to internal organs and systems. Tertiary syphilides (gummas) on the skin are single painless dense tubercles that capture the deepest layers of the skin and the subcutaneous fat layer. In the center of the gumma, it often forms an area of ​​necrosis, followed by the formation of a rough retracted scar. Exactly the same gummas can appear in any internal organ. Most often, bone and cartilage tissue and the nervous system are involved in the process. In the first case, holes are formed in the hard and soft palate, cartilage of the nose and larynx.

Infection of the nervous system (neurosyphilis) leads to the appearance of symptoms of damage to the meninges, the development of paresis and paralysis, as well as mental disorders. The formation of gum in the cardiovascular system is fraught with the development of aneurysms, inflammation of the aortic wall, narrowing of the vessels of the heart.

Diagnostics

There are many blood tests that can detect syphilis. All of them are based on the detection of specific antibodies and are divided into two groups: non-treponemal and treponemal. For a mass examination, the so-called non-treponemal qualitative Wasserman test (RW) with cardiolipin antigen is used. Under certain conditions, the result of this analysis may be false positive. In this case, confirmation with treponemal studies (RW with treponemal antigen, RIBT) is required, the results of which remain positive after the illness for life. Allergies to penicillin are prescribed antibiotics from a number of macrolides or cephalosporins. The drugs are administered intramuscularly or in tablets.

Treatment of active forms of the disease takes place in stationary conditions, patients with a latent form can receive outpatient therapy. The duration of treatment depends on the stage of the disease and can take from several weeks to several years.

Signs of syphilis in humans do not appear until a few weeks after infection, because the disease is characterized by a long incubation period. Without knowing about the disease, its carrier can continue to have sex, introducing the infection into the body of random partners, and not even know about it.

• Symptoms of secondary syphilis
• Diagnosis and treatment
• Exciter properties
• Syphilis infection
• Complications
• Classification
• Clinic of the primary period
• Epidemiology of syphilis
• The pathogenesis of syphilis
• Screening
• Reasons for development
• Treatment of syphilis

Symptoms of secondary syphilis

During the period of secondary syphilis, the disease, unlike the initial stage, spreads through the vessels of the whole organism with blood and lymph and manifests itself with various symptoms. The first signs of syphilis of the secondary period occur in people 40-50 days after the formation of the chancre. It all starts with a painless enlargement of the lymph nodes, which are cold and hard to the touch, while the person feels unwell and weak. Runny nose and cough, elevated body temperature up to 37.5 ° C can also be attributed to syphilis as the first signs.

But the characteristic symptoms of the disease are specific formations: papillomas, nodules and spots (syphilides) on the mucous membranes of organs and skin. Most often, with a secondary fresh disease on the abdomen and sides of the human body, roseolous syphilis occurs (round and smooth roseola spots of a pale pink color). A syphilitic symptom is often hair loss in different parts of the head - alopecia, or baldness. After the treatment of syphilis, the hairline is partially restored.

On the 60th day of the secondary period of syphilis, the signs of it (rashes) disappear, because. the body's immune system fights infection. But the disease continues to run its course. If a person catches a cold or experiences stress, a weak immune system will not be able to resist the disease, and a relapse will soon occur. It will present with one or more of the previous syphilitic symptoms. They can be roseola on the body and mucous membranes of the sky or papular syphilis, the photo of which is below.

The last sign is hemispherical nodules (papules) with a smooth, and later with a scaly surface. They are localized not only on the genitals, but also on the palms and feet of the patient. In the clinic (clinical picture) of syphilis at this time, there may be a chancre of the genital organs (a sign more characteristic of its first period).

Other manifestations of secondary syphilis, which appear less frequently, include leukoderma (light oval-shaped spots localized in the armpits, on the neck) and wide condylomas (warts) in the anus and genitals. All these symptoms can be in people for several years, if nothing is done against them, then tertiary syphilis develops in men and women.

Diagnosis and treatment

With an early diagnosis of the disease, doctors conduct an external examination of the human body and pay attention to the symptoms of 1 syphilis (photo). Often at this time, doctors make an erroneous diagnosis of patients, because. many skin diseases have manifestations similar to syphilis. Doctors take ulcers and rashes in the genital area as signs of a dangerous infection.

For example, with basal cell skin cancer, a dense roller of the tumor is formed with a gray-brown crust in the center, and with scabies ecthyma, the glans of the penis ulcerates. These phenomena resemble hard chancre (syphiloma).

Sometimes you can take, for example, the primary syphiloma of the hard palate for manifestations of angina, and the sore of the chancre on the lip for herpes.

In the first and second periods of syphilis, if there are visible signs of the disease on the human body, doctors use a diagnostic method such as microscopy, i.e. smears are taken from the surface of ulcers, papules and erosions and pale treponema, the causative agent of the disease, is detected under a microscope on a dark background. In the latent period of syphilis, such a study is not carried out.

The most common method for diagnosing the disease in its early stages is serological tests of human blood serum for the presence of infection antibodies. The nonspecific Wasserman reaction is positive if, as a result of the study, white flakes fall out in the test tube. This method is not always reliable, therefore, laboratories additionally carry out a clarifying specific reaction of passive hemagglutination (RPHA). It occurs only in the presence of antibodies of pale treponema in the blood.

In the tertiary period of syphilis, it is possible to carry out the above diagnostic methods, but the presence of gum (purulent seals) on the human body indicates the presence of the disease in the body.

Exciter properties

The causative agent of syphilis is a pale spirochete (treponema), which easily enters the body through skin lesions (wounds, ulcers). It has the shape of a spiral and can move both rotationally and flexionally. Once in the lymphatic vessels, the spirochete actively reproduces by division. Pale treponema in the blood accumulates in large quantities only in the second period of the disease, therefore, only at this stage does a rash appear on the body and mucous membranes of a person.

This microorganism with syphilis shows resistance to low temperatures for several days, and the best condition for its vital activity is a humid and warm environment (37 ° C). Spirochete dies under the influence of acidic and alkaline solutions, at a temperature of 55 ° C - after 15 minutes, and at 100 ° C - immediately.

Syphilis infection

The disease syphilis is an infection that in 97% is transmitted from a sick person to a healthy person through sexual contact through semen. This disease can be contracted by kissing (through saliva), using hygiene items shared with a sick person (straight razor, toothbrush) or one syringe, which is typical for drug addicts. Treponema infection is rare in a medical facility during direct blood transfusion.

Syphilis can be transmitted to an unborn child by a sick pregnant woman or a nursing mother while breastfeeding. Sometimes domestic cases of infection are recorded, which can occur through shaking hands or sharing a wet towel.

Complications

With each subsequent week after the first symptoms of syphilis appear, the infection enters the body more and more. If a person does not pay attention to the appearance of a rash, ulcers in the area of ​​​​the glans penis, etc., an untreated disease causes a number of complications. It leads to damage to the central nervous system (CNS). Over time, there are disorders in the musculoskeletal system, the organs of hearing, vision, and breathing suffer. Ulcers and syphilides leave scars for life.

Classification

After treponema enters the body, syphilis goes through several stages in its development:

1. Primary seronegative (incubation) and seropositive.
2. Secondary (fresh, latent, recurrent).
3. Tertiary (active, latent, visceral, neurosyphilis).

The disease is congenital. All stages of syphilis pass from one to another.

The incubation period of the disease

The period lasts from the moment of infection to the first sign of the manifestation of the disease - a hard chancre (2-6 weeks). If a person is taking antibiotics at the same time, the incubation period increases to several months. Test results at this time will be negative.

Clinic of the primary period

The disease always manifests itself at the site of infection (in the mouth, on the genitals) with a round sore (chancre). Since the ulcer does not hurt, the person often does not notice it. After 5 weeks, the chancre heals, a scar remains in its place. The bacteria then invade the lymph nodes, which swell in response. This sign means that the second period of syphilis is coming.

Epidemiology of syphilis

In the 90s of the XX century in Russia there was a surge in the incidence of syphilis. The highest infection rate was recorded in 1997. It amounted to 277.3 cases per 100,000 people. In those years, the number of prostitutes and drug addicts increased in the country, and the sick self-medicated. Since 1998, the incidence began to decline sharply, 30% less cases were recorded in 2003-2004. From 2007 to 2013, this indicator either increased or decreased. Now there are 20.4 registered cases of syphilis per 100,000 population in Russia, which is 10.4% more than in 2013.

The pathogenesis of syphilis

Syphilis is a chronic infection caused by Treponema pallidum, which eventually affects all human tissues and organs. The disease develops in the body in stages. The symptoms of the first period are the same in all cases (with slight variations), at other stages the course of the infection is individual. A feature of syphilis is the successive change of active and latent stages.

Screening

Screening (examination of the population for infection) plays a positive role in detecting syphilis and reducing the incidence. It allows you to identify the disease at an early stage. Screening is carried out when applying for a job in children's institutions and catering establishments. It is mandatory for pregnant women (prevention of congenital syphilis) and donors. Specialists examine people's blood by conducting serological tests in the laboratory.

Reasons for development

Syphilis can be contracted in different ways, but it develops in the body if a person does not treat the disease from the moment the first signs appear. This is because many people are embarrassed to see a doctor. They either self-medicate, which is not always correct, or they ignore the disease.

A severe complication of the infection is CNS damage (neurosyphilis), which can appear at any stage of the disease. The development of neurosyphilis occurs in the first few years from the moment of infection, later damage to the central nervous system is attributed to the 7-8th year of untreated syphilis. At this time, progressive paralysis and dorsal tabes occur.

Treatment of syphilis

In the early stages of the disease, hospitalization is not needed. The infection is treated with antibiotics - Penicillin, Erythromycin. If neurosyphilis has arisen, antibacterial drugs are administered intramuscularly to patients and the body temperature is artificially raised. In the third stage of syphilis, not only antibiotics are used, but also bismuth-based drugs, while treatment is carried out only in a hospital. Together with the sick person, his sexual partners should be treated. Early contact with doctors guarantees a quick recovery.