Home » Psychology » How is syphilis treated, treatment regimens for the disease. Syphilis: definition, etiology, clinical characteristics and treatment Syphilis signs and consequences

How is syphilis treated, treatment regimens for the disease. Syphilis: definition, etiology, clinical characteristics and treatment Syphilis signs and consequences

Syphilis - chronic disease sexually transmitted. The causative agent is Treponema Pallidum (white treponema). Venereal disease is characterized by alternating relief and exacerbation. Chronic syphilis is called secondary. Those suffering from the disease have one or more areas of inflammation in different tissues and internal organs. People become infected mainly during sexual intercourse (vaginal, oral, anal) and due to the transfer of the pathogen transplacentally (there is a significant risk of having a child with defects). Treponema Pallidum enters the body through damaged skin (epidermis) and mucous membranes. The pathogen moves to the lymph nodes, and then into the bloodstream.

Treponema pallidum is a gram-negative spirochete. The bacterium is surrounded by a capsule-like substance that performs a protective function and survives well at the temperature of the human body. Requires a moist environment for development and reproduction. Drying, heating, and the use of disinfectants, acids, and alkalis contribute to the rapid death of harmful bacteria. There is a risk (though it is small) of infection through household means through a shared towel, washcloth, toothbrush, or mug. You should not kiss a patient or smoke a cigarette together; minor damage to the oral mucosa can contribute to the transmission of the disease. A person can become infected through a blood transfusion from an untested donor.

Peculiarities

There are primary, secondary and tertiary periods of syphilis. Often people do not attach importance to the appearance of signs of this disease, so it can be chronic. When a person feels excellent, he or she becomes a source of infection. The disease develops approximately in the following sequence:

The first sign of syphilis is a dense chancre at the site of Treponema Pallidum penetration with a smooth shiny bottom, appearing four weeks after infection. The formations do not merge and are not capable of bleeding when normal conditions, located on the genitals (external and internal), in the oral cavity, on the lips. A spot no larger than 5 centimeters in size is formed, turning into erosion or an ulcer. It does not cause much discomfort and is painless, so a person may not notice an important sign of the disease. At this stage, the disease is easily curable. It is easy to confuse labial chancre with herpes, but it does not burn and takes longer to resolve. Treponema pallidum is present in the genital smear. The chancre increases significantly in two weeks, turns into a scar, which disappears after one and a half to two months. Often there is not just one chancre, there are several of them. This ulcer sometimes becomes infected with the appearance of inflammation and pus.
After a week, the lymph nodes near the dense chancre become inflamed and become mobile when palpated due to the pathogen entering the blood. Tests of a smear from an ulcer will not always reveal the disease, which makes early diagnosis difficult.
Two months after infection, serological tests detect antibodies to the causative agent of syphilis. In the early stages, there is no point in examining blood. If a person has been treated with appropriate antibiotics, the blood test may not detect antibodies.
Secondary syphilis replaces primary syphilis at 9-11 weeks of the disease. The chancre heals completely, but the body temperature rises, joint aches and weakness appear, hair begins to fall out, teeth and skin deteriorate.

What does lack of treatment lead to?

The chronic form of the disease begins, which lasts approximately 2-5 years. The pathogen multiplies in the body, causing a destructive effect on various organs. Symptoms of chronic syphilis appear and disappear, which is why people often refer to ARVI. The rash resembles skin irritation or allergies, fever, migraines, body aches, and a constant feeling of fatigue occur. The chronic form is often called old or neglected; it is more serious than the primary form.

Sick chronic form a latent disease can infect others and your child, if we are talking about a pregnant woman. Antibodies to infection are present in the circulatory system. The secondary period sometimes lasts a lifetime. If appropriate measures are not taken, the disease enters the tertiary stage.

Gummas are the main sign of the last stage of the disease. These are single hard tubercles that occupy the skin down to the subcutaneous fat. In the middle of the formation there is an anesthetized area where a scar is formed. Such gummas occur in internal organs, and this leads to irreversible changes. Bones, cartilage and nervous system with the brain. Multiple holes appear in the hard and soft palate, nasal cartilage. Neurosyphilis is the most dangerous complication, causes brain damage, paresis and paralysis, and disorders of consciousness. Gunma's cardiovascular system provoke aneurysms, inflammation of the aortic wall, and narrowing of the heart vessels.

Classification

Syphilis of this form is divided into:

Fresh. It occurs after the primary stage and is characterized by small rashes of various shapes, the appearance of dense chancre and polyadenitis. Lasts for 2-4 months.
Hidden. Symptoms disappear for a while, but serological tests show a positive result. Can last up to three months or more.
Recurrent. Relapses replace latent periods. The rash is much smaller than during the primary period, but it is larger and grouped in the form of rings or garlands.

Symptoms

The following symptoms are usually observed with the disease:

A rash in the form of roseola, irregular in shape, smooth, without itching, located throughout the body and mucous membranes of a person, does not protrude above the skin. Then it disappears on its own, but after a while it appears again. Sometimes antiallergic treatment and antibiotic therapy suppress this symptom, but it is very difficult to completely cure syphilis on your own.
A nodular, round rash that protrudes above the skin. It can be found everywhere, even between your toes and under your breasts. The influence of sweat contributes to the appearance of wet erosion. Therefore, there is a risk of infection even with a handshake.
“Necklace of Venus” - light rashes on the neck and upper limbs that occur six months after infection.
Hair loss. Eyebrows, eyelashes, facial hair in men, fuzz on the arms, hair in armpits. The symptom develops slowly, within 3-6 months after the pathogen enters the body.
Defeat vocal cords with hoarseness, hoarseness and weakening of the voice.
Changes in various organs. Enlarged liver, gastritis, digestive disorders. Irritability, bad dream. Meningitis and bone pain. Otitis media, dry pleurisy, retinitis, and neurosyphilis are sometimes observed.

Symptoms may reappear for many years after the onset of the disease. Except external manifestations, human organs are irrevocably affected, causing disruption of homeostasis and coordinated functioning of the body. Without medical care general condition health deteriorates significantly.

Treatment

It is carried out under the supervision of a doctor who prescribes specific antibiotics. Penicillin is the mainstay of treatment, since the pathogen is sensitive to this antibiotic. If the patient has an allergic reaction to the drug, macrolides or cephalosporins are used. Medicines are available in the form of injections and tablets. Acute forms of syphilis are treated in a hospital in compliance with preventive standards; for latent forms, outpatient therapy is used. Great value has a period of illness, which affects the complexity and duration of treatment.

Prevention

This prevention is similar to the prevention of sexually transmitted infections. It includes the following measures:

Control over people suffering from sexually transmitted infections. Information about a new victim is urgently sent to the district epidemiologist, who decides to hospitalize the patient and thoroughly check his family.
Referral of people with syphilis within 24 hours after diagnosis to a skin and venereal disease clinic or a special department of a regular hospital with a separate ward.
Examination of the sick person’s family and people close to him: friends, lovers, colleagues. Test orders.
Control over treatment, drug dose, systematic laboratory tests. If the patient decides to change his address, he should go to the venereology department close to his new home.
Pediatric examination of children in kindergartens and schools with a referral to a dermatologist if syphilis is suspected. A child with a congenital form is allowed to fully communicate with peers after special treatment, but with constant monitoring of his health.
Examination of pregnant women during pregnancy and stay in the maternity hospital.
Sterilization of surgical and hygienic instruments.
If you have sexual intercourse with a dubious partner, you need to wash your genitals and treat them with gibinate. At the venereal care point, the urethra is treated with potassium permanganate, protargol is instilled (it contains silver) and 33% calomel ointment is used.

Diagnostics

Consists of blood tests for specific antibodies. For research, many people use the Wassermann reaction (RW) with cardiolipin antigen, but sometimes the result is unreliable. Additional treponemal studies are needed (RW with treponemal antigen, RIBT), but they will show a positive result if the person has already been ill.

To assess the effectiveness of medical care, a quantitative Wasserman reaction with treponemal antigen is used.

In Russia, out of 100 thousand people, 186 people are sick. Sometimes primary syphilis is asymptomatic; testing for this disease after questionable sexual intercourse will help eliminate the risk of developing the disease. The sooner treatment begins, the better.

Venereal diseases have been known to mankind for a very long time. Even if it was not possible to diagnose them as accurately and treat them effectively as it is today, people from ancient times clearly understood: sexual intercourse can carry not only pleasure, but also danger. Syphilis is one of the most common, best known and most dangerous sexually transmitted infections. This disease became the hero of many works of art, inspired fear and meant inevitable death. But all this is in the past: modern medicine can easily cure this pathology. However, it is very important to know what signs this disease has in order to consult a doctor in time and begin treatment. This article will discuss exactly how to recognize syphilis at any stage of the disease.

Syphilis is an infection that belongs to the group of sexually transmitted diseases. And although unprotected sexual contact- This is not the only way to “catch” syphilis, it is the main one. The pathology can last for many years with periods of deterioration and improvement of the condition. It is worth noting that the disease affects all organs and systems in the human body, including skin and mucous membranes, heart and blood vessels, nerves, muscles, gastrointestinal tract, bones, cartilage tissue. The disease can last for many years if it is not treated or treated incorrectly, gradually destroying the body of its “host”.

Etiology and pathogenesis

Syphilis is an infectious disease, which means it is caused by a specific microorganism. Such a microbe is Treponema pallidum. It looks like a twisted, curved stick, capable of moving in different directions and reproducing by dividing in half.

Due to the fact that this microorganism is very comfortable to exist in lymphatic vessels and lymph nodes human body, it multiplies exactly there, appearing in the systemic bloodstream only in the second period of development of the disease. The peculiarity of treponema is that it can live outside humans for quite a long time. Preserves in linen, towels, toothbrushes, dishes, bed linen - feels great in warm and humid conditions. That is why all syphilitic patients require separate containers for food, strictly individual hygiene items, clothing and bedding.

This need is fueled by the fact that a person with syphilis is contagious at any time point in his illness, especially at the very beginning.

Table. Methods of transmission of syphilis.

Situation	Transmission factor
Unprotected sexual contact	Seminal fluid, vaginal secretion
Kisses	Saliva
Breast-feeding	Mother's milk
Hemotransfusions (blood transfusions), surgical interventions, use of shared syringes, non-sterile instruments	Blood
Household contact	Dishes, towels, bed linen
Possible intrauterine infection and development of congenital syphilis

Periodization of the disease

As already mentioned, a syphilitic infection occurs in waves, with periods of “blooming and fading” of symptoms.

Incubation period. The countdown begins from the moment Treponema pallidum first enters the body of a healthy person. The microbe needs time to “get comfortable” and begin to reproduce, continuously increasing the population. Typically the incubation period lasts about a month. However, this time period may be shortened if the bacterial load is high at the source of infection or, conversely, increased if the sick person takes medicines that can slow down the growth of bacteria in the body. But in insufficient doses to completely kill the pathogen. The spread of bacteria occurs along lymph flow paths and blood vessels; the pathogen infects all organs and tissues of the body. At this time, the disease does not yet manifest itself in any way, but the person can already infect other people.
. The first manifestations of the disease. In those places where treponema has penetrated into the mucous membrane or skin, so-called syphilomas appear (they are also called chancroid). In addition, the surrounding lymph nodes increase significantly in size. At this time (1.5-2 months from the moment of infection), you can first notice signs of the disease.
Secondary syphilis. A very long period, which can take more than 3-4, less often - 5 years. At this time, all the internal organs of the patient suffer, a widespread (generalized) rash may appear on the mucous membranes and skin, and alopecia (hair loss) often occurs. There are several options for the course of this period of the disease, but the most diagnostically unfavorable is latent secondary syphilis, when there are no skin symptoms.
. Today this is pure casuistry, isolated cases. This is a long-term untreated disease that kills all organs and tissues in the human body. It can flow for years, corroding the central nervous system (neurosyphilis), skin, heart and other organs (visceral syphilis). This is a disabling, disfiguring stage at which the destruction of skin formations called gummas occurs. “People without a nose” are prominent representatives of patients with tertiary syphilis.

In order to suspect the disease in time and begin its treatment, it is important to have a good understanding of the symptoms that manifest one or another of its stages.

If a person has had unprotected sexual intercourse, it is very important for him to be thoroughly attentive to himself. The first and main sign of syphilitic lesion is development chancre . This term refers to a single round erosion or ulcer with completely clear and smooth edges. Its peculiarity is the presence of a purple-red bottom. The ulcer does not hurt, is not inflamed, does not itch, does not have a red ridge around it - does not bring any discomfort at all. The formation does not increase in size, it may become slightly wet, but its contents are not purulent, but a light serous fluid. The chancre at the same time can be dry and covered with a film or scab. It is not affected by any local antiseptics; it cannot be squeezed out or “picked off”. Typically, syphiloma is about 1 cm in diameter, but there may be other options.

It is necessary to understand that the localization of erosion can be absolutely any - from the crown to the heels, on the surface of the forearm or in the most hidden folds of the body. However, the most common location of the chancre is the genitals (glans penis, foreskin, shaft, urethra, labia, perineal surface, on the walls of the vagina and even in the cervix).

Education may develop even on the tonsils. In this case, a tonsillitis-like condition appears, but the symptoms are much less intense - the temperature does not rise, the sore throat is weak or absent, but there is a sensation of a foreign body in the throat.

The greatest diagnostic difficulty is the fact that chancre does not hurt or itch. There are only two exceptions - anal syphiloma and felon syphiloma, which develops on the nail phalanx of the finger. In other cases, the formations are completely asymptomatic and finding them on your own is often not only difficult, but also completely impossible (for example, a chancre that has developed on the cervix can only be seen by a gynecologist during a vaginal examination).

However, there is a very important “hint”: about a week after the formation of syphiloma, the regional lymph nodes begin to enlarge, which eventually reach 8-10 cm in diameter. Most often this is the inguinal group, but there can be any others. Nonspecific symptoms of the disease may appear - malaise, joint pain, headache, drowsiness. It is by the combination of all these signs and the presence of a risk factor for transmission of the disease in the anamnesis that one can and should suspect a syphilitic lesion and consult a dermatovenerologist.

There is a danger of a secondary infection, then the process is symptomatically activated and delayed; otherwise, primary syphiloma heals within a couple of months after its appearance. Often this is the only sign of primary syphilis and the disease does not manifest itself in any way until the second stage develops.

Secondary syphilis

This stage is a period of generalized infection, the spread of the disease throughout the body. Most often it begins 3 months after infection and can last several years. Treponema attacks everything:

articular apparatus;
musculoskeletal system;
central nervous system;
hematopoietic organs (bone marrow, spleen);
gastrointestinal tract;
sense organs.

The main symptom by which one can guess the presence of a syphilitic lesion is a rash. They appear both on the skin and on the mucous membranes. Moreover, unlike primary syphilis, at this time they are very common and are accompanied by a feeling of aches throughout the body, headache, and elevated body temperature.

Secondary syphilis - photo

Clinically, there are three stages of secondary syphilis: fresh(when the rashes first appeared, they are bright, there are many of them), recurrent(their second and subsequent appearances are paler, there are fewer of them) and hidden(“periods of silence” when there are no skin symptoms).

There are several types of rash.

Other signs of secondary syphilis include the following:

angina-like syndrome (inflammation of the tonsils, the appearance of white spots on them, absence of fever);
jams (in the corners of the mouth);
general weakness, malaise;
damage to most lymph nodes on the body;
baldness;
depigmentation of the skin (often looks like pale spots, including the characteristic symptom of the “necklace of Venus” - a chain of white areas on the neck);
voice disorders.

The stage of serious multiple organ disorders, the appearance of crippling changes in appearance, disability, and sometimes death. There are latent and active forms of tertiary syphilis.

For diagnosis (if it was not carried out at the previous stages), active tertiary syphilis is, of course, more favorable, since it has manifestations: the presence of a small amount of infiltrates (called tubercles, gummas), which easily and often disintegrate, bringing with them the destruction of organs and tissues . At the same time, there are no changes in the well-being of the infected person, and the likelihood of transmitting the disease at this stage is close to zero. However, ulceration of skin formations always leads to a change in the patient’s appearance and disruption of the functions of the organ in which these formations appeared. Thus, tertiary syphilides of the oral cavity, larynx, and nose cause not only significant changes in the patient’s appearance, but also disturbances in the processes of swallowing food, speech production, and even breathing.

Syphilitic formations provoke bleeding, perforation of hollow organs, proliferation of coarse connective scar tissue, adhesions, causing failure of almost all organs.

At this stage, even a completed diagnosis does not guarantee success in treatment. The therapy is practically ineffective, the body’s compensatory reserves are exhausted, and neurosyphilis can significantly change the patient’s personality. Almost always, tertiary syphilis ends in death.

Photo - manifestation of syphilis on the tongue

Laboratory diagnostics

In addition to detection characteristic symptoms diseases, syphilis can be recognized in laboratory conditions. The following methods are used.

Microscopic method. The discharge from syphiloma (if present) is examined.
Serological method. These include nonspecific (Wassermann reaction and reaction to rapid pigment reagins), which are used for screening studies, but can give false positives, as well as specific ones (immunofluorescent analysis, etc.), which are highly sensitive and make it possible to determine infection by the end incubation period.

Thus, syphilis is a disease with a huge number of very specific symptoms that can be diagnosed and treated without problems, you just need to be careful about your body.

Video - Syphilis symptoms

This disease is one of the most common diseases that are transmitted primarily through sexual contact.

Modern diagnostic methods and medications make it possible to overcome the disease in the shortest possible time, provided that you contact a medical institution for help in a timely manner.

Etiology

Syphilis is a disease caused by Treponema pallidum. The pathogen has the appearance of a corkscrew-shaped spiral with narrowed ends.

The number of turns ranges from 5 to 24. Treponema pallidum, unlike other types of spirochetes, is very mobile. There are three forms: spiral, cyst, L-form.

The most common shape is spiral. It is this that causes the “classic” course of syphilis.

Treponema pallidum survives very poorly under the influence of oxygen, so it “prefers” to live in the human lymphatic system.

Treponema pallidum is very sensitive to increasing temperatures: at 41⁰ C it dies in 3-6 hours, at 60⁰ C – within 20 minutes, and at 100⁰ C it is destroyed instantly.

By pasteurizing food, rinsing dishes and tools with boiling water after illness, you can achieve complete disinfection of materials.

The bacterium behaves completely differently when low temperatures. Able to maintain its viability at 0⁰ C for 2 days.

The bacterium is very sensitive to acidic and alkali conditions: when exposed to laundry soap, it dies instantly.

In the acidic environment of the vagina, treponema quickly loses its motor ability. That is why the appearance of hard chancre on the walls of the vagina is very rare. The ideal acidity value for bacteria is 7.4.

Pathogenesis

Infection occurs from direct contact of a sick person with a healthy one. Most often, during sexual intercourse.

The most dangerous are “donors” who are in the primary and secondary periods of the disease, when the skin has rashes in the form of erosions with a weeping surface.

It is in these secretions that a huge number of pathogenic treponemas are contained. The incubation period is usually from 20 to 40 days.

Often, if not detected in a timely manner, improperly treated or “undertreated”, this disease can progress to the chronic stage with periodic clinical symptoms. Advanced syphilis is dangerous because it does not cause painful symptoms.

And it often goes unnoticed. At the same time, the person is contagious. If the disease has passed into the chronic stage, then, in the absence of rashes on the patient’s skin, infection from him can only be through sexual contact.

If rashes and wounds are present, then there is a chance of “catching a sore” through everyday life, using shared dishes, towels, etc.

Chronic syphilis develops with the appearance of a secondary period of the disease. The first sign of the disease is the appearance of a dense chancre (syphilide of the primary period) - this is the place through which the bacterium entered the body. After its appearance, generalized rashes appear after 6 weeks.

The secondary period is characterized by healing of the chancre and lasts from 2 to 4 years. It is a disease with periodic, quite obvious clinical symptoms, which are expressed by the appearance of: spotting, papules, pigmentation and baldness.

The most difficult period is the tertiary period. Occurs in the fourth year of the disease. And, if treatment is not started, it accompanies the person for the rest of his life. It is characterized by a wave-like appearance of bumps and nodes with long periods of latency.

Such rashes significantly disfigure the patient’s appearance. Over time, this leads to disability, and subsequently to death. The mortality rate is 10% among all cases.

How to diagnose the disease

The very first manifestation venereal disease– the appearance of a characteristic ulcer (chancre), which does not have an inflammatory phenomenon. The chancre has a smooth, shiny bottom and does not cause any pain.

Most often there is one, has the correct shape and smooth edges, the size of a penny. If such a formation is found in the mouth or on the lips, it is often confused with herpes.

But, unlike a “cold on the lips,” such an ulcer does not hurt, does not itch, and does not disappear for a long time.

If you notice skin growths in the genital area and suspect that they are syphilitic, you should immediately contact a specialist for timely diagnosis so as not to trigger the disease. On initial stages syphilis is easy to treat.

It is worth noting that at the first stage of infection, even a blood test, known to everyone RW, will not be informative.

Often, in the first period the result is negative. And the only “diagnostic” option is to collect the contents from the surface of the “ulcer.” If syphilis is present, then the pale spirochete will be cultured in the analysis.

If you give up on the disease, the chancre will heal on its own after 6 weeks, but in this case syphilis goes into the second stage.

Skin rashes appear, which patients often mistake for an allergic reaction to something.

Apart from being externally “unaesthetic,” such spots do not cause any discomfort, and many people mistakenly think that they are completely healthy. In this case, the disease simply passes into the chronic stage.

An old infection continues to have a detrimental effect on the entire body. Treponema attacks healthy organs. The process of disrupting their proper functioning begins.

There are situations when initial treatment is ineffective, so be careful.

If, after some time, skin rashes appear after antibiotic therapy, you must definitely donate blood for the Wasserman reaction (RW). In the second period of the disease, it is already quite informative.

According to his data, one can say with confidence whether the patient has syphilis or not. Research is necessary so that the disease does not become chronic.

Sometimes you have to take tests several times, because... The results can be false positive and false negative.

Treatment

Do not self-medicate. Contact a specialist for help. Timely and correct diagnosis and adequate prescription of medications will help you get rid of the disease quickly and forever.

The basis of treatment is antibiotic therapy. The drug is selected individually according to the sensitivity of the bacteria.

To do this, a bacteriological culture of the rash is taken to determine sensitivity to the antibiotic.

Syphilis is sensitive to penicillin drugs, but given that viruses are now mutating quite strongly, it is impossible to clearly prescribe a medication without analysis.

And sensitivity culture provides a high guarantee of the correct selection of medicine.

If, during treatment, it turns out that the patient has an allergic reaction to a prescribed antibiotic, the doctor will prescribe another drug.

Medicines for treatment are both injectable and oral.

It all depends on the specific situation and severity of the disease. Acute syphilis can only be treated in a hospital setting.

It is impossible to interrupt the treatment that has been started, since the bacteria, if the course of antibiotic therapy is not fully completed, develops resistance to the drug. And next time it will become more difficult to choose the right medication.

After the full course of treatment has been completed, the patient must periodically undergo serological blood tests for a certain period (depending on the complexity of the disease).

This is necessary to make sure complete absence virus in the body. If a state of seroresistance is detected, a repeat course of treatment is prescribed.

How to protect yourself from this disease

One of the main conditions is prevention. Better to play it safe. Don't be disorderly sex life. If you don't trust your partner, don't even think about it, use protection.

If the relationship has taken place “openly”, and the partner does not inspire much confidence, then treat the genitals with gibinate. (chlorhexidine digluconate), and after 4 weeks, if a suspicious rash occurs, consult a doctor for diagnosis and treatment.

Remember that timely diagnosis is the key to a quick recovery!

To prevent the spread of a sexually transmitted disease from a particular patient, it is necessary to examine all members of his family for infection.

Methods of infection that not everyone knows about

This disease can occur in any person. There is no innate resistance of the body to Treponema pallidum. If a person has already suffered from the disease, this does not protect him at all from subsequent infections.

The only moment when it is impossible to “catch a sore” is the presence of infectious immunity, the so-called “non-sterility”. This is the period when, after suffering the first stage of the disease, the pathogens of syphilis are still present in the body.

The disease can be transmitted from a sick mother to a child through breast milk, as well as during intrauterine development of the fetus.

If treatment is started on time, and it occurs in the first trimester of pregnancy, then there is a very high probability of giving birth to an absolutely healthy child.

When it comes to a congenital disease, with timely treatment the prognosis is quite optimistic for the patient.

In addition to sexual contact, you can become infected with the spirochete through a blood transfusion (if the donor is a carrier of the infection), through the use of a shared syringe (common among drug addicts), as well as high risk among medical personnel if safety precautions are not observed when working with biomaterials (blood, seminal fluid, etc.).

Possible consequences of syphilis

Complications after the primary disease: tissue necrosis at the site of the chancre, phimosis, acute complication of phimosis, in which the head is pinched by the flesh and does not close completely (paraphimosis), balanitis (inflammation of the glans penis).

Possible problems after the secondary stage: defeat internal organs, bones and nervous system.

Severe consequences of the third stage: damage to the brain, internal organs, skin of the face and neck, pathological bone fractures, bleeding as a result of vascular ruptures.

Syphilis is a sexually transmitted infectious disease that affects the outer layer of the dermis, internal organs, nervous system and bone structure in the human body.

Syphilis has a wave-like course, when phases of exacerbation and latent periods of its course alternate with each other - it is provoked by treponema pallidum.

Reasons

Syphilis is caused by a bacterium called Treponema pallidum.

Treponema pallidum

Infection most often occurs through sexual contact, somewhat less often - through blood transfusion or during gestation, when the bacterium falls from mother to child.

Bacteria can enter the body through small cuts or abrasions on the skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes during the early latent period.

Syphilis is not spread by sharing toilets, bathtubs, clothing or utensils, through door handles and swimming pools.

After treatment, syphilis itself does not recur, but you can become infected again by coming close to an infected person.

Risk factors

You are at increased risk of contracting syphilis if you:

participated in unprotected sex;
participated in sex with multiple partners;
a man who has sex with men;
infected with HIV, the virus that causes AIDS.

Primary signs of the disease

Before you begin treatment for syphilis, it is worth knowing how syphilis manifests itself. So the most important sign of syphilis in a patient manifests itself in the form of a hard, dense chancre and a significant increase in the size of the lymph nodes.

Chankra – Photo of the initial stage

Chancre is an ulcerative neoplasm or a focus of erosion, regular rounded in shape, with clear edges, filled with liquid and most often occurs at the site of contact with the carrier of the disease.

Syphilis also manifests itself with the following additional signs:

insomnia and increased body temperature in the patient;
attacks of headache, aches in joints and bones;
swelling of the genitals and the appearance of such a symptom as a syphilitic rash.

Periods of syphilis and their symptoms

Before selecting the correct treatment for syphilis, it is worth knowing at what stage of the disease the disease develops. The disease itself has 4 stages – let’s look at them in more detail.

Treatment of the disease is quite possible at each of its stages, with the exception of the last, when all organs and systems are affected and cannot be restored - the only difference is the duration and intensity of the course.

Incubation period and its symptoms

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

Primary stage of syphilis and its symptoms

Every person should know how the disease manifests itself - the sooner it is diagnosed, the sooner treatment for syphilis is started, the better the chances of a successful recovery.

First of all, treponema, after entering the body, affects nearby lymph nodes, beginning to actively develop and multiply in them.

The first symptoms of syphilis will manifest themselves in the formation of a chancre at the site of penetration of pathogenic microorganisms - a hard, regular oval shape, which will open as the disease progresses, forming an ulcer.

Most often, chancre does not cause concern, is not painful and is mostly localized in the area:

genitals;
groin area;
less often on the thighs and abdomen;
near the anus;
mucous tonsils;
vagina.

After a certain period of time, the patient is diagnosed with enlarged lymph nodes located near the chancre - most often they are localized in the groin area. A person can independently identify this symptom in himself - in this case, a nodular-shaped compaction that is hard to the touch is palpated.

In certain cases, due to problems with the outflow of lymph, the patient is diagnosed with swelling of the genitals, tonsils and larynx - it all depends on the location of the source of infection, the place of introduction of pathogenic microflora.

Primary syphilis as a stage of the disease lasts about 2-3 months - if treatment is not started in a timely manner, then the negative symptoms simply disappear. This does not indicate a complete recovery of the patient, but rather signals the transition of the disease to a new, next level of progression in its manifestation.

Secondary form of syphilis and its symptoms

The first symptoms of syphilis at the second stage of its course do not appear immediately - this phase of the disease lasts quite a long time, from 2 to 5 years.

This stage of the disease is characterized by its undulating course, when negative symptoms either manifest themselves or disappear again. The main symptoms are hardening of the lymph nodes and the formation of chancre and a rash.

Separately, it is worth paying attention to such a symptom as a syphilitic rash (see photo above). The rash itself, as a sign of syphilis, has a copper or yellowish tint, but the neoplasms themselves may peel off, and uncharacteristic scabs of a grayish color may appear. During the period of latent, hidden course, the rash may disappear, and during the period of exacerbation, it may manifest itself again.

During the course of syphilis in the later stages, the first sign is the thickening of the rashes, as well as the formation of ulcerative tumors in their place, and necrosis develops. It is most often localized at the site where the infection enters the body, but it is not limited to it - it will manifest itself throughout the body.

In some cases, the disease may be accompanied by another bacterial infection - purulent neoplasms will appear throughout the body. In addition to rashes on the body, which, by the way, do not cause concern, do not itch or itch, do not cause pain, allergic reactions may also occur.

As the doctors themselves note, in some infected patients the rash manifests itself only in the initial stages of the disease, disappearing in the future for many years. At the same time, other patients may suffer from periodic rashes on the body.

During the secondary stage of syphilis, people develop these red or reddish-brown spots, and at this point they are highly contagious.

Stress and weakened immunity, exhaustion of the whole body and hypothermia, or, conversely, overheating, can provoke further rashes throughout the body.

Hidden syphilis

Latent syphilis is the third stage of syphilis. Here the infection lies dormant (inactive), causing no symptoms.

Tertiary syphilis and its symptoms

The last stage of the disease does not occur immediately - the first symptoms of syphilis may appear 3 to 10 years after infection.

Symptoms of syphilis at this fourth stage manifest themselves in the form of the formation of gummas - these are specific, infiltrative tubercles with a clear edge, localized on the tissues and mucous membranes of internal organs. Over time, they can disintegrate and transform into scars.

As doctors note, gummas affect all organs and systems, causing dangerous consequences and complications. For example, if such tubercles form on bones or affect a joint, then the patient may develop:

arthritis;
arthrosis;
periostitis;
or other similar pathology.

Infection of the intra-abdominal lymph nodes leads to the development in the body, and when the central nervous system is damaged, when the brain suffers, the patient’s personality steadily begins to degrade. If treatment is not started in a timely manner, the likelihood of death is high.

If we summarize all the signs of the last stage of syphilis, then it is marked by the following symptoms:

damage to the dermis and bone tissue of the musculoskeletal system, joints, internal organs and systems, the formation of gummas in the patient;
the heart is affected and vascular system, coronary arteries narrow;
damage not only to the brain, but also to the central nervous system;
when syphilis is affected and its course is at the fourth stage, deafness and paralysis appear, the patient is worried about constant depression and split personality, even to the point of madness;
tumors and nodes form on the body, which gradually grow, increase in size and then open on their own, forming ulcerative lesions that bleed and do not heal for a long time;
and during the course of syphilis at the last stage, deformation of bones and joints develops - there are frequent cases in which ulcers primarily destroy the bones of the nose;
The first signs of deformity in appearance appear, which are provoked by the destructive effects of the disease.

A patient with this diagnosis should remember that each of its stages can be cured, but the fourth is unlikely, since there is large-scale damage to internal organs and systems that can no longer be restored. In this case, the person is diagnosed as disabled and assigned a certain group.

Neonatal or congenital syphilis

Neonatal syphilis in pregnancy results in fetal death in 40% of infected pregnant women (stillbirth or death soon after birth), so all pregnant women should be tested for syphilis at their first prenatal visit.

Diagnosis is usually repeated in the third trimester of pregnancy. If infected children are born and survive, they are at risk of serious problems, including developmental delays. Fortunately, syphilis during pregnancy is treatable.

Manifestations of the disease in both sexes

In men Syphilis most often affects the penis and scrotum - it is on the external genitalia that the disease primarily manifests itself in the form of negative symptoms.

In women The disease most often affects the labia minora, vagina and mucous membrane. If sexual partners practice oral or anal sex, infection and subsequent damage to the circumference of the anus, oral cavity, mucous membrane of the throat and skin in the chest and neck area occurs.

The course of the disease is long-term, if it is not treated in a timely manner, it is characterized by a wave-like manifestation of negative symptoms, a change in how active form pathology and hidden course.

How is syphilis diagnosed?

In the process of diagnosing such a serious disease, you should not diagnose yourself, even if its characteristic symptoms and signs are clearly expressed. The thing is that rash, thickening and enlargement of lymph nodes can also manifest themselves in other diseases such as characteristic feature. It is for this reason that doctors diagnose the disease itself by visually examining the patient, identifying characteristic symptoms on the body, and by conducting laboratory tests.

In the process of a comprehensive diagnosis of the disease, the patient undergoes:

Examination by a dermatologist and venereologist. It is these specialists who examine the patient, his genitals and lymph nodes, skin, collect anamnesis and refer him for laboratory tests.
Detection of treponema in the internal contents, gum fluid and chancre by application of PCR, direct reaction to immunofluorescence and through dark-field microscopy.

In addition, doctors conduct various tests:

non-treponemal - in this case, the presence of antibodies against the virus, as well as tissue phospholipids that are destroyed by it, is detected in the blood in the laboratory. These are VDRL and others.

treponemal, when the presence or absence of antibodies to such a pathogen as treponema pallidum is diagnosed in the blood. These are RIF, RPGA, ELISA, immunoblotting level research.

In addition, doctors also prescribe instrumental methods examinations to search for gummas include examination using ultrasound, MRI, CT and x-rays.

Modern treatment of syphilis

Modern treatment effective drugs allows us to talk about timely cure of the patient, but only if the disease has not entered the last stage of its course, when many organs, bones and joints are destroyed and damaged, which cannot be restored.

Treatment of pathology should be carried out exclusively by a qualified venereologist in a medical hospital, based on the results of an examination, a survey of the patient and the results of laboratory and instrumental studies.

So treatment of syphilis at home, with your own and traditional methods and recipes are unacceptable. It is worth remembering that this disease is not just something that can be cured with hot tea with raspberries - it is a very serious infectious period that destroys the body from the inside. At the first suspicion or symptoms of the disease, immediately consult a doctor, undergo an examination and a prescribed course of treatment.

The course of therapy takes a lot of time - the recovery process itself is long and the main thing here is to have a lot of patience.

As medical statistics and the practice of doctors show, advanced cases can be treated for more than one year. You can talk about recovery only after laboratory confirmation of the diagnosis - healthy, but do not stop it after all the pimples and ulcers and hardening of the lymph nodes have disappeared from the body.

The main thing that the patient himself should remember while undergoing treatment is to completely exclude any sex during this time.

Even if the partner’s results showed a negative result for the presence of a pathogen in the body, he is still recommended to undergo a course of preventive treatment. The course of treatment for syphilis itself includes several directions - this will be discussed further.

Course of antibiotic treatment

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

The disease is sensitive to the following groups of drugs:

drugs containing penicillin;
macrolides and antibiotic Ceftriaxone.

Thus, antibiotics containing penicillin act very effectively during treatment, having a detrimental effect on the causative agent of the pathology. When diagnosing primary syphilis, they provide excellent treatment dynamics.

Today, dermatovenereologists do not practice the method of the first loading dose of penicillin administration; the method of intramuscular administration of the drug at intervals of every 3 hours is more effective, which ensures its constant concentration in the body.

Penicillin (a product made from certain types of mold)

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

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

Azithromycin is a new generation drug

Syphilis and its treatment with azithromycin and macrolides also show good results, in its penicillin group. At the same time, side effects negative consequences from the drug are minimal.

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

Ceftriaxone

Treatment of syphilis with a drug such as ceftriaxone also produces positive results and dynamics - it is prescribed even to pregnant women and in particularly advanced cases. All compounds that are part of this drug suppress the internal synthesis of division and growth of Treponema pallidum cells.

The treatment regimen is simple - 1 injection per day, course of treatment for at least six months. The only limitation is that doctors do not treat the congenital form of syphilis with this drug.

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

Follow-up

After you are treated for syphilis, your doctor will ask you to:

be tested periodically to make sure that the body responds positively to the usual dosage of penicillin;
avoid sexual contact until treatment is completed and blood tests show that the infection has been completely cured;
inform your partners about the disease so that they also undergo diagnosis and, if necessary, treatment;
be tested for HIV infection.

Complications associated with syphilis

Pregnant mothers and newborns

Mothers infected with syphilis are at risk of miscarriage and premature birth. There is also a risk that a mother with syphilis will pass the disease to her fetus. This type of disease is known as congenital syphilis (discussed above).

Congenital syphilis can be life-threatening. Babies born with congenital syphilis may also have the following conditions:

external deformity;
developmental delays;
seizures;
rashes;
fever;
inflammation or);
and in men;
sudden, lightning pain.

Cardiovascular problems

These may include – the main artery of your body – and other blood vessels. Syphilis can also damage the heart valves.

HIV infection

People with syphilis are much more likely to become infected with HIV. Ulcers on the patient’s body facilitate the penetration of the human immunodeficiency virus (HIV) into the body.

It is also important to note that people with HIV may experience various symptoms syphilis.

Prevention of syphilis

To date, doctors and scientists have not yet invented special vaccines that are effective in preventing syphilis.

If the patient has previously had this sexually transmitted infection, he can become infected and get it again. As a result, only preventive measures will help avoid infection and thereby prevent damage to the internal organs and systems of the body.

First of all, it is worth excluding promiscuous sexual relations with an untested partner, especially without a condom. If you have had such sex, immediately treat your genitals with an antiseptic and visit a doctor for a preventive examination and examination.

Having syphilis once does not mean that a person is protected from it. Once it is cured, you can change it again.

It is enough to understand that not every person knows that he is currently a carrier of the infection and, if the patient has a regular sex life, doctors recommend regularly undergoing examinations by highly specialized doctors, taking tests for STDs, thereby identifying the disease at early stages its flow.