Spirochete pallidum is the causative agent of syphilis. The causative agent of syphilis is Treponema pallidum: description of the type of bacteria, causes and symptoms of sexually transmitted disease

There are many different bacteria and viruses that can threaten human health. We can easily encounter many of them in Everyday life, while others are able to penetrate the body only in certain predisposing situations. The latter include those organisms that provoke the development venereal diseases. They are mostly transmitted only during sexual intercourse. One of these organisms is the pallidum spirochete, the causative agent of syphilis. Let's talk about its features in a little more detail.

Pale spirochete - features and characteristics

Spirochete pallidum is also known as treponema pallidum, at its core, it is a representative of the order spirochetals, the family of spirochetes, the genus Treponema and the species Teponema pallidum. This pathogen received its name for its ability to perceive color. Back in 1905, two scientists Shaulnn and Goffman conducted a study of discharge from a papule located on the genitals, where they discovered a spirochete that weakly refracted light. It was recognized as the causative agent of syphilis and given the name pale spirochete.

Treponema pallidum is characterized by a spiral shape; it can consist of eight to twelve rounded curls, which are located at the same interval from each other. The height of such curls decreases somewhat towards the end of the spirochete. Such a microorganism is capable of making characteristic movements - it rotates around its axis, as if screwing into a crack in the skin or mucous membrane.

Such a pathogen may have different lengths, and most often reaches six to ten microns. The thickness of this treponema can reach up to 0.25 microns.

The pale spirochete is an anaerobic organism; it can live in an environment without oxygen. Such a pathogen is found in lesions, mostly in intertissue spaces, as well as in various cells. In addition, it was found in the perivascular space, inside the blood vessels and lymphatic vessels, as well as in nerve fibers.

This treponema is quite unstable outside the body; it is particularly sensitive to external influences and dies very quickly when it dries out. The optimal temperature for the pale spirochete is considered to be 37C; if it is exposed to a temperature of 60C, it dies after a quarter of an hour, and when exposed to a temperature of 100C, it dies instantly.

If the treponema is at room temperature and in a sufficiently humid environment, it can remain motile for up to twelve hours. Being in a lower temperature promotes better preservation. Thus, scientists have proven that the pale spirochete can remain infectious for nine years if it is in temperature conditions of about -70C.

Experts say that this treponema is particularly mobile. At the slightest opportunity, it tries to penetrate inside the body and begin reproduction.

Thanks to its high resistance to external influences The pale spirochete can be easily transmitted from person to person not only during sexual intercourse, but also in everyday life, for example, through a shared towel or utensils. It is because of this feature that syphilis is considered an extremely contagious disease.

About syphilis

Syphilis appeared in Europe around the 15th century. Since then this disease confidently marches all over the world, and there is no way to get rid of it completely. It is believed that syphilis is the third most common of all sexually transmitted diseases. Every year, approximately twelve million new patients are seen with this diagnosis. In addition there is great amount patients whose medical histories are not included in the statistical tables.

Scientists say that syphilis is most often diagnosed in people aged between fifteen and forty years, and the maximum peak incidence occurs in men between twenty and twenty-nine years old. In women, this disease is much less common.

Now there are several countries where such a disease has practically become obsolete. They are represented by the UK and Scandinavian countries.

In our country there is no unified record of all patients diagnosed with syphilis. However, there is evidence that the highest incidence rate is typical for the Far Eastern, Siberian and Volga regions.

Modern methods of therapy

Our ancient ancestors treated syphilis with mercury and mercury ointments, but now such a rather dangerous, but at the same time widespread disease is treated with the long-known penicillin and its derivatives. Surprisingly, Treponema pallidum is almost the only microorganism that has been able to preserve a unique and quite high sensitivity To this antibiotic. Only if the patient is allergic to penicillin or if the pathogen is unexpectedly resistant, therapy can be carried out using erythromycin, tetracycline derivatives or cephalosporins.

Also modern therapy Syphilis treatment often involves the use of immunomodulators, represented by methyluracil or cycloferon. Biostimulants, for example, aloe, etc., are very popular.

So, the pale spirochete has been known to mankind for many centuries, and today, fortunately, the syphilis that it causes is completely treatable.

Ekaterina, www.site

P.S. The text uses some forms characteristic of oral speech.

is a sexually transmitted disease that has a long, wave-like course and affects all organs. The clinical picture of the disease begins with the appearance of hard chancre (primary syphiloma) at the site of infection, enlargement of regional and then distant lymph nodes. Syphilitic rashes appear on the skin and mucous membranes, which are painless, do not itch, and occur without fever. In the future, everyone can be affected internal organs and systems, which leads to their irreversible changes and even death. Treatment of syphilis is carried out by a venereologist; it is based on systemic and rational antibiotic therapy.

(Lues) is an infectious disease that has a long, wave-like course. In terms of the extent of damage to the body, syphilis is classified as a systemic disease, and in terms of the main route of transmission it is considered a sexually transmitted disease. Syphilis affects the entire body: skin and mucous membranes, cardiovascular, central nervous, digestive, musculoskeletal systems. Untreated or poorly treated syphilis can last for years, alternating periods of exacerbations and latent periods. During the active period, syphilis manifests itself on the skin, mucous membranes and internal organs; during the latent period, it practically does not manifest itself in anything.

Syphilis comes first among all infectious diseases(including STIs), according to the level of morbidity, contagiousness, degree of harm to health, certain difficulties in diagnosis and treatment.

Features of the causative agent of syphilis

The causative agent of syphilis is the microorganism pale spirochete (treponema - Treponema pallidum). The pale spirochete has the appearance of a curved spiral and is capable of movement. different ways(translationally, rotationally, bendingly and wavy), propagated by transverse division, painted with aniline dyes in a pale pink color.

Spirochete pallidum (treponema) optimal conditions in the human body it is found in the lymphatic tract and lymph nodes, where it actively multiplies, and appears in the blood in high concentrations at the stage of secondary syphilis. The microbe persists for a long time in a warm and humid environment (optimum t = 37°C, in wet underwear for up to several days), and is also resistant to low temperatures (in the tissues of corpses - viable for 1-2 days). The pale spirochete dies when dried, heated (55°C - after 15 minutes, 100°C - instantly), when treated with disinfectants, solutions of acids, alkalis.

A patient with syphilis is contagious during any period of illness, especially during periods of primary and secondary syphilis, accompanied by manifestations on the skin and mucous membranes. Syphilis is transmitted through contact of a healthy person with a sick person through secretions (sperm during sexual intercourse, milk - in nursing women, saliva during a kiss) and blood (through direct blood transfusion, during operations - from medical staff, using a shared straight razor, a shared syringe - from drug addicts). The main route of transmission of syphilis is sexual (95-98% of cases). Less common is an indirect household route of infection - through wet household items and personal belongings (for example, from sick parents to children). There have been cases of intrauterine transmission of syphilis to a child from a sick mother. A necessary condition infection is the presence in the patient’s secretions of a sufficient number of pathogenic forms of pale spirochetes and a violation of the integrity of the epithelium of the mucous membranes and skin of his partner (microtraumas: wounds, scratches, abrasions).

Periods of syphilis

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

• Incubation period

It begins from the moment of infection and lasts on average 3-4 weeks. Pale spirochetes spread through the lymphatic and circulatory tract throughout the body, multiply, but clinical symptoms do not appear. A person with syphilis is unaware of his illness, although he is already contagious. The incubation period can be shortened (up to several days) and extended (up to several months). Extension occurs when taking medications that somewhat inactivate the causative agents of syphilis.

• Primary syphilis

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

• Secondary syphilis

Can last from 2 to 5 years. Internal organs, tissues and systems of the body are damaged, generalized rashes appear on the mucous membranes and skin, and baldness occurs. This stage of syphilis occurs in waves, with periods of active manifestations followed by periods of absence of symptoms. There are secondary fresh, secondary recurrent and latent syphilis.

Hidden (latent) syphilis does not have skin manifestations disease, signs of specific damage to internal organs and nervous system, is determined only laboratory tests(positive serological reactions).

• Tertiary syphilis

It is now rare and occurs in the absence of treatment years after the lesion. Characterized by irreversible damage to internal organs and systems, especially the central nervous system. It is the most severe period of syphilis, leading to disability and death. It is detected by the appearance of tubercles and nodes (gummas) on the skin and mucous membranes, which, when disintegrating, disfigure the patient. They are divided into syphilis of the nervous system - neurosyphilis and visceral syphilis, in which internal organs are damaged (brain and spinal cord, heart, lungs, stomach, liver, kidneys).

Symptoms of syphilis

Primary syphilis

Primary syphilis begins from the moment when primary syphiloma, chancre, appears at the site of introduction of pale spirochetes. A chancre is a single, round-shaped erosion or ulcer with clear, smooth edges and a shiny bluish-red bottom, painless and non-inflamed. The chancre does not increase in size, has scanty serous contents or is covered with a film or crust; a dense, painless infiltrate is felt at its base. Hard chancre does not respond to local antiseptic therapy.

Chancre can be located on any part of the skin and mucous membranes ( anal area, oral cavity - lips, corners of the mouth, tonsils; mammary gland, lower abdomen, fingers), but most often located on the genitals. Usually in men - on the head, foreskin and shaft of the penis, inside the urethra; in women - on the labia, perineum, vagina, cervix. The size of the chancre is about 1 cm, but can be dwarf - the size of a poppy seed and gigantic (d = 4-5 cm). Chancres can be multiple, in the case of numerous small lesions of the skin and mucous membranes at the time of infection, sometimes bipolar (on the penis and lips). When a chancre appears on the tonsils, a condition resembling a sore throat occurs, in which the temperature does not rise and the throat almost does not hurt. The painlessness of chancre allows patients not to notice it and not attach any importance. The slit-like chancre in the fold is painful anus, and chancre - panaritium on the nail phalanx of the fingers. During the period of primary syphilis, complications (balanitis, gangrenization, phimosis) may occur as a result of the attachment secondary infection. Uncomplicated chancre, depending on the size, heals after 1.5 - 2 months, sometimes before signs of secondary syphilis appear.

5-7 days after the onset of chancre, uneven enlargement and thickening of the lymph nodes closest to it (usually inguinal) develops. It can be unilateral or bilateral; the nodes are not inflamed, painless, have an ovoid shape and can reach the size of a chicken egg. Towards the end of the period of primary syphilis, specific polyadenitis develops - an enlargement of most subcutaneous lymph nodes. Patients may experience malaise, headache, insomnia, fever, arthralgia, muscle pain, neurotic and depressive disorders. This is associated with syphilitic septicemia - the spread of the causative agent of syphilis through the circulatory and lymphatic system from the lesion throughout the body. In some cases, this process occurs without fever or malaise, and the patient does not notice the transition from the primary stage of syphilis to the secondary stage.

Secondary syphilis

Secondary syphilis begins 2-4 months after infection and can last from 2 to 5 years. Characterized by generalization of infection. At this stage, all systems and organs of the patient are affected: joints, bones, nervous system, hematopoietic organs, digestion, vision, hearing. The clinical symptom of secondary syphilis is rashes on the skin and mucous membranes, which are widespread (secondary syphilides). The rash may be accompanied by body aches, headache, fever and may feel like a cold.

The rash appears in paroxysms: after lasting 1.5 - 2 months, it disappears without treatment (secondary latent syphilis), then appears again. The first rash is characterized by abundance and brightness of color (secondary fresh syphilis), subsequent repeated rashes are paler in color, less abundant, but larger in size and prone to merging (secondary recurrent syphilis). Relapse rate and duration latent periods secondary syphilis are different and depend on the body’s immunological reactions in response to the proliferation of pale spirochetes.

Syphilides of the secondary period disappear without scars and have a variety of forms - roseola, papules, pustules.

Syphilitic roseolas are small round spots of pink (pale pink) color that do not rise above the surface of the skin and mucosal epithelium, which do not peel and do not cause itching; when pressed on, they turn pale and disappear for a short time. Roseola rash with secondary syphilis is observed in 75-80% of patients. The formation of roseola is caused by disturbances in the blood vessels; they are located throughout the body, mainly on the torso and limbs, in the face - most often on the forehead.

A papular rash is a rounded nodular formation protruding above the surface of the skin, bright pink in color with a bluish tint. Papules are located on the body and do not cause any subjective sensations. However, when pressing on them with a button probe, sharp pain. With syphilis, a rash of papules with greasy scales along the edge of the forehead forms the so-called “crown of Venus.”

Syphilitic papules can grow, merge with each other and form plaques, becoming wet. Weeping erosive papules are especially contagious, and syphilis at this stage can easily be transmitted not only through sexual contact, but also through handshakes, kisses, and the use of common household items. Pustular (pustular) rashes with syphilis are similar to acne or chicken rash, covered with crust or scales. Usually occur in patients with reduced immunity.

The malignant course of syphilis can develop in weakened patients, as well as in drug addicts, alcoholics, and HIV-infected people. Malignant syphilis is characterized by ulceration of papulopustular syphilides, continuous relapses, impaired general condition, fever, intoxication, and weight loss.

Patients with secondary syphilis may experience syphilitic (erythematous) tonsillitis (severe redness of the tonsils, with whitish spots, not accompanied by malaise and fever), syphilitic seizures in the corners of the lips, and oral syphilis. Observed general lung an illness that may resemble the symptoms of a common cold. Characteristic of secondary syphilis is generalized lymphadenitis without signs of inflammation and pain.

During the period of secondary syphilis, disturbances in skin pigmentation (leukoderma) and hair loss (alopecia) occur. Syphilitic leukoderma manifests itself in loss of pigmentation various areas skin on the neck, chest, abdomen, back, lower back, and armpits. On the neck, more often in women, a “Venus necklace” may appear, consisting of small (3-10 mm) discolored spots surrounded by darker areas of skin. It can exist without change for a long time (several months or even years), despite antisyphilitic treatment. The development of leukoderma is associated with syphilitic damage to the nervous system; upon examination, pathological changes in the cerebrospinal fluid.

Hair loss is not accompanied by itching or flaking; its nature is:

• diffuse - hair loss is typical of normal baldness, occurring on the scalp, in the temporal and parietal regions;
• small-focal - clear symptom syphilis, hair loss or thinning in small patches located randomly on the head, eyelashes, eyebrows, mustache and beard;
• mixed - both diffuse and small-focal are found.

With timely treatment of syphilis, the hairline is completely restored.

Skin manifestations of secondary syphilis accompany lesions of the central nervous system, bones and joints, and internal organs.

Tertiary syphilis

If a patient with syphilis was not treated or the treatment was incomplete, then several years after infection he develops symptoms of tertiary syphilis. Happening serious violations organs and systems, the patient’s appearance is disfigured, he becomes disabled, and in severe cases death is likely. Recently, the incidence of tertiary syphilis has decreased due to its treatment with penicillin, and severe forms of disability have become rare.

There are tertiary active (if there are manifestations) and tertiary latent syphilis. Manifestations of tertiary syphilis are a few infiltrates (tubercles and gummas), prone to decay, and destructive changes in organs and tissues. Infiltrates on the skin and mucous membranes develop without changing the general condition of patients; they contain very few pale spirochetes and are practically not infectious.

Tubercles and gummas on the mucous membranes of the soft and hard palate, larynx, and nose ulcerate and lead to disorders of swallowing, speech, breathing (perforation of the hard palate, “failure” of the nose). Gummy syphilides, spreading to bones and joints, blood vessels, internal organs, cause bleeding, perforation, scar deformities, disrupt their functions, which can lead to death.

All stages of syphilis cause numerous progressive lesions of internal organs and the nervous system, the most severe form of which develops with tertiary (late) syphilis:

• neurosyphilis (meningitis, meningovasculitis, syphilitic neuritis, neuralgia, paresis, epileptic seizures, tabes dorsalis and parenchymal keratitis, Hutchinson's teeth.

  Diagnosis of syphilis

  Diagnostic measures for syphilis include a thorough examination of the patient, taking an anamnesis and conducting clinical studies:

  1. Detection and identification of the causative agent of syphilis by microscopy of serous discharge from skin rashes. But in the absence of signs on the skin and mucous membranes and in the presence of a “dry” rash, the use of this method is impossible.
  2. Serological reactions (nonspecific, specific) are performed with serum, blood plasma and cerebrospinal fluid - the most reliable method diagnosis of syphilis.

  Nonspecific serological reactions are: RPR - rapid plasma reagin reaction and RW - Wasserman reaction (compliment binding reaction). Allows the determination of antibodies to spirochete pallidum - reagins. Used for mass examinations (in clinics, hospitals). Sometimes they give false positive result(positive in the absence of syphilis), therefore this result is confirmed by carrying out specific reactions.

  Specific serological reactions include: RIF - immunofluorescence reaction, RPHA - passive hemagglutination reaction, RIBT - immobilization reaction of treponemal pallidum, RW with treponemal antigen. Used to determine species-specific antibodies. RIF and RPGA are highly sensitive tests that become positive at the end of the incubation period. Used in the diagnosis of latent syphilis and to recognize false-positive reactions.

  Positive indicators serological reactions become only at the end of the second week of the primary period, therefore the primary period of syphilis is divided into two stages: seronegative and seropositive.

  Nonspecific serological reactions are used to assess the effectiveness of treatment. Specific serological reactions in a patient who has had syphilis remain positive for life; they are not used to test the effectiveness of treatment.

  Treatment of syphilis

  Treatment for syphilis begins after a reliable diagnosis is made, which is confirmed by laboratory tests. Treatment of syphilis is selected individually, carried out comprehensively, recovery must be determined in a laboratory. Modern methods of treating syphilis, which venereology has today, allow us to talk about a favorable prognosis for treatment, subject to correct and timely therapy that corresponds to the stage and clinical manifestations of the disease. But only a venereologist can choose a therapy that is rational and sufficient in terms of volume and time. Self-medication of syphilis is unacceptable! Untreated syphilis becomes latent, chronic form, and the patient remains epidemiologically dangerous.

  The treatment of syphilis is based on the use of penicillin antibiotics, to which the pale spirochete is highly sensitive. At allergic reactions patient on penicillin derivatives, erythromycin, tetracyclines, and cephalosporins are recommended as an alternative. In cases of late syphilis, iodine, bismuth, immunotherapy, biogenic stimulants, physical therapy.

  It is important to establish sexual contacts of a patient with syphilis, and be sure to carry out preventive treatment of possibly infected sexual partners. At the end of treatment, all previously patients with syphilis remain on dispensary observation from a doctor until the result of a complex of serological reactions is completely negative.

  In order to prevent syphilis, examinations of donors, pregnant women, children's workers, food and medical institutions, patients in hospitals; representatives of risk groups (drug addicts, prostitutes, homeless people). Blood donated by donors must be tested for syphilis and canned.

Treponema pallidum is the bacterium that causes the sexually transmitted disease syphilis. It is a microorganism in the shape of a spiral. Thanks to this shape, it is classified as a spirochete - a spiral-shaped bacteria.

Spirochetes are a group of bacteria that are very similar to each other. Among them are pathogenic bacteria, and harmless. In addition to the causative agent of syphilis, these also include the causative agents of leptospirosis, relapsing fever, borreliosis, as well as opportunistic (harmless) bacteria that live on human skin, in the genital tract and mucous membranes oral cavity.

What does a pale spirochete look like?

Treponema pallidum has a small size (a quarter of a micrometer), a thread-like spirally twisted shape and pointed ends. In general, it is very similar to other spirochetes. It can be distinguished by the number of curls (on average, from 7 to 14), as well as by its characteristic movements: it rotates around its axis, bends, and makes translational and wave-like movements. The length varies from 6 to 10 micrometers, the diameter of the curls is about a quarter of a millimeter.

In the photo and under a microscope it looks like a delicate thread-like formation, almost transparent in color. The bacterium is not stained with any dye, which is why in microbiology it is called “pale”. In microbiology, this type of bacteria is called gram-negative. To see it, they look at it dark background by shining light on the bacterium. The rays refracted by it reflect light and allow you to see the bacterium. This is quite difficult, since, in addition to the fact that the bacterium is transparent, it moves quickly and is difficult to catch.

It is extremely difficult to cultivate the causative agent of syphilis on artificial nutrient media.

If conditions are favorable, then the proliferation of pale spirochetes occurs every 33 hours: the bacterium is divided transversely into several curls, each of which contains all the structures of a full-fledged bacterium.

Spirochetes consist of parts that are standard for bacteria:

1. kernel with included DNA- stretches along the entire length of Treponema pallidum
2. cytoplasm (protoplasmic cylinder), which contains the main functional elements of the microbe. First of all, it ensures protein synthesis (in ribosomes) and produces energy (in mesosomes)
3. cytoplasmic membrane - transports nutrients from the outside, participates in cell division and in the transformation of unfavorable conditions (more on this later), plus serves as a warehouse for enzymes and antigens
4. microcapsule is an outer cell wall that protects the spirochete from the external environment, primarily from phagocytes and antibodies.

At the ends of the bacterium there are flagella, with the help of which it moves. Thanks to them, treponema pallidum is very mobile. How mobile she is can be seen from this video:

“Sweet Life”, or ideal living conditions

Treponema pallidum loves warmth, moisture and the absence of oxygen. Entering the body (usually sexually), the bacterium, like a corkscrew, is screwed inside through the mucous membrane or damaged skin and reaches the nearest lymphatic vessels and lymph nodes. Lymphatic system- this is paradise for her. The optimal temperature (37⁰) and the absence of oxygen makes this system its favorite habitat. Over time, it spreads throughout the lymph system, and during periods of greatest activity, it even enters the blood. This is usually accompanied by symptoms of secondary syphilis - the appearance of a rash spread over the entire surface of the body. During the primary and secondary periods, treponema can also be found in semen, cervical secretions, saliva, and skin rashes.

Surprisingly, treponema is difficult to tolerate vaginal secretions and rarely settles on the walls of the vagina. This is explained by the bacteria’s love for a neutral environment (pH 7.4). The acidic environment of the vagina immobilizes the bacteria and partially neutralizes it. Unfortunately, this is not enough to protect against infection, and the bacteria can easily settle on the cervix or at the entrance to the vagina.

While in the body, the causative agents of syphilis can survive, even if the bacterium is captured and tried to digest by a leukocyte or macrophage - the body's main protective cells. This property allows Treponema pallidum to resist nonspecific immunity(that is, specializing not on a specific pathogen, but aimed at enemies in general).

Treponema in difficult conditions. Survival tactics

If the body creates unfavourable conditions for the life of a bacterium (for example, if a person starts taking antibiotics), then it can change its form to another, more adapted to survival. There are two such forms: cystic and -form.

Even in these protective forms It is quite possible for treponema to penetrate the body and infect a person with syphilis. At the same time, in the -form it becomes even easier for the microbe to do this; in this form, it better penetrates barriers - the skin and mucous membranes, including those treated with antiseptics. If the infection occurs with the cyst form, then an extension of the incubation period, latent syphilis, and the development of drug resistance are more likely.

As syphilis progresses, the ratio between the different forms of Treponema pallidum present in the body changes.

1. On early stages Standard spiral shapes predominate. They have not yet penetrated the body's cells, are actively dividing and are more vulnerable to antibiotics.
2. In secondary recurrent syphilis it is already observed a large number of cyst forms. Microbes caught by phagocytes penetrated inside them. Treatment is less effective.
3. With late syphilis, there are noticeably fewer standard forms; protective ones predominate. Total Treponema is reduced.

In order to avoid a recurrent (persistent, periodically manifested) course of syphilis, it is important to start treatment as early as possible and only (!) under the supervision of a doctor

Treponema outside the body. How long will he live?

Treponema pallidum does not like the external environment. On a dry surface and when dried, the bacterium dies almost instantly. In a humid environment and water it lasts much longer: wet wipes, handkerchiefs, underwear - it can survive for several days. When washing clothes (at a temperature of 60⁰), Treponema pallidum is neutralized within five to twenty minutes, and when boiled, within a few seconds. Treponema tolerates cold somewhat easier. In the refrigerator, at 0⁰, it can live up to two days. In medicine, there have even been cases of syphilis infection from corpses that had lain for some time in refrigerators.

Also, the bacterium does not like acidic and alkaline environment. It dies instantly when used laundry soap and 0.5% solutions of alkalis and acids.

What can kill Treponema?

The bacterium is sensitive to the action of many antiseptic solutions. It instantly dies when treated with a 0.05% solution of chlorhexidine, 0.001% solution of sublimate, 1-2% solution of phenol and already 70% alcohol.

Vodka (40% alcohol) kills the causative agent of syphilis less effectively: to completely kill them, they must be kept in it for up to 20 minutes. Also, potassium permanganate is ineffective against treponema pallidum: it is not used at all to neutralize treponema pallidum.

To neutralize treponemas that have already penetrated the body, antibiotics are used: penicillins, cephalosporins, tetracyclines and macrolides. Penicillins are the main drugs used to treat syphilis primarily. The remaining antibiotics are reserve drugs: they are less effective and are used only in cases of intolerance or ineffectiveness of penicillins.

How is treponema pallidum found in the body?

The first test to clearly identify the pathogen and diagnose syphilis was invented by August Wasserman in 1906. Before this, people were guided solely by symptoms.

Treponema is a genus of bacteria that includes numerous species, of which the most common is the causative agent of syphilis - treponema pallidum (treponema pallidum, treponema pallidum). This genus also includes the pathogens of yaws and pinta. Treponema pallidum is a spiral-shaped bacterium of the family Spirochaetiaceae (spirochetes) that causes the infectious sexually transmitted disease -. The pathology has an undulating course and is manifested by a characteristic clinic. Infection occurs primarily through sexual contact, making syphilis an STI.

Currently, a huge number of sexually transmitted diseases are being registered in the world, which pose a real threat to human life. Treponema pallidum - dangerous microbe, causing a systemic disease affecting the skin and internal organs. At the site of spirochete introduction, a primary pathological focus is formed -. Then syphilitic rashes appear on the skin, and regional lymph nodes become enlarged. In the absence of adequate therapy, internal organs are affected, irreversible changes develop, and death is possible.

Treponema pallidum

Morphology

Treponema pallidum is a gram-negative microorganism that has the shape of a thin spiral twisted into 8-12 small curls. Treponema pallidum received its name due to its ability to not perceive conventional laboratory dyes.

The spirochete is a strict anaerobe that grows well in oxygen-free environments. But despite this, the viability of bacteria remains on surrounding household objects for 3 or more days. Treponema has flagella and fibrils. Thanks to them and the cell’s own contractions, the bacterium makes translational, rotational, flexion, wave-like, helical and contractile movements. It quickly penetrates living cells and rapidly multiplies in them by transverse division.

Treponema pallidum has three layers cell wall, cytoplasm and organelles: ribosomes, mesosomes, vacuoles. Ribosomes synthesize proteins, and mesosomes provide respiration and metabolism. Enzymes and antigens are contained in the cytoplasmic membrane. The body of the bacterium is covered with a mucous, structureless capsule that performs a protective function.

Physical properties

Microbes are resistant to low temperatures and sensitive to high temperatures. When heated they die within 20 minutes, when dried within 15 minutes, and when boiled - instantly. Antiseptics and disinfectants quickly destroy Treponema pallidum. The following have a detrimental effect on the bacterium: ultraviolet radiation, light, alcohol, alkalis, vinegar, arsenic, mercury, and chlorine-containing disinfectants. Treponema pallidum is resistant to some antibiotics.

Treponema pallidum exhibits its pathogenic properties in a humid and warm environment. In the human body favorite place reproduction are lymph nodes. At the stage of secondary syphilis, microbes concentrate in the blood and exhibit their pathogenic properties.

Cultural properties

Treponema pallidum does not grow on artificial nutrient media, in cell culture or in chicken embryos. It is cultured in rabbit testicles. In these cells, the microbe grows and multiplies well, fully retaining its properties and causing orchitis in the animal.

There are enriched nutrient media designed to isolate pure culture. Microbes grow on them under a thick layer of petroleum jelly. In this way, antibodies necessary for staging specific reactions to syphilis are obtained.

Treponemas grow on blood or serum agar in an oxygen-free environment. At the same time, they lose their pathogenic properties, but retain their antigenic properties. Pathogenic treponemes are able to ferment mannitol, utilize lactate and form specific metabolites.

Pathogenicity

Factors and components of pathogenicity and virulence of bacteria include:

1. Adhesin proteins that ensure fixation of the microbe on the host cell,
2. Myofibrils, which promote deep penetration into the body and migration of bacteria in the host body,
3. Formation of L-forms,
4. Lipopolysaccharides of the outer membrane,
5. Fragments of pathogenic cells penetrating deep into tissues
6. The ability to penetrate into the intercellular junctions of the endothelium,
7. Antigenic variability.

Treponema pallidum has a direct toxic effect on the synthesis of macromolecules - DNA, RNA and proteins. T. pallidum antigens are used in the Wassermann reaction for the serodiagnosis of syphilis. Under unfavorable conditions, the spirochete is transformed into L-forms, which ensure its resistance to antibacterial agents and antibodies.

Epidemiology

Syphilis is a severe anthroponosis. The infection persists only in the human body, which is its natural reservoir in nature. The entrance gates of infection are: damaged squamous or columnar epithelium of the oral cavity or genital organs.

The spread of infectious agents occurs:

• Sexually during sexual intercourse through semen,
• In everyday life through underwear, hygiene products, cosmetics, by kissing,
• Vertically from an infected mother to a child during childbirth, as well as through milk during breastfeeding,
• Transplacentally in late pregnancy,
• Hematogenously through direct blood transfusion, during operations, when using a shared syringe among drug addicts.

The risk of infection is increased in medical workers- dentists, cosmetologists. Infection occurs during medical procedures and procedures that damage the skin. Individuals who engage in disorderly behavior become infected with treponema pallidum. sex life having multiple sexual partners, neglecting barrier methods contraception. In order for infection to occur, the patient must have a lot of bacteria in the secretion, and the partner must have damage to the mucous membrane.

first manifestations of the disease

The patient is most contagious during periods of primary and secondary syphilis, when the first signs of the disease appear on the skin and mucous membranes of the genital organs. At this time in environment many spirochetes are released.

Currently registering big number patients with extragenital chancre located on the mucous membrane of the mouth, pharynx, and anus. Their rashes are localized on the face, syphilides - on the palms and soles. The tertiary period of syphilis has recently developed in a very in rare cases and is practically asymptomatic.

Symptoms

Incubation is characterized by the migration of bacteria through the lymphatic and blood vessels and their active reproduction in the lymph nodes. The duration of the period is from 3 weeks to 3 months.

Congenital syphilis develops as a result intrauterine infection fetus This severe pathology is manifested by a characteristic triad of symptoms in a child: congenital deafness, keratitis, Hutchinson teeth.

Diagnostics

Diagnosis of syphilis includes interviewing and examining the patient, collecting anamnestic information, as well as clinical trials, which play an important role in detecting treponema pallidum and making a diagnosis.

• Microscopic examination of biomaterial. Bacterioscopy of a chancre smear or a lymph node biopsy is carried out in the first 4 weeks of the disease. To obtain a high-quality smear, the surface of the erosion and ulcer is treated with saline, scraped, and a preparation for microscopy is prepared from the resulting material. The smear is stained according to Romanovsky-Giemsa. Treponema has a pale pink color. Living microbes in an unstained and unfixed smear are not visible under a light microscope. To detect them, dark-field or phase-contrast microscopy is used. To conduct dark-field microscopy, material is taken from a syphilitic ulcer and examined in a special apparatus. The bacterium has the ability to refract light: in a microscope it looks like a white spiral strip. Fluorescent microscopy is also used to detect treponemes in various clinical materials.

Treatment

A dermatovenerologist treats syphilis. He selects therapy individually, taking into account the stage, clinical picture of the disease and the characteristics of the patient. Complex treatment promotes complete recovery, which must be confirmed by laboratory tests.

Treatment of syphilis is etiotropic, aimed at destroying the pathogen - treponema pallidum. Patients are prescribed large doses of antibiotics to which the microbe is sensitive. Typically used are penicillins “Benzylpenicillin”, tetracyclines “Doxycycline”, macrolides “Clarithromycin”, “Sumamed”, cephalosporins “Cefazolin”, fluoroquinolones “Ciprofloxacin”. Antibacterial therapy is continued for 2 months. Pregnant women are also treated.

Immunostimulation, vitamin therapy, and physiotherapy complement etiotropic treatment and help patients recover from illness. Preventive therapy is carried out to the sexual partner and persons in contact with the patient.

Video: dermatovenerologist on the treatment of syphilis

Prevention

Preventive measures include maintaining personal hygiene, using separate linen and dishes, and individual cosmetics. It is recommended that immediately after unprotected sexual intercourse, treat the genitals or other parts of the body with which contact occurred with a solution of chlorhexidine or albucid. These products must be kept in your home medicine cabinet.

For preventive purposes, the following are examined:

1. Donors,
2. Pregnant women,
3. Workers of kindergartens, schools, catering and medical institutions,
4. Patients admitted for inpatient treatment.

Modern antimicrobial therapy allows you to get rid of the pathology and makes the prognosis of the disease favorable. Only a dermatovenerologist will be able to select the correct and sufficient treatment appropriate to the stage of the disease. Self-medication of syphilis is strictly prohibited. An incompletely cured pathology can become chronic. Such a patient is dangerous to others.

Syphilis is a social disease, the treatment of which must be approached seriously and responsibly.

Video: syphilis in the Health program

The content of the article

Treponema pallidum

Morphology and physiology

Pathogenicity and pathogenesis

Immunity

Ecology and epidemiology

Syphilis and other treponematoses

Bacterioscopic examination

Serological diagnosis of syphilis

Precipitation microreaction

Immunofluorescence reaction (RIF)

Treponema pallidum immobilization reaction (PIT)

Enzyme-linked immunosorbent assay (ELISA)