What affects syphilis? Syphilis: signs, manifestations of all stages, diagnosis, how to treat. What is dangerous about syphilis: complications and death

The bacterial causative agent of syphilis - treponema pallidum- got its name due to the fact that when the material is painted with special dyes, it is not visible under a light microscope. It looks like a thread twisted into a spiral. Outside the body it quickly dies when it dries out. High temperatures and disinfectants are also destructive to the bacterium, but it tolerates cold very well.

Infection occurs in a large number of cases during unprotected sexual intercourse, when there are open foci of infection in the area of ​​contact. Recently, there has been an increase in cases of infection through the oral route. Also, the microorganism can enter directly into the blood (transfusion from an infected person, syringes used repeatedly by drug addicts). There are frequent cases of infection during pregnancy, when the disease passes from mother to child. The domestic route of infection is unlikely - Treponema pallidum quickly dies outside the human body. However, transmission of infection is possible through close, prolonged contact with a patient, when pale treponema from the affected areas gets onto towels or dishes.

There are also forms of congenital syphilis.

What happens when infected?

After 3-4 weeks, a chancre appears at the site of entry of the pathogen - a painless, bright red ulcer with a dense base. It heals after some time, which does not mean the death of the infection. On the contrary, at the same time, active reproduction of Treponema pallidum occurs and its movement throughout the body through the lymphatic vessels. A sick person may feel a headache, fever, and general malaise, but most often during this period there are almost no symptoms of the disease.

Later, syphilis manifests itself with small ulcers on the palms, a rash on the skin, mucous membranes and soles. If the disease is left to chance, it can flare up and fade over the course of several years, and rashes can appear and then disappear without a trace. The person feels healthy. With distance from the onset of the disease, quiet intervals become longer. People who are not familiar with the characteristics of syphilis even think that they will fully recover. However, such well-being is imaginary, since pathogens are already present in all tissues and organs and begin to affect them.

Causes

The causative agent of the disease is a bacterial microorganism, Treponemapallidum (treponema pallidum). It enters the human body through microcracks, abrasions, wounds, ulcerations, from the lymph nodes it enters the general bloodstream, affecting mucous surfaces, skin, internal organs, the nervous system, and the skeleton. The bacterium multiplies quickly, dividing every 33 hours; it is on this time period that the treatment of syphilis is based.

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

Classification

The classification of the stages of syphilis is based on the first treatment method, i.e. This is the stage of the disease at which the patient first noticed the first symptoms of syphilis and sought medical help.

Stages of syphilis:

• Primary gray-negative is characterized by the formation of a specific wound - a chancre, a non-painful, round ulceration with definite boundaries and a depression in the middle. It mainly affects the external genitalia, however, it can also be localized in other places on the skin, mucous surfaces, and internal organs. Appears 3-6 weeks from the moment of infection and disappears after the same period of time after occurrence.
• Primary sero-positive - positive seroreactions are detected.
• Primary hidden occurs without a standard clinical picture.
• Secondary fresh appears 4-10 days after the appearance of ulceration, i.e. From the onset of the disease, 2 to 4 months pass. Symptoms of syphilis at this station - characteristic rashes on the skin and mucous membranes. The patient feels weakness, malaise, headaches, and fever. Clinical tests reveal positive seroreactions, accelerated ROE, anemia, etc. in human blood. Damage to internal organs is noted: digestive tract, of cardio-vascular system, lungs.
• Secondary relapse. Appears after a period of relative calm. The first symptoms of syphilis at this stage are reappearance rash merging into continuous foci, formation of papules. Each relapse can last up to several months. But in general this form The disease manifests itself for up to three years.
• A secondary latent form, in which the symptoms characteristic of syphilis are not observed, and can only be determined using clinical tests. A patient with a latent form of the disease is highly contagious.
• The tertiary active stage is extremely rare today. Appears in individuals who have not received treatment or have been insufficiently treated. Occurs in a time period from 3 to 10 years after the onset of the disease (cases of recording durations up to 60 years after the alleged contact infection have been described!) It is characterized by severe forms of diseases of the internal organs, meninges and nervous system, skeletal bones and articular cartilage. The surface of the epidermis is affected by cicatricial atrophies, and peculiar gummas are formed. This stage may be fatal to the patient.
• The tertiary latent stage proceeds latently, without typical clinical manifestations.
• The latent form of the disease is asymptomatic, but tests for syphilis are positive. This group also includes patients whose treatment was started with an unknown form of the disease.
• Early congenital form transmitted to the fetus in utero through the blood of a sick mother. Usually such children are not viable, but if the child survives, he has numerous disorders of all functional systems. Such children are developmentally delayed, weakened and often get sick.
• The late congenital stage practically does not manifest itself until the age of 15-16 years, followed by symptoms of tertiary syphilis.
• Hidden congenital, which includes all categories of children’s ages.

What are the symptoms of syphilis?

The symptomatic picture of syphilis is multivariate and depends on the nature of the disease and its form. There are three phases of the disease that determine the symptoms and treatment of syphilis:

Primary:

The first symptom of the disease is the appearance of a hard chancre, which is mainly localized on the genitals or has another location. A hard chancre is a dense round ulcer with a diameter of up to 20 mm. It does not bleed, has no purulent discharge and is absolutely painless. A week after the chancre appears, the patient’s lymph nodes begin to enlarge near the affected area. The difficulty of diagnosing syphilis at this stage lies in the absence of pronounced symptoms. In addition, there is a possibility of infection of the ulcer, when swelling and redness appear around the chancre, and pus begins to be discharged. As a result correct positioning diagnosis may be difficult.

Spontaneous healing of ulceration (chancroid) over the next 3-6 weeks.

What signs are characteristic of the secondary form of the disease:

• Formation at 4-10 weeks after primary chancroid of a characteristic pale rash located symmetrically throughout the body.
• The patient's health deteriorates - headaches, general malaise, fever.
• Lymph nodes in and outside the affected area are enlarged.
• Characteristic scalloped hair loss or focal baldness involving eyebrows, eyelashes, hairy part heads.
• Wide beige condylomas appear on the skin and mucous membranes of the genital organs, in the anus area.
• Repeatability of this pattern of symptoms with intervals of bursts and absolute attenuation.

What are the symptoms of tertiary syphilis:

• The brain (both brain and spinal column), nervous and cardiovascular systems are affected.
• Bones, joints and internal organs are affected.
• Changed skin with visible scarring.
• Characteristic granulomas, gummas, bumps and bumps appear.

Diagnostics

Activities for diagnosing syphilis include studying anamnesis, examination and assessment of the general clinical picture, and conducting clinical blood tests. The main goal is to identify what symptoms are observed in the patient and confirm the presence of pathology. All diagnostic measures are divided into two groups: treponemal and nontreponemal.

Non-treponemal tests are carried out in mass studies; sometimes they can give a false positive result in the absence of disease. If such an answer is received, treponemal tests are additionally prescribed. They are also used to evaluate the success of treatment over time.

Treponemal tests to detect antibodies that remain in the body of a person cured of syphilis forever cannot be used to assess the effectiveness of treatment, but with their help they identify hidden forms of the disease.

Treatment of syphilis

After carrying out procedures that revealed the first signs of syphilis and establishing a diagnosis, an adequate treatment protocol is prescribed, which can be quite long - from 2-4 months, and in in some cases advanced disease - more than two years. Depending on general condition The patient is treated in a hospital, rarely on an outpatient basis. For the entire time, until complete recovery, confirmed by clinical tests, sexual activity is prohibited. In addition, examinations and preventive treatment All members of the patient's family are examined.

Antibiotic therapy is the only effective method in the treatment of syphilis, since Treponema pallidum is highly sensitive to penicillin drugs, which are most effective in combating the microorganism. Water-soluble penicillins are injected into the patient’s body for 24 days every three hours. inpatient conditions- this is the most effective method.

If there is an allergy to penicillin, the patient is prescribed antibiotics from a number of cephalosporins or macrolides - in tablets or intramuscularly. Active forms diseases are treated in an inpatient setting, latent diseases are treated through outpatient therapy. The duration of treatment is determined by the stage of the disease and can reach several years.

It is necessary to treat syphilis with simultaneous support of the body’s internal reserves, which is carried out with the help of immunostimulating complexes, vitamins, etc.

It is very important to inform all sexual partners about the presence of the disease and convince them to undergo the necessary tests, even in the absence of symptoms - such a course of the pathology does not reduce the risk of complications. If the patient is cured, but his sexual partner is not, re-infection is very likely.

Complications

On different stages symptoms and treatment of syphilis can give a multiple picture of complications, which is due to the stage of the disease.

The primary period is characterized by:

• Examination of all pregnant women, passing tests for serological reactions three times in order to avoid cases of congenital syphilis.
• Mandatory preventive treatment for pregnant women who were previously registered, but were removed from it after treatment.
• Regular examinations for those at risk (drug addicts, prostitutes).
• Everyone who has had close contact with the sick person should definitely be examined, including family members.
• Hospitalization of persons with a positive reaction, after treatment - dispensary observation.

Prevention and prognosis for recovery

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

Public prevention should be carried out in accordance with general rules fight against sexually transmitted diseases. The components of such prevention are mandatory registration of all patients, examination of his family members and people who were in close contact with him, hospitalization of the infected and monitoring them over the next few months, constant dispensary monitoring of the treatment of sick patients.

The prognosis for clinical cure of early stages of syphilis is favorable. The earlier the disease is diagnosed and treated, the more favorable the prognosis.

On late stages With the help of treatment, it is possible to significantly improve the patient's condition.

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Syphilism is one of the most common sexually transmitted diseases (STDs). The causative agent of the disease is the bacterium Treponema pallidum. Modern medicine can easily cope with this disease, but if the patient is not treated, then he will face a slow and painful death with large spectrum symptoms.

According to 2014 data, 26 people per 100 thousand population of our country are sick with syphilis. The incidence of sexually transmitted diseases is decreasing at a slow pace, so the government is educating the population about STDs. Awareness about STD prevention helps to avoid serious health problems for both young people and adults.

Syphilitic infection symptoms

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person is unaware of the infection, as he has no signs of illness. Even most tests cannot detect the disease at this stage. Eat high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of his actions.
The first signs of the disease appear after the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (cutaneous syphilides) and on the mucous membranes - chancre in the mouth, on the genitals, rash on the mucous membranes (syphilides of the mucous membranes).

Symptoms of syphilitic infection in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). A hard chancre forms where the bacterium enters. Its appearance indicates the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of Treponema pallidum. It is localized in the mouth, in the area of ​​the external and internal genital organs, and in the anus.

A chancre is a round inflammatory growth with a flat base. In the initial stages of its appearance there is practically no pain. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre on visible parts of the body and on mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a chancre. Ulcers often form on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, and in the anus. The symptoms and course of the disease are practically no different in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest in women?

• The primary stage of sifak in women begins with the detection of hard chancre on the skin or mucous membranes. At the initial stage, this does not cause serious discomfort. Then a gradual inflammation of the chancre occurs, it takes on a red or bluish color, characteristic of a severe inflammatory process.
• During the first week after the first symptoms appear, women begin to experience inflammation of the lymph nodes and vessels near the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of balls, forming significant edema and swelling around the chancre. If the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, making it difficult to swallow and breathe. Symptoms cause significant distress when verbal communication and eating. Scleradenitis in the genital area makes walking and defecation difficult.

Photo: Jarun Ontakrai/Shutterstock.com

The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern diagnostic methods make it possible to detect syphilism immediately after the first symptoms appear. The most commonly used are enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist at a clinic or a venereologist at a dermatovenereal dispensary. average cost analysis costs 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will not show anything other than a seronegative reaction, indicating the absence of Treponema pallidum in the body.

Symptoms of secondary syphilis

• The skin around the chancre becomes covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and unite into large areas on the skin and mucous surfaces, causing the patient severe discomfort. There are three types of syphilitic rash.
  Roseola rash - pink or red spots with clear or blurred boundaries 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
  Papular rash - small conical growths Pink colour. May peel off at the top of the cone. This kind of cheese looks extremely unpleasant.
  Pustular rash - growths with purulent cavities.
• Along with the appearance of a rash, damage to the nervous system may begin. Degradation nerve tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, treatment of the disease will not lead to the restoration of lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
• Signs of partial or complete baldness appear. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, becomes thinner, and thins out. Then the hair thinning intensifies and large bald patches of skin appear. After recovery from syphilis, hair growth does not renew.

Stages of syphilis

Nowadays, every person infected with Treponema pallidum can quickly and efficiently receive adequate and effective treatment. Only a few go through all stages of syphilis. Without treatment, a person lives in terrible agony for 10 or even 20 years, after which he dies.
Below is a brief description of the stages of syphilis.
Incubation stage

Stage of primary syphilis

Stage of secondary syphilis. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Stage of tertiary syphilis. It is divided into three stages of the disease. In the absence of adequate treatment, the order will be as follows:

Neurosyphilis begins towards the end of secondary syphilis. Usually manifests itself in the form of the following diagnoses:

• Asymptomatic neurosyphilis – in which there are no painful manifestations yet, but tests already show inflammation and infection of the cerebrospinal fluid. This stage of neurosyphilis usually begins a year and a half after infection.
• Gummy neurosyphilis - accompanied by the formation of gummas inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, and causes an increase in pressure inside the patient’s skull.
• Syphilitic meningitis is a lesion of the membranes of the brain at the base and in the area of ​​the cranial vault. Accompanied by severe symptoms, including disturbances of attention, thinking, memory, and the emotional sphere of a person.
• Meningovascular form of neurosyphilis - destroys the blood vessels of the brain, accompanied by chronic meningitis. In the absence of therapy, it leads to headaches, personality changes, behavior changes, sleep is disturbed, and convulsions begin. This ultimately leads to strokes.
• Taste dorsalis is a disorder of the nerve fibers of the spinal cord, their thinning and dysfunction. This leads to an irreversible impairment of the ability to move in space: the gait is bent, the patient may fall, losing the feeling of the ground under his feet. When you close your eyes, you lose orientation in space.
• Progressive paralysis - causes dysfunction of the central nervous system, accompanied by personality disorders, behavior dangerous to society, and all higher mental functions are degraded. A person turns into a madman and can easily end up in a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
• Atrophy optic nerve– degradation visual function. At first, the vision of only one eye deteriorates, but gradually the infection approaches the second optic nerve. Leads to complete blindness if left untreated. Changes in the visual apparatus are irreversible.
• Late visceral syphilis is degradation of tissues of internal organs. Mainly the cardiovascular system and liver are affected. Other organs are rarely affected. Patients complain of deterioration in health at the slightest exertion, and they develop systolic heart murmurs due to dilation of the aorta. When late visceral syphilis is localized in the heart, a heart attack can occur.
• Late syphilism of bones and joints - causes local expansion of bones and large joints. Accompanied by the formation of gumma on the bones.

Atypical syphilis

In addition to hard chancre, others, so-called, may also appear at the stage of primary syphilis. atypical chancre. That is why this variant of the development of the disease is called atypical syphilis. Atypical chancres are of the following types:

• Indurative edema.
  Looks like a change in color of the scrotum in men, the clitoris and labia in women. The color varies from scarlet to bluish in the center, turning pale at the edges of the swelling. Women are susceptible to this symptom more often than men. Usually the patient perceives indurative syphilitic edema as an infectious-inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the true cause of the edema. It can be distinguished from another infection by the absence of an inflammatory process in the blood and the presence of inflammation of the lymph nodes.
• Chancre felon.
  It may appear in people caring for patients with syphilis: medical personnel, relatives. The thumb, index and middle fingers are affected. This is a very painful attack. The skin pulls away from the fingers, revealing large areas of bleeding, similar to second-degree burns. Panaritium is also accompanied by swelling and inflammation of the fingers, which interfere with normal human functioning. Often appears together with chancre of the genital organs.
• Chancroid-amygdalitis.
  It manifests itself in the form of inflammation of one tonsil, and its surface is not disturbed and remains smooth. The oral cavity is subject to severe pain, and the swallowing process becomes difficult. The patient experiences a fever, as if he had a sore throat. The difference from a sore throat is that with amygdalitis, only one tonsil becomes inflamed.

Congenital syphilis

It is highly undesirable for a mother to suffer from illness during pregnancy. The fetus is exposed to Treponema pallidum, which leads to irreversible morphological consequences, disruption intrauterine development.
Medicine knows three main symptoms:

• • Parenchymal keratitis is a pathology of the external epithelium of internal organs and the eyeball. It manifests itself as severe redness and inflammation of the organ on the outside. Sometimes the inflammation penetrates a little deeper into the surface. After healing, scars remain and an eyesore may remain. The most common consequence for the eye is decreased visual acuity. Keratitis is accompanied by clouding visual perception, acute pain, lacrimation.
  • Deafness from birth. The causative agent of syphilis actively destroys the nerve tissue of the fetus during pregnancy. One option may be a pathology of the auditory nerve, which leads to irreversible deafness.
  • Congenital dental anomalies. Occur due to underdevelopment of tooth tissue during fetal development. This pathology called Hutchinson's teeth. The teeth grow in the shape of a screwdriver with a rounded notch on the cutting edge, and are set sparsely. Sometimes teeth are not completely covered with enamel. Which leads to their early destruction and unflattering appearance.

A child who has had intrauterine syphilis has poor health, even if the mother has successfully completed treatment. If adequate treatment is not followed, the child will have severe deformities and remain disabled for life. If a mother is infected with syphilis, breastfeeding the baby should be stopped immediately, since syphilis is transmitted through mother's milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for Treponema pallidum (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide to become pregnant.

The causative agent of syphilis

Treponema pallidum is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common venereal diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to quickly curing syphilis, and the way was also opened for them to invent methods early diagnosis diseases.

Properties of the pathogen

The bacterium was called pale due to the fact that for a long time scientists could not examine it with a microscope. The transparent color of treponema is difficult to stain in other colors for subsequent research. For staining, the Romanovsky-Gizma and silver impregnation methods are used, which make it possible to detect bacteria under a dark-field microscope for subsequent study.
It was possible to discover that in favorable conditions(this must only be a human or animal organism) Treponema pallidum divides every 30 hours. The weak point of Treponema pallidum is that it lives and reproduces only at a temperature of 37 °C. This explains the effectiveness of archaic methods of treating syphilis, when, by artificially increasing the patient’s body temperature to 41 °C with the help of malaria, some relief of the symptoms of the underlying disease occurred.
The length of the bacterium is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, its body forms curls in the form of a ball. At the same time, it constantly changes the shape and number of curls due to the ability of the Treponema pallidum cell to contract.

Incubation period

Entering the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Dividing at a rate of about once every 30 hours, it accumulates at the site of infection. There are no visible symptoms. After about a month, a hard chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of the immune system varies from patient to patient, which makes for a large variation in length. initial period infection. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases through sexual contact. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. Hard chancre forms where bacteria enter.

When caring for patients, infection is likely through contact with the patient's clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. This is one of the most painful symptoms in the stage of primary syphilis. Then hard chancre of the genital organs may appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when reusing a patient’s syringe, his razor, scissors, or utensils.

How to treat syphilis

Treatment should begin at the first signs of syphilis. This way the healing process will take place as quickly as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, drugs based on it are also used, since Treponema pallidum cannot adapt to this species antibiotics. Sufficient doses of penicillin effectively fight the disease. For the treatment of syphilis in patients with allergic reactions for penicillin, use erythromycin or tetracycline.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Pyrotherapy (artificial increase in body temperature) is added and intramuscular injection antibacterial drugs.

For tertiary syphilis, highly toxic bismuth-based drugs are used along with antibiotics. Treatment occurs strictly in a hospital with multi-level supportive therapy.

If a patient is diagnosed with primary syphilis, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the last trimester.
If secondary syphilis is diagnosed, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bedding and underwear, clothing, etc.
Hospitalization in the initial stages of syphilis is not required, it is enough outpatient treatment. Only when severe forms, starting from secondary stage, the patient is admitted to the hospital. Treatment of syphilis by compulsory medical insurance policy is free and anonymous.

It is highly not recommended to cope with the disease using folk remedies. Only well-designed treatment can defeat Treponema pallidum. Otherwise, there is a high probability of the disease progressing to more severe stages.

Which doctor treats sifak disease?

Since sifak is a disease transmitted primarily through sexual contact, treatment is carried out by a venereologist. The patient can contact a general practitioner and receive a referral to a venereologist. The option of direct contact with a skin and venereal disease clinic is possible.

After examination and receipt of test results, the patient is treated either by a venereologist himself, specializing in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

There is a syphilidologist in every major city at skin and venereal dispensaries. He can select the maximum effective dosages medications and develop a treatment program that must be strictly followed. In case of complications in men (when the head of the penis is pinched), syphilis is treated together with a urologist.
In case of complications in women (chancre in the vagina, on the cervix), you need to go to a gynecologist.

How long to treat syphilis

The duration of treatment for the disease is determined solely by the doctor. Depending on the stage of the disease, complications and general condition of the body, healing may take from two weeks to six months.

It is very important to know that under no circumstances should you interrupt the course of treatment. If treatment is not completed, the patient will soon experience a relapse. Therefore, treatment must be taken extremely seriously.

Syphilis– venereal infection, flowing in chronic form, which affects the skin, mucous membranes, bones, many internal organs, as well as the immune and nervous systems.

Other names for syphilis - Lues.

The main cause of syphilis is infection of the body with the bacterium Treponema pallidum (treponema pallidum).

The main symptoms of syphilis are painless ulcerations on the skin (chancres), a specific rash on the skin and mucous membranes, general malaise, and weakness.

How is syphilis transmitted? Syphilis infection occurs primarily through sexual contact. However, infection can also occur through blood, kisses, by everyday means or from mother to child (congenital disease).

Is there a cure for syphilis? Yes, modern medicine timely application see a doctor who knows how to treat this disease. Of course, if a person does not respond to the disease and does not seek help, there is a high probability of death with multiple severe health disorders.

Development of syphilis

The development of syphilis occurs during 4 periods (stages) - incubation, primary, secondary and tertiary. The pathogenesis of syphilis is based on the body’s immune response to the presence of infection and its waste products, which are toxins (poison).

Let's look at the stages of syphilis in more detail.

Stages of syphilis (periods)

Incubation period of syphilis(from the moment of infection to the appearance of the first signs of the disease) ranges from 7 days to 6 weeks, and even 6 months. The first signs of the disease usually appear in the place where the bacterium has entered the body of a healthy person. During incubation, Treponema pallidum rapidly increases its presence at the site of introduction. Prolongation of the incubation period may be due to the intake of antibacterial drugs by the infected person at this time.

Syphilis stage 1 (primary syphilis)- lasts on average from 6 to 7 weeks and is characterized by the appearance of a hard chancre, usually painless, at the site of contact of a healthy area of ​​skin or mucous membrane of a person with an infection. Chancre can have atypical forms - multiple chancre, chancre amygdalitis, chancre felon. After a few days (7-10), near the site of infection, the lymph nodes increase in size and sometimes become inflamed (regional scleradenitis, lymphadenitis or lymphangitis).

Until the mid-80s 20th century. Primary syphilis was divided into 2 periods – seronegative and seropositive. Seronegative syphilis was characterized by the absence of classical serological reactions (CSR) - the Wasserman, Kahn, Kolmer and Sachs-Vitebsky reactions. Seropositive syphilis usually formed 3-4 weeks after the appearance of primary syphiloma (the first chancre). This division was made to determine the timing of infection of the body, however, with the advent of diagnostic methods such as RIF, RIBT, ELISA and PCR, the designations “seronegative” and seropositive” lost their significance.

The end of the primary stage of the disease is indicated by the appearance of a specific rash on the skin and mucous membranes.

Syphilis stage 2 (secondary syphilis)– forms approximately 6-7 weeks after the first signs of the disease appear. During this period, the infection goes beyond the infectious focus and, having penetrated the bloodstream, spreads throughout the body through the bloodstream. The appearance of a specific rash on the skin and mucous membranes (syphilitic rash) is an immune response to the spread of infection and endotoxins released by bacteria throughout the body.

Syphilitic rash has a papular, pustular and roseolous character. Systemic damage to white treponema causes damage to many organs and systems, but the liver, kidneys, bones, and nervous system are primarily affected. After some time, the immune system limits the activity of endotoxins and the disease enters a latent phase, during which the rash disappears. And therefore, secondary syphilis is divided into 3 phases - fresh, or early (Lues secundaria recens), followed by recurrent, or recurrent (Lues secundaria recidiva, Lues secundaria reccurens) and ending with a latent period (Lues secundaria latens). However, due to the fact that the immune system does not kill the bacterial infection on its own, when it weakens, a relapse of the disease occurs, mainly visual sign which is the return of the syphilitic rash.

Syphilis stage 3 (tertiary syphilis)– is formed if the patient has not received adequate treatment. It is characterized by a weakening of the immune system, due to which the infection begins to affect all organs and systems of the patient. One of the obvious signs of tertiary syphilis is the appearance of syphilitic gummas (gummy syphilide).

The end of the tertiary stage of the disease may be accompanied by neurosyphilis with paralysis, as well as syphilitic gonitis, uveitis, damage to bones, heart valves, aorta, kidneys () and liver (,), and ultimately death.

When white treponema enters the body, the immune system produces three groups of antibodies - IgA (fluorescins), after the appearance of primary syphiloma - IgM (reagins), and then IgG (immobilisins). In addition, the main elements of the immune system - T-lymphocytes, B-lymphocytes and macrophages - are involved in the fight against infection.

Photos of secondary and tertiary syphilis can be viewed on the forum.

Syphilis statistics

Syphilis is one of the most common sexually transmitted diseases (STDs).

Despite the skill modern medicine treat this disease, it is still in developed countries officially occurs in 20-30% of people.

In the territories of the former USSR, the epidemiological situation is also worsening. So, in 1991, in Russia, out of 100,000 people, syphilis was diagnosed in 7, and in 2009 there were already 52 patients.

Syphilis - ICD

ICD-10: A50-A53;
ICD-9: 090-097.

Syphilis - symptoms

Symptoms of syphilis largely depend on the duration of contact with the infection, the person’s health status and the stage of the disease, which we discussed above.

The first signs of syphilis (symptoms of primary syphilis)

The first symptoms of the disease (primary syphilis) appear several days and sometimes months after contact with the infection. Among them are:

• The appearance of hard chancre (primary syphiloma);
• Enlarged lymph nodes (regional lymphadenitis, scleradenitis or lymphangitis);
• Indurative edema, which appears predominantly in the genital area (due to the fact that this is where infection enters the body) and represents a slight increase in the form of a bulge with discolored skin, also painless, lasting from 1 week to 1 month during primary syphilis .
• The formation of a hard chancre, which is an almost painless deep dense ulcer, looks like a pit with a smooth rounded bottom, without bleeding and a tendency to increase in diameter. Chancre may also be present on the body in the form atypical forms- multiple chancre, chancre amygdalitis (appears on one of the tonsils in the oropharynx, resembles symptoms), chancre felon (appears on 1-3 fingers of the right hand);
• Increased body temperature.

Symptoms of secondary syphilis

• The appearance of a generalized rash on the skin and mucous membranes (syphilitic rash);
• Hair falls out in places on the head, even to the point of baldness;
• Enlarged lymph nodes, cold to the touch, without adhesions, painless or slightly painful (lymphadenitis);

In practice, the symptoms of the secondary stage of the disease resemble those of the usual stage.

Symptoms of tertiary syphilis

Symptoms of tertiary syphilis in the first months, and sometimes decades, may be absent or minimal, and the patient remains a carrier of the infection.

Afterwards, the disease worsens again, but already affects almost all organs and systems, which is expressed in the following destructive processes:

• Damage to the skin and mucous membranes;
• The formation of gummas, which are initially soft tissue tumors, and then degenerate into fibrous scars;
• Vascular damage - syphilitic aortitis, syphilitic endarteritis;
• Brain damage – progressive paralysis;
• Damage to the musculoskeletal system;
• Damage to the nervous system – neurosyphilis.

Symptoms of neurosyphilis

At the end of the second stage, neurosyphilis begins to develop, the main symptoms of which are:

• Damage to blood vessels (intimal hyperplasia, where milliary gummas ultimately form) and the membranes of the brain and spinal cord;
• Development of syphilitic in chronic form;
• Argyle-Robertson sign;
• Other, but rarer, symptoms include syphilitic and meningoencephalitis;
• Paresis, paralysis, ataxia;
• The patient practically does not feel support under his feet;
• Dizziness;
• Visual impairment;
• Mental disorders - forgetfulness, inattention, lethargy, etc.

Symptoms of congenital syphilis

It is transmitted from mother to baby during pregnancy, and due to the fact that at this time the child is just developing, then after birth, he often experiences the following symptoms:

• Congenital lack of hearing (deafness);
• Parenchymatous;
• Hypoplasia of dental tissue, or so-called. "Hutchinson's teeth"

After the infection is stopped, congenital pathologies usually remain, which worsens the patient’s quality of life.

Complication of syphilis

• Paralysis;
• Syphilitic ecthymas, rupees, gummas;
• Optic nerve atrophy, blindness;
• Hearing loss;
• Disability;
• Miscarriage;
• Diseases of the cardiovascular system: , vasculitis, ;
• Diseases of the musculoskeletal system - reactive osteitis;
• Death.

Causes of syphilis

The causative agent of syphilis– the bacterium “treponema pallidum” (lat. Treponema pallidum), infection of which is the cause of this.

Syphilis infection occurs in the following ways:

• Through sexual intercourse with a carrier of the infection (the infection is found both in the blood and semen of the patient, even if the carrier has no obvious signs);
• Through kisses;
• Through the placenta - from an infected mother to the fetus;
• Through breastfeeding, the infection enters the child’s body with infected milk;
• Through the blood, which usually happens when an infected donated blood, using a syringe, razor, toothbrush, scissors and other objects that were previously used by a carrier of the infection;
• Bodily contact with open ulcers found on the patient during the tertiary phase of the disease, or with his bedding and household items for caring for the body (including towels, bedding, spoons, dishes);
• When carrying out diagnostic and treatment measures;
• For cosmetic procedures (manicure, pedicure), tattooing or dental services.

An exacerbation of the disease usually occurs against a background of weakened immunity, which may be caused by -, lack of good rest and sleep, strict diets, insufficient intake of vitamins and (and), the presence of others.

According to WHO, about 30% of patients infected with white treponema with high immune reactivity recovered without the use of traditional methods of treating this disease.

Syphilis is classified as follows:

Primary syphilis (Syphilis I), which could be:

• Seronegative (Syphilis I seronegativa);
• Seropositive (Syphilis I seropositiva);
• Hidden, or latent (Syphilis I latens).

Secondary syphilis (Syphilis II), which could be:

• Early (Syphilis II recens);
• Recurrent (Syphilis II recidiva);
• Hidden (Syphilis II latens).

Tertiary syphilis (Syphilis III), which could be:

• Active (Syphilis III gummosa);
• Hidden (Syphilis III latens).

Congenital syphilis (Syphilis congenita), which could be:

• Early (Syphilis congenita praecox);
• Late (Syphilis congenita tarda);
• Hidden (Syphilis congenita latens).

In addition, there are special forms of syphilis, usually expressing special clinical manifestations:

• Syphilis of the nervous system (neurosyphilis);
• Progressive paralysis (Paralysis progressiva);
• Tabes dorsalis;
• Syphilis of the brain (lues cerebri);
• Visceral syphilis;
• Syphilis unspecified.

Diagnosis of syphilis

Diagnosis of syphilis includes:

• Visual examination, medical history;
• Cerebrospinal fluid examination;
• Serodiagnosis;
• Polymerase chain reaction (PCR);
• Enzyme-linked immunosorbent assay (ELISA);
• Cardiolipin test in combination with ELISA;
• Immunofluorescence reactions (RIF);
• Direct hemagglutination reactions (DRHA);
• Immobilization reactions of Treponema pallidum (RTI);
• Microreactions of precipitation (MPR - microsedimentary reactions).

Syphilis - treatment

How to treat syphilis? Treatment for syphilis includes following methods therapy:

1. Drug treatment;
2. Physiotherapeutic procedures.

The primary stage of the disease is treated on an outpatient basis. Treatment in a hospital setting is carried out in the presence of complications, or if the patient develops a secondary stage.

1. Drug treatment of syphilis

Important! Before using medications, be sure to consult your doctor!

1.1. Antibacterial therapy

As we already know, the causative agent of the infection is the bacterium “white treponema”. In this regard, antibacterial therapy is used to stop the bacterial infection.

The most popular antibacterial substances against white treponema are penicillin, and in case of an allergy to penicillin or if another strain of bacteria is somewhat resistant to it, tetracycline and erythromycin are prescribed. Also against Treponema pallidum, more rarely, but still used are cephalosporins. Sulfonamides are not effective against white treponema.

An interesting fact is the almost complete absence of resistance of white treponema to penicillin and its derivatives. However, the disease syphilis continues to spread throughout the world, especially in developed countries.

Treatment of neurosyphilis is carried out by administering antibiotics - orally, intramuscularly and endolumbarally. In addition, to achieve maximum effectiveness, the patient’s body temperature is artificially increased (pyrotherapy - “Pyrogenal”), which leads to an increase in the blood-brain barrier.

Treatment of tertiary syphilis is carried out not only with the help of antibiotics, but also if the patient is in good condition - with the addition of drugs based on bismuth (Biyoquinol) and arsenic (Miarsenol, Novarsenol). However, we must remember that these substances are very toxic to the body.

Antibiotics against syphilis: penicillins ("Ampicillin", "Amoxicillin", "Oxacillin"), prolonged forms of penicillin ("Bicillin", "Retarpen", "Extencillin"), tetracyclines ("", "Doxycycline"), erythromycin ("", "Clarithromycin" ), cephalosporins (“Cefotaxime”, “”, “Cefepime”).

To prevent the spread of infection to surrounding people, all things and objects in the patient’s place of stay must be disinfected - dishes, plumbing fixtures, clothes, linen, etc.

1.2. Detoxification therapy

White treponema and its waste products, which are toxins (poisonous substances) for the body, complicate the course of the disease. In addition, after using antibiotics, dead bacteria also poison the body. To remove toxins from the body, detoxification therapy is used, which includes:

• Drink plenty of fluids, preferably with added vitamin C;
• Taking sorbents: “Hemodez”, “Atoxil”, “Enterosgel”, “Polysorb”, “Smecta”;
• Intravenous infusion of glucose-saline solutions, the dosage of which depends on the degree of intoxication;
• Hemosorption (blood purification);
• Plasmapheresis (blood purification by collecting, purifying and re-infusing it);
• ILBI (blood purification using intravenous laser irradiation);
• UV blood irradiation (blood purification using ultraviolet irradiation);
• Lymphosorption (lymph cleansing);
• Hemodialysis (blood purification for kidney failure).

1.3. Strengthening the immune system

The high reactivity of the immune system, which plays a protective role in the body, contributes to a faster recovery of a patient with syphilis.

The following are used to stimulate the immune system: medications: “Laferon”, “Timalin”, “Timogen”, “Methyluracil”, “Likopid”, “Imunofan”, “Galavit”, “Pantocrin”, “Plasmol”.

1.4. Vitamin therapy

2. Physiotherapeutic procedures

To improve the patient’s condition, maintain the functioning of organs and systems and accelerate recovery, the use of physiotherapy is prescribed, methods of which include:

• Inductothermy;
• Magnetotherapy;
• UHF therapy;
• Laser therapy.

Important! Before using folk remedies against syphilis, be sure to consult your doctor!

Garlic, wine, jam and apple juice. Pour 1 glass strawberry jam half a glass of water, put the mixture on the fire and bring to a boil. After simmering for 3-4 minutes over low heat, remove the mixture from the heat and add 2 cups of warm red wine and 1 cup of apple juice. Mix everything thoroughly and cool. Then add another 6-7 cloves of crushed powder to the product, mix everything again and set the mixture aside for 3 hours to infuse. Then strain and drink 100 ml per day.

Garlic, apples, hawthorn and rose hips. Grate 2 Antonovka apples and mix with them 1 cup of fruit, 1 cup of fruit and 7 chopped garlic cloves. Pour the mixture into 2 liters of boiling water, stir, cover the vessel and set aside for a couple of hours to infuse. Then strain the product and drink half a glass after meals, 3 times a day.

Sedge. Thoroughly peel and finely chop 20 g of sandy sedge root, pour 600 ml of boiling water over it, put the mixture on low heat and simmer until the amount of liquid is half as much. Then leave the product for a couple of hours to infuse and cool, strain and drink 3-4 times a day.

Field jar. Pour 1.5 tbsp. spoons of field grass herb with a glass of boiling water and set the product aside for 4 hours to infuse. After the infusion, you need to strain and drink 1 teaspoon 5 times a day.

Burdock. 1 tbsp. Pour a glass of boiling water over a spoonful of burdock root, put the product on low heat, boil it for 20 minutes, then set aside to cool, strain and drink 1 tbsp. spoon 4 times a day.

Hop. 2 tbsp. spoons of common hops, pour 500 ml of boiling water, cover the container and let the product brew for 2.5 hours. Afterwards, you need to strain the product and drink half a glass 4 times a day.

Prevention of syphilis

Prevention of syphilis includes:

• Refusal of promiscuous sex life, especially with strangers;
• Instilling in children the awareness that extramarital relations are prohibited, not only from the moral, but also from the spiritual side, because fornication is a sin—“Flee fornication; every sin that a person commits is outside the body, but the fornicator sins against own body"(1 Corinthians 6:18, Bible);
• Washing the genitals after intimacy with soapy water;
• Use of contraceptives, but remember, contraceptives do not provide a guarantee of safety;
• Timely consultation with a doctor after the first signs of illness;
• Avoid visiting little-known beauty salons and dental clinics;
• Avoid tattoos on your body (by the way, according to the texts of the Holy Scriptures, tattoos on the body in ancient times were done for the sake of the dead);
• Compliance.

Which doctor should I contact if I have syphilis?

• Syphilidologist.
• In some cases, additional treatment may be required in (women) and (men).

Syphilis - video

Syphilis is a bacterial infection, predominantly sexually transmitted, which, without treatment, causes serious damage to the patient’s health and leads to death. It appears a few weeks after infection in the form of a solid formation on the genitals, skin or mucous membranes. Diagnosis of syphilis is also carried out at home using special tests, but PCR analysis is considered the most accurate.

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Description of the disease

Treponema pallidum is a bacterium that belongs to the spirochete family. Mobile, spiral-shaped, gram-negative. Its length ranges from 5 to 12 microns and thickness 0.2-0.4. On the outside, it is surrounded by a shell of polysaccharides and lipids, so the body is resistant to the effects of antibodies. The pathogen divides every 28-32 hours at a temperature of 36.6-37.5 degrees.

Treponema is a facultative anaerobes, i.e. it exists without oxygen. In the body it settles in the interstitial space near lymphatic and blood vessels and in nerves.

Outside the body, it is unstable to environmental influences. Negative Impact it is affected by drying, heating to 55 degrees, etc. In a humid environment, it remains active for up to 12-13 hours.

During activity, it produces endotoxins, which cause a reaction from the immune system. The ability to produce them determines the ability of the bacterium to infect organs and tissues.

Methods of infection

98% of syphilis cases are attributed to sexual contact. Even if you use a condom, there is a small chance of infection.

Bacteria easily penetrate through minor injuries and cracks in the mucous membranes. You can get sick not only after sexual intercourse, but even after a kiss if the pathogen is in the partner’s saliva.

The infection can also occur through blood transfusion or organ transplantation. It can happen on poorly processed instruments from a cosmetologist, manicurist and dentist.

There is a possibility of infection in everyday life when using a shared razor, towels, or toothbrush. In public places, in a bathhouse, in a swimming pool, there is a risk of finding a spirochete. You need to follow the rules of personal hygiene, cover the shelves in the bathhouse with your own sheet, and be interested in disinfection.

An ill mother can transmit syphilis during childbirth and lactation to her child. Infection rarely occurs in workers associated with people or animals infected with the microbe.



Signs of syphilis

To determine if you have syphilis, you need to track its initial symptoms. In both men and women, the first sign of the disease appears in the form of an ulcer (chancre).



It forms in the form of a tubercle in the groin, on a man’s penis (at its base or on the head), and can appear on the scrotum, near the anus, or on the mucous membrane of the mouth.



Symptoms of primary syphilis

The first stage begins with the detection of chancre on the surface of the skin or mucous membranes. At first it does not cause serious discomfort, but then inflammation occurs: it becomes red or bluish, which is characteristic of a pronounced inflammatory process.

Over the course of 1 week, lymph nodes or regional vessels are affected. The lymph nodes become inflamed in the form of balls, forming edema and swelling around the chancre. When the formation is concentrated in the oral cavity, this is fraught with inflammation of the tonsils and swelling of the throat, making breathing and swallowing difficult. Symptoms cause distress with verbal communication and eating. When lesions appear in the genital area, the process of walking and defecation becomes difficult.

The beginning of secondary syphilis is considered to be the appearance of a specific rash. You can detect the disease after the first signs appear using enzyme immunoassay and PCR, which are prescribed by a therapist or venereologist.

You can understand that an infection has occurred by the nature of the discharge during syphilis. In women they become thick, in men they become yellowish. In more advanced cases - with admixtures of blood and pus.

The analysis will be appropriate only at the stage of primary syphilis; during the incubation period, the results will not show anything other than a seronegative reaction, which indicates the absence of treponema pallidum.

Signs of secondary syphilis

The skin around the chancre becomes covered with spots up to 15 mm in diameter. The rash (syphilides) grows extensively and unites into zones on the skin and mucous membranes, causing discomfort; there are 3 types:

1. 1. Roseola- pink spots up to 5 cm in diameter, no cavities, boundaries can be clear or blurred, does not protrude above the skin.
2. 2. Papular- small conical growths (papules) of pink color. Peeling at the top. They look unpleasant.
3. 3. Pustularrash- growths (pustules) with purulent cavities.



In parallel with the appearance of the rash, damage to the central nervous system begins, degradation of nervous tissue begins, vision, memory, attention, and coordination of movements deteriorate. Treatment of the disease does not lead to the restoration of central nervous system functions, but only stops the process of further damage.

Symptoms of baldness appear, hair falls out mainly on the head. First, the quality of the hair decreases, it splits, becomes thinner, and thins out. Why does the process intensify, bald areas appear. After treatment for syphilis, hair growth cannot be restored.

Stages of syphilis

Today, having contracted the disease, every person undergoes a quick diagnosis and receives adequate treatment, therefore, only a few pass through all stages of the disease. If left untreatedsyphilis, a person lives in terrible agony for 10 or 20 years, after which death occurs.

The disease begins with an incubation period that lasts on average one month. At this time, there are no objective signs of the disease in the body.

If the infection penetrates several places at once, the incubation period is reduced to 1-2 weeks. If a person takes antibiotics for flu and sore throat, it can last much longer (six months). Then the first symptoms appear - chancre and inflammation of the lymph nodes.

When the pathogen drops directly into the blood, the stage of primary syphilis does not appear and the disease immediately passes to the secondary stage.

Stages of primary syphilis:

Name	Period	Description
Primary syphilis	From the moment the chancre appears to the rash and inflammation of the lymph nodes	Syphilitic chancre is a deep-penetrating solid formation caused by an immune response to a pathogen. It can be recognized by its rounded shapes and clearly defined edges. It is localized in the area of ​​infection. It is painless, but causes serious concern and motivates you to stop sexual intercourse and go to the doctor. At the end of the stage, multiple chancre may appear, the lymph nodes may become inflamed, malaise and elevated body temperature, dizziness may appear.
Headless	It is difficult to determine whether it begins when an infection enters the blood	There are no signs, the disease is asymptomatic and enters the second or latent stage

The stages of secondary syphilis are divided into 4 stages. In the absence of treatment, the order of development is as follows:

Name	Time periods	Description
Early	From 60-70 days of invasion or 40-45 days after symptoms appear. Lasts from several days to 1-2 weeks	External signs are expressed in three types of rashes, caused by the response of the immune system and the production of endotoxins that fight infections. The nervous system, bones, and internal organs suffer. The temperature rises to low-grade levels. Accompanied by malaise, cough and runny nose. Baldness is possible during this period
Hidden	From 60 days after the onset of the primary stage or later	At certain points, the immune system blocks an infection that destroys the body. The rash stops. The infection does not leave organs and tissues and lives in anticipation of a relapse
Age	After hidden phases	With any weakening of the immune system (cold, stress, skipping meals, injury), a relapse occurs. Appears as a new rash with areas of hemorrhage. Symptoms characteristic of early syphilis recur. Multiple chancres often form on the genitals
Early neurosyphilis	Begins 2 years after infection	Associated with damage to blood vessels and neurons of the brain, organs, bones and joints. Manifests itself in the form of chronic meningitis, impaired reaction of the pupils to light. Miliary gunnas form inside the brain vessel, increasing intracranial pressure, which causes headaches and worsens general well-being. Many symptoms impair higher mental functions, such as attention, memory, and coordination of movements. The changes are irreversible

The stages of tertiary syphilis are divided into 3 stages; in the absence of treatment, the order of progression is as follows:

Name	Time periods	Description
Hidden chronic stage	From year 1 to 20 years	About 70-75% of patients without treatment live as carriers, moving from the asymptomatic phase of tertiary syphilis to relapse, sooner or later the body weakens, the patient moves to the next stage, with a high probability of disability or death
Tertiary syphilis	With the onset of symptoms	Advanced syphilis. Extensive damage to organs, tissues, bones and the nervous system occurs. Gummas are formed - characteristic purulent tumors, which often bleed and are moist due to the large amount of lymph and pus. Often appear on the face. They heal hard and form strong scars. Sometimes infected with other bacteria that lead to gangrene
Late neurosyphilis	The final stage leading to death, 10-20 years from the onset of the disease	Extensive damage to the central nervous system, which leads to loss of vision, paralysis, and impaired cognitive function of the psyche

Brain diseases of an infectious nature appear - meningitis, bone and brain gummas.

Neurosyphilis

Neurosyphilis begins at the end of the stage of secondary syphilis. Manifests itself in the following forms of the disease:

Name	Description
Asymptomatic neurosyphilis	There are no painful manifestations, tests will show inflammation and infection of the cerebrospinal fluid. This stage begins 12-188 months after infection
Gummy	Accompanied by the formation of gumma inside the spinal cord and brain. Feels like a large tumor, causes pain, causes increased intracranial pressure
Syphilitic meningitis	Damage occurs to the base of the brain in the area of ​​the cranial vault. Accompanied by severe symptoms, including disturbances in thinking, attention, emotional sphere, memory
Tabes dorsalis	Damage to the spinal cord neurons begins, with dysfunction and thinning. Leads to irreversible impairment of the ability to move in space. The gait becomes distorted, the patient falls, losing the sense of balance. Closing the eyes leads to disorientation in space
Meningovascular form of neurosyphilis	Becomes the cause of destruction of brain vessels, accompanied by meningitis. In the absence of therapy, it leads to headaches, behavioral, personality, and sleep disturbances. Ultimately leads to strokes
Progressive paralysis	It provokes damage to the central nervous system: personality is disrupted, behavior dangerous to society appears. Leads to complete paralysis of the body, atrophy of the optic nerve, and degradation of vision. First, vision deteriorates on one side, then the infection spreads to the second optic nerve and leads to complete blindness. Without treatment, changes are permanent
Late visceral syphilis	Damage to tissues and internal organs, mainly the heart and liver. Other organs are rarely affected. The patient complains of deterioration in health, with exertion, heart murmurs appear, and the aorta dilates. When visceral syphilis is localized in the heart, a heart attack may occur
Late syphilis of bones and joints	Provokes local expansion of bones and joints, accompanied by the formation of gummas on the bones

Diagnostics

Laboratory diagnostics are carried out using 2 types of studies:

1. 1. Direct (non-treponemal)- methods are based on recognizing the bacterium itself in liquids and tissues.
2. 2. Indirect (treponemal)- antibodies to the pathogen are detected in the cerebrospinal fluid and plasma.

The diagnosis is determined reliably by direct methods, these include:

• Detection of treponema using dark background microscopy or immunofluorescence.
• PCR determines the presence of DNA and RNA fragments of the pathogen.

Indirect methods include treponemal and nontreponemal tests.

Non-treponemal

The principle is that substances (antibodies) that are in the patient’s blood interact with the cardiolipin antigen, which is similar to the pathogen antigen. Antibodies are detected 2 weeks after the onset of the first signs of pathology (ulcers).

The reactions determine the presence of antibodies in only 70-80% of those infected. At later stages their sensitivity decreases. The main disadvantage of this type of test is the large number of false positive reactions. The advantage is low cost and ease of implementation.

Non-treponemal tests are usually used when it is necessary to diagnose simultaneously a large number of of people. Such reactions include:

• microprecipitation reaction (Wassermann reaction);
• plasma reagin test;
• laboratory test for sexually transmitted diseases and others.



Treponemal tests

In this case, a treponemal allergen is used. The sensitivity is much higher, reaching 70-100%. Quantity false positive results less. They are used mainly in controversial and in doubtful cases, when examining small groups of patients. They are not used to monitor the dynamics of treatment; false positives occur in patients with autoimmune pathologies.

Kinds:

• linked immunosorbent assay;
• immunoblotting;
• immunochemiluminescence;
• immunochromatography;
• immunofluorescence reaction.

False positive reaction

Sometimes in people, even in the absence of a pathogen, tests show the presence of antibodies. There are 2 explanations for this: an incorrectly performed analysis or a special condition of the body. Acute reactions(when a positive result is determined before six months) are detected in the following situations:

• menstrual bleeding;
• pregnancy;
• time after vaccination;
• myocardial infarction;
• infectious diseases: chickenpox, influenza, HIV, acute respiratory disease,
• dermatosis

Chronic false-positive tests are observed in the following cases:

• malignant tumors;
• liver and gallbladder diseases;
• autoimmune reactions;
• systemic connective tissue diseases;
• diseases of the heart, blood vessels, lungs, endocrine system;
• old age;
• drug use;
• endemic treponemes.

Treatment

Therapy depends on the goals:

• specific - with the aim of destroying the pathogen;
• preventive – prescribed to sexual partners;
• preventive - for pregnant women with the presence of the pathogen or, if these recommendations are not followed, for a newborn;
• A trial treatment is prescribed if the presence of a disease is suspected until the diagnosis is confirmed by the laboratory.

Treatment is carried out on an outpatient basis. Hospitalization is necessary only in case of tertiary disease, pregnant women, children, and persons with complications of the disease.



The main therapeutic drug is benzylpenicillin in extended-release forms. Semi-synthetic penicillins, macrolides, tetracyclines and cephalosporins are also effective.

In modern conditions, the disease is considered completely curable.

Syphilis (syphilis) refers to infectious diseases, transmitted in most cases sexually. The causative agent of syphilis is a spiral-shaped microorganism Treponema pallidum(treponema pallidum), is very vulnerable in the external environment, multiplies quickly in the human body. Incubation period, that is time from infection to the appearance of the first symptoms, approximately 4-6 weeks. Can be shortened to 8 days or lengthened to 180 with accompanying venereal diseases(,), if the patient is weakened by an immunodeficiency state () or has taken antibiotics. In the latter case, primary manifestations of syphilis may be absent altogether.

Regardless of the length of the incubation period, the patient at this time is already infected with syphilis and is dangerous to others as a source of infection.

How can you get infected with syphilis?

Syphilis is transmitted mainly through sexual contact - up to 98% of all cases of infection. The pathogen enters the body through defects in the skin or mucous membranes of the genitals, anorectal areas, and mouth. However, approximately 20% of sexual partners who have been in contact with people with syphilis remain in good health. Risk of infection is significantly reduced if there are no conditions necessary for the penetration of infection - microtraumas and a sufficient amount of infectious material; if sexual intercourse with a patient with syphilis was one-time; if syphilides (morphological manifestations of the disease) have little contagiousness(ability to infect). Some people are genetically immune to syphilis because their body produces specific protein substances that can immobilize Treponema pallidum and dissolve their protective membranes.

It is possible that the fetus may become infected in utero or during childbirth: then congenital syphilis is diagnosed.

The everyday route - through any objects contaminated with infectious material, handshakes or formal kisses - is very rarely realized. The reason is the sensitivity of treponemes: as they dry, their level of contagiousness drops sharply. Getting infected with syphilis through a kiss it is quite possible if one person has syphilitic elements on the lips, mucous membrane of the mouth or throat, or tongue containing a sufficient amount of virulent (that is, living and active) pathogens of the disease, and another person has scratches on the skin, for example, after shaving.

The causative agent of syphilis is Treponema pallidum from the spirochete family.

Very rare routes of transmission of infectious material through medical instruments. Treponemas are unstable even under normal conditions, and when instruments are sterilized or treated with conventional disinfectant solutions, they die almost instantly. So all the stories about syphilis infection in gynecological and dental offices most likely belong to the category of oral folk art.

Transmission of syphilis during blood transfusions(blood transfusions) practically never occurs. The fact is that all donors are required to be tested for syphilis, and those who do not pass the test simply will not be able to donate blood. Even if we assume that an incident occurred and there are treponemes in the donor blood, they will die when the material is preserved within a couple of days. The very presence of a pathogen in the blood is also rare, because Treponema pallidum appears in the bloodstream only during the period treponemal sepsis"with secondary fresh syphilis. Infection is possible if a sufficient amount of the virulent pathogen is transmitted with direct blood transfusion from an infected donor, literally from vein to vein. Considering that the indications for the procedure are extremely narrowed, the risk of contracting syphilis through blood is unlikely.

What increases the likelihood of contracting syphilis?

• Liquid discharge. Since treponemas prefer a moist environment, mother's milk, weeping syphilitic erosions and ulcers, sperm, vaginal discharge contain great amount pathogens and therefore most contagious. Transmission of infection through saliva is possible if there is syphilides(rash, chancre).
• Dry rash elements(spots, papules) are less contagious, in ulcers ( pustules) treponemes can be found only at the edges of the formations, and they are not present at all in the pus.
• Period of illness. With active syphilis, nonspecific erosions on the cervix and head of the penis, blisters of herpetic rash and any inflammatory manifestations leading to defects in the skin or mucous membranes are contagious. During the period of tertiary syphilis, the possibility of infection through sexual contact is minimal, and papules and gummas specific to this stage are actually not contagious.

In terms of the spread of infection, latent syphilis is the most dangerous: people are unaware of their illness and do not take any measures to protect their partners.

• Accompanying illnesses. Patients with gonorrhea and other STDs are more easily infected with syphilis, since the mucous membranes of their genitals are already damaged by previous inflammations. Treponemas multiply quickly, but the primary lues is “masked” by the symptoms of other sexually transmitted diseases, and the patient becomes epidemically dangerous.
• Immune system status. The likelihood of contracting syphilis is higher in people who are weakened chronic diseases; AIDS patients; in alcoholics and drug addicts.

Classification

Syphilis can affect any organs and systems, but the manifestations of syphilis depend on clinical period, symptoms, duration of illness, patient age and other variables. Therefore, the classification seems a little confusing, but in reality it is built very logically.

1. Depending from time period, elapsed from the moment of infection, early syphilis is distinguished - up to 5 years, more than 5 years - late syphilis.
2. By typical symptoms syphilis is divided into primary(hard chancre, scleradenitis and lymphadenitis), secondary(papular and pustular rash, spread of the disease to all internal organs, early neurosyphilis) and tertiary(gummas, damage to internal organs, bone and joint systems, late neurosyphilis).

chancre - an ulcer that develops at the site of entry of the syphilis pathogen

1. Primary syphilis, based on blood test results, May be seronegative And seropositive. Secondary, based on the main symptoms, is divided into the stages of syphilis - fresh and latent (recurrent), tertiary is differentiated as active and latent syphilis, when the treponemes are in the form of cysts.
2. By preference damage to systems and organs: neurosyphilis and visceral (organ) syphilis.
3. Separately – fetal syphilis and congenital late syphilis.

Primary syphilis

After the end of the incubation period, characteristic first signs appear. At the site of penetration of treponemas, a specific round erosion or ulcer is formed, with a hard, smooth bottom and “turned-up” edges. The size of the formations can vary from a couple of mm to several centimeters. Hard chancre can disappear without treatment. Erosions heal without a trace, ulcers leave flat scars.

The disappearance of chancre does not mean the end of the disease: primary syphilis only passes into a latent form, during which the patient is still infectious to sexual partners.

in the picture: chancre of genital localization in men and women

After the formation of chancre, after 1-2 weeks it begins local enlargement of lymph nodes. When palpated, they are dense, painless, and mobile; always alone bigger size than the rest. After another 2 weeks it becomes positive serum (serological) reaction to syphilis, from this moment primary syphilis passes from the seronegative stage to the seropositive stage. The end of the primary period: body temperature may rise to 37.8 - 380, sleep disturbances, muscle and headaches, and joint aches appear. Available dense swelling of the labia (in women), the head of the penis and scrotum in men.

Secondary syphilis

The secondary period begins approximately 5-9 weeks after the formation of chancre, and lasts 3-5 years. Main symptoms syphilis at this stage - skin manifestations (rash), which appears with syphilitic bacteremia; condylomas lata, leukoderma and baldness, nail damage, syphilitic tonsillitis. Present generalized lymphadenitis: the nodes are dense, painless, the skin over them is at normal temperature (“cold” syphilitic lymphadenitis). Most patients do not note any special deviations in their health, but a rise in temperature to 37-37.50, a runny nose and a sore throat are possible. Because of these manifestations, the onset of secondary syphilis can be confused with a common cold, but at this time the syphilis affects all systems of the body.

syphilitic rash

The main signs of the rash (secondary fresh syphilis):

• The formations are dense, the edges are clear;
• The shape is regular, round;
• Not prone to fusion;
• Does not peel off in the center;
• Located on visible mucous membranes and throughout the entire surface of the body, even on the palms and soles;
• No itching or pain;
• They disappear without treatment and do not leave scars on the skin or mucous membranes.

Accepted in dermatology special names for morphological elements of the rash that can remain unchanged or transform in a certain order. First on the list - spot(macula), may progress to the stage tubercle(papula), bubble(vesicula), which opens to form erosion or turns into pustule(pustula), and when the process spreads deep into ulcer. All of the above elements disappear without a trace, unlike erosions (after healing, a spot first forms) and ulcers (the outcome is scarring). Thus, it is possible to find out from the trace marks on the skin what the primary morphological element, or predict the development and outcome of existing skin manifestations.

For secondary fresh syphilis, the first signs are numerous pinpoint hemorrhages in the skin and mucous membranes; profuse rashes in the form of rounded pink spots (roseolaе), symmetrical and bright, randomly located - roseola rash. After 8-10 weeks, the spots turn pale and disappear without treatment, and fresh syphilis becomes secondary hidden syphilis, occurring with exacerbations and remissions.

For the acute stage ( recurrent syphilis) characterized by preferential localization of rash elements on the skin of the extensor surfaces of the arms and legs, in folds (groin areas, under the mammary glands, between the buttocks) and on mucous membranes. There are significantly fewer spots, their color is more faded. The spots are combined with a papular and pustular rash, which is more often observed in weakened patients. During remission, all skin manifestations disappear. During the relapse period, patients are especially infectious, even through household contacts.

Rash with secondary acute syphilis polymorphic: consists of spots, papules and pustules at the same time. Elements are grouped and merged, forming rings, garlands and semi-arcs, which are called lenticular syphilides. After they disappear, pigmentation remains. At this stage, diagnosing syphilis based on external symptoms is difficult for a layperson, since secondary recurrent syphilides can be similar to almost any skin disease.

Lenticular rash with secondary recurrent syphilis

Pustular (pustular) rash with secondary syphilis

Pustular syphilides are a sign of a malignant ongoing disease. They are more often observed during the period of secondary fresh syphilis, but one of the varieties is ectymatous– characteristic of secondary acute syphilis. Ecthymas appear in weakened patients approximately 5-6 months after the time of infection. They are located asymmetrically, usually on the front of the legs, less often on the skin of the torso and face. Syphilides number 5–10, round, approximately 3 cm in diameter, with a deep abscess in the center. A gray-black crust forms above the pustule, under it there is an ulcer with necrotic masses and dense, steep edges: the shape of the ecthyma resembles a funnel. This leaves deep dark scars, which over time lose pigmentation and become white with a pearlescent tint.

Necrotic ulcers from pustular syphilides, secondary-tertiary stages of syphilis

Ecthymes can turn into rupioid syphilides, with the spread of ulceration and tissue decay outward and inward. Centered Rs. multilayer “oyster” crusts are formed, surrounded by a ring-shaped ulcer; outside – a dense ridge of reddish-violet color. Ecthymas and rupees are less contagious; during this period all serological tests for syphilis are negative.

Acne syphilides are ulcers 1-2 mm in size, localized in the hair follicles or inside the sebaceous glands. The rashes are localized on the back, chest, and limbs; heal with the formation of small pigmented scars. Smallpox syphilides are not associated with hair follicles, have the shape of a lentil. Dense at the base, copper-red color. Syphilide, similar to impetigo – purulent inflammation skin. It is found on the face and scalp, the size of the pustules is 5-7 mm.

Other manifestations of secondary syphilis

Syphilitic condylomas look like warts wide base, most often form in the fold between the buttocks and in the anus, under the armpits and between the toes, near the navel. In women - under the breasts, in men - near the root of the penis and on the scrotum.

Pigmentary syphilide(spotted leucoderma literally translated from Latin - “white skin”). White spots up to 1 cm in size appear on the pigmented surface, which are located on the neck, for which they received the romantic name “Venus’ necklace”. Leucoderma is determined after 5-6 months. after infection with syphilis. Localization is possible on the back and lower back, abdomen, arms, and on the anterior edge of the armpits. The spots are not painful, do not peel or become inflamed; remain unchanged for a long time, even after specific treatment for syphilis.

Syphilitic alopecia(alopecia). Hair loss can be local or cover large areas of the scalp and body. On the head, small foci of incomplete alopecia are more often observed, with rounded irregular outlines, mainly located on the back of the head and temples. On the face, first of all, attention is paid to the eyebrows: with syphilis, hairs first fall out from their inner part, located closer to the nose. These signs marked the beginning of visual diagnosis and became known as " omnibus syndrome" In the later stages of syphilis, a person loses absolutely all hair, even vellus hair.

Syphilitic sore throat- the result of damage to the mucous membrane of the throat. On the tonsils and soft palate small (0.5 cm) spotted syphilides appear, they are visible as bluish-red foci with sharp outlines; grow up to 2 cm, merge and form plaques. The color in the center changes rapidly to a greyish-white opalescent hue; the edges become scalloped, but retain their density and original color. Syphilides can cause pain when swallowing, a feeling of dryness and a constant sore throat. They occur together with a papular rash during the period of fresh secondary syphilis, or as an independent sign of secondary acute syphilis.

manifestations of syphilis on the lips (chancre) and tongue

Syphilides on the tongue, in the corners of the mouth due to constant irritation, they grow and rise above the mucous membranes and healthy skin, dense, grayish surface. They may become covered with erosions or ulcerate, causing pain. Papular syphilides on vocal cords At first they manifest themselves as hoarseness, later a complete loss of voice is possible - aphonia.

Syphilitic nail damage(onychia and paronychia): papules are localized under the bed and at the base of the nail, visible as reddish-brown spots. Then the nail plate above them becomes whitish and brittle, and begins to crumble. With purulent syphilide it is felt strong pain, the nail moves away from the bed. Subsequently, crater-shaped depressions form at the base, and the nail becomes three or four times thicker than normal.

Tertiary period of syphilis

Tertiary syphilis manifests itself as focal destruction of the mucous membranes and skin, any parenchymal or hollow organs, large joints, and nervous system. Main features – papular rashes and gummas, degrading with rough scarring. Tertiary syphilis is rarely detected and develops within 5-15 years if no treatment is provided. Asymptomatic period ( latent syphilis) can last more than two decades, diagnosed only by serological tests between secondary and tertiary syphilis.

what can affect advanced syphilis

Papular elements dense and round, up to 1 cm in size. They are located deep in the skin, which becomes bluish-red above the papules. Papules occur in different time, are grouped into arcs, rings, elongated garlands. Typical for tertiary syphilis focus rash: each element is determined separately and in its own stage of development. The disintegration of papular syphilomas begins from the center of the tubercle: round ulcers appear, the edges are steep, there is necrosis at the bottom, and a dense ridge along the periphery. After healing, small dense scars with a pigment border remain.

Serpinginous Syphilide is grouped papules that are in different stages of development and spread over large areas of the skin. New formations appear along the periphery, merging with old ones, which at this time are already ulcerated and scarred. The sickle-shaped process seems to crawl towards healthy areas of the skin, leaving a trail of mosaic scars and foci of pigmentation. Numerous tuberculate compactions create a motley picture truly polymorphic rash, which is visible in late periods of syphilis: different sizes, different morphological stages of identical elements - papules.

syphilitic gumma on the face

Syphilitic gumma. At first it is a dense node, which is located deep in the skin or under it, mobile, up to 1.5 cm in size, painless. After 2-4 weeks, the gumma is fixed in relation to the skin and rises above it as a rounded dark red tumor. Softening appears in the center, then a hole forms and the sticky mass comes out. In place of the gumma, a deep ulcer is formed, which can increase along the periphery and spread along an arc ( serping gummous syphilide), and in the “old” areas healing occurs with the appearance of retracted scars, and in new areas – ulceration.

Most often, syphilitic gummas are located alone and are localized on the face, near the joints, and on the front of the legs. Closely located syphilides can merge to form gumm pad and turn into impressive ulcers with compacted, jagged edges. In weakened patients, when syphilis is combined with HIV, gonorrhea, viral hepatitis, gummas may grow in depth - mutilating or irradiating gummas. They disfigure the appearance and can even lead to the loss of an eye, testicle, perforation and death of the nose.

Gunma in the mouth and inside the nose disintegrate with destruction of the palate, tongue and nasal septum. Defects are formed: fistulas between the cavities of the nose and mouth (voice is nasal, food may enter the nose), narrowing of the throat opening(difficulty swallowing), cosmetic problems- failed saddle nose. Language At first it enlarges and becomes lumpy, after scarring it shrinks, and it becomes difficult for the patient to talk.

Visceral and neurosyphilis

At visceral In tertiary syphilis, organ damage is observed, with the development neurosyphilis– symptoms from the central nervous system (CNS). During the secondary period, early syphilis of the central nervous system appears; it affects the brain, its vessels and membranes ( meningitis And meningoencephalitis). In the tertiary period, manifestations of late neurosyphilis are observed, these include optic atrophy, tabes dorsalis and progressive paralysis.

Tabes dorsalis– manifestation of syphilis of the spinal cord: the patient literally does not feel the ground under his feet and cannot walk with his eyes closed.

Progressive paralysis maximum manifests itself one and a half to two decades after the onset of the disease. The main symptoms are mental disorders, from irritability and memory impairment to delusional states and dementia.

Optic atrophy: with syphilis, one side is first affected, and a little later vision deteriorates in the other eye.

Gummas affecting the head brain, are rarely observed. By clinical signs they look like tumors and are expressed by symptoms of brain compression - increased intracranial pressure, rare pulse, nausea and vomiting, prolonged headaches.

bone destruction due to syphilis

Among visceral forms it predominates syphilis of the heart and vascular system(up to 94% of cases). Syphilitic mesaortitis– inflammation of the muscular wall of the ascending and thoracic aorta. Often found in men, it is accompanied by dilation of the artery and symptoms of cerebral ischemia (dizziness and fainting after physical activity).

Syphilis liver(6%) leads to the development of hepatitis and liver failure. Cumulative proportion of syphilis of the stomach and intestines, kidneys, glands internal secretion and lungs does not exceed 2%. Bones and joints: arthritis, osteomyelitis and osteoporosis, consequences of syphilis - irreversible deformities and blockade of joint mobility.

Congenital syphilis

Syphilis can be transmitted during pregnancy, from an infected mother to her child at 10-16 weeks. Frequent complications are spontaneous abortions and fetal death before birth. Based on time criteria and symptoms, congenital syphilis is divided into early and late.

Early congenital syphilis

Children with obvious underweight, with wrinkled and sagging skin, resemble little old people. Deformation of the skull and its facial part (“Olympic forehead”) is often combined with dropsy of the brain and meningitis. Present keratitis– inflammation of the cornea of ​​the eyes, loss of eyelashes and eyebrows is visible. Children aged 1-2 years develop syphilitic rash, localized around the genitals, anus, on the face and mucous membranes of the throat, mouth, nose. The healing rash forms scarring: scars that look like white rays around the mouth are a sign of congenital lues.

Syphilitic pemphigus– a rash of vesicles, observed in a newborn several hours or days after birth. It is localized on the palms, skin of the feet, on the folds of the forearms - from the hands to the elbows, on the torso.

Rhinitis, the causes of its occurrence are syphilides of the nasal mucosa. Small purulent discharge appears, forming crusts around the nostrils. Breathing through the nose becomes problematic, the child is forced to breathe only through the mouth.

Osteochondritis, periostitis– inflammation and destruction of bones, periosteum, cartilage. Most often found on the legs and arms. Local swelling, pain and muscle tension are noted; then paralysis develops. During early congenital syphilis, destruction of the skeletal system is diagnosed in 80% of cases.

Late congenital syphilis

Late form manifests itself in the age period of 10-16 years. The main symptoms are blurred vision with possible development complete blindness, inflammation inner ear(labyrinthitis) followed by deafness. Cutaneous and visceral gummas become more complicated functional disorders organs and disfiguring scars. Deformation of teeth and bones: the edges of the upper incisors have semilunar notches, the shins are curved, and due to the destruction of the septum, the nose is deformed (saddle-shaped). Problems with the endocrine system are common. The main manifestations of neurosyphilis are tabes dorsalis, epilepsy, speech impairment, progressive paralysis.

Congenital syphilis is characterized by a triad of symptoms Hutchinson:

• teeth with an arched edge;
• cloudy cornea and photophobia;
• labyrinthitis – tinnitus, loss of orientation in space, weakened hearing.

How is syphilis diagnosed?

Diagnosis of syphilis is based on clinical manifestations characteristic of different forms and stages of the disease, and laboratory tests. Blood taken to conduct a serological (serum) test for syphilis. To neutralize teponems, specific proteins are produced in the human body - which are determined in the blood serum of someone infected or sick with syphilis.

RW analysis blood (Wassermann reaction) is considered obsolete. It can often be false-positive for tuberculosis, tumors, malaria, systemic diseases And viral infections. Among women– after childbirth, during pregnancy, menstruation. Consuming alcohol, fatty foods, and certain medications before donating blood for RW may also cause unreliable interpretation of the syphilis test.

Based on the ability of antibodies (immunoglobulins IgM and IgG) present in the blood of people infected with syphilis to interact with antigen proteins. If the reaction has passed, analysis positive, that is, the causative agents of syphilis were found in the body of this person. Negative ELISA – there are no antibodies to treponema, there is no disease or infection.

The method is highly sensitive, applicable for the diagnosis of latent - hidden forms - syphilis and checking people who had contact with the patient. Positive even before the first signs of syphilis appear (by IgM - from the end of the incubation period), and can be determined after the complete disappearance of treponemes from the body (by IgG). ELISA for the VRDL antigen, which appears during alteration (“deterioration”) of cells due to syphilis, is used to monitor the effectiveness of treatment regimens.

RPHA (passive hemagglutination reaction)– gluing of red blood cells that have antigens on their surface Treponema pallidum, with specific antibody proteins. RPHA is positive in case of illness or infection with syphilis. Remains positive throughout the patient’s life, even after full recovery. To exclude a false-positive response, RPGA is supplemented with ELISA and PCR tests.

Direct methods laboratory tests help identify the causative microorganism, and not antibodies to it. Using this, you can determine the DNA of treponemes in biomaterial. Microscopy smear from the serous discharge of a syphilitic rash - a method for visual detection of treponemes.

Treatment and prevention

Treatment of syphilis is carried out taking into account the clinical stages of the disease and the patient's susceptibility to drugs. Seronegative early syphilis is easier to treat; with late variants of the disease, even the most modern therapy unable to eliminate consequences of syphilis– scars, organ dysfunction, bone deformities and nervous system disorders.

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

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

Prescribe a diet with an increased proportion of complete proteins and a limited amount of fat, and reduce physical activity. Sexual contact, smoking and alcohol are prohibited.

Psychological trauma, stress and insomnia negatively affect the treatment of syphilis.

Patients with early latent and contagious syphilis undergo the first course of 14–25 days in the clinic, then are treated on an outpatient basis. Treatment for syphilis begins with penicillin antibiotics– intramuscular injection of sodium or potassium salt benzylpenicillin, bicillins 1-5, phenoxymethylpenicillin. A single dose is calculated based on the patient’s weight; if there inflammatory signs in the cerebrospinal fluid (spinal fluid), then the dosage is increased by 20%. The duration of the entire course is determined according to the stage and severity of the disease.

Permanent method: the starting course for seronegative primary syphilis will require 40-68 days; seropositive 76-125; secondary fresh syphilis 100-157.

Course treatment: tetracyclines are added to penicillins ( doxycycline) or macrolides ( azithromycin), bismuth-based preparations – bismovrol, bijoquinol, and iodine - potassium or sodium iodide, calcium iodine. Cyanocobalamin (Vit. B-12) and solution koamida enhance the effect of penicillin and help increase the concentration of the antibiotic in the blood. Injections of pyrogenal or prodigiosan, autohemotherapy, and aloe are used as nonspecific therapy for syphilis, increasing resistance to infection.

During pregnancy, syphilis can only be treated penicillin antibiotics, without preparations with bismuth salts.

Proactive(preventive) treatment: carried out as in the case of seronegative primary syphilis, if sexual contact with an infected person was 2-16 weeks ago. One course of penicillin is used for drug prevention syphilis, if contact was no more than 2 weeks ago.

Prevention of syphilis– identification of infected people and their circle of sexual partners, preventive treatment and personal hygiene after sexual intercourse. Examinations for syphilis of people belonging to risk groups - doctors, teachers, staff of kindergartens and catering establishments.

Video: syphilis in the program “Live Healthy!”

Video: syphilis in the STD encyclopedia