Syphilis - symptoms and signs, causes. How to treat syphilis

How is it transmitted?

The most common and typical route of transmission of the causative agent of syphilis is sexual. Infection can occur through vaginal, oral or anal sex. As already mentioned, infection is most likely with skin manifestations of syphilis; the most contagious are hard chancre - painless ulcers that form during primary syphilis. Erosive papules that appear with secondary syphilis also pose a great danger, but with nonspecific rashes it is possible to become infected. The sexual route of transmission of syphilis is the most common, since during intimate intimacy microtraumas are formed on the mucous membranes and skin, through which the pathogen actually penetrates.

Another route of transmission of infection is transplacental (from mother to fetus). It is known that in the first three years after the mother is infected, the likelihood of developing congenital syphilis increases. The pathogen penetrates the placenta at 4–5 months of pregnancy, but there are cases of infection as early as 10 weeks of gestation.

Blood transfusion is another way of contracting syphilis. The transfusion route is possible at any stage of infection, including the incubation period. Currently, all donor blood is thoroughly checked, so this route of transmission of infection is practically excluded.

It is almost impossible to become infected through household contact, but in medical practice this has still happened. The infection is not transmitted through shared utensils and household items, but in close contact with a patient this is still considered possible.

There is another way of infection - professional. We are talking about laboratory employees, as well as sex workers. There are known cases of syphilis infection among surgeons, dentists and obstetricians-gynecologists.

At risk for the disease:

• prostitutes;
• homosexuals;
• persons who are promiscuous;
• persons practicing group sex;
• asocial elements of society;
• drug addicts;
• patients with gonorrhea;
• patients with hemophilia.

Stages of development

When treponema pallidum or spirochete penetrates damaged areas of the skin or mucous membrane, it proceeds in 3 stages and quickly begins to divide and multiply.

• Stage 1 - incubation period lasting 3-4 weeks;
• Stage 2 - after 7 weeks, when septicemia begins to develop if bacteria enter the subclavian vein with the appearance of secondary syphilomas;
• Stage 3 – development of secondary syphilis with the spread of Treponema pallidum through the bloodstream throughout the body.

Syphilis manifests itself in different ways and you can see photos in women: in the form of herpes, a single ulcer or chancre on the body. However, only diagnostics and a complete examination of the microbiological level in the body can accurately determine the type of infection and the causative agent of the disease.

A serology test for primary syphiloma may show a negative result. The reaction will become positive in the secondary stage of the disease, although the incubation period can be quite long, up to 1-2 years.

Classification of the disease

Syphilis is divided into forms and types, due to different timing, routes of spread and varied symptoms.

According to the degree of damage, syphilis is divided into:

• primary;
• secondary;
• tertiary.

In addition, it can be:

• hidden,
• congenital,
• late,
• chronic.

Primary syphilis - stage 1 of infection, a distinctive feature is the appearance of chancre. Chancres often appear on the genitals, since the sexual tract is the most common route of transmission of infection. Chancres can also appear on the face, mouth, mammary glands, and legs. Primary syphilis has no other manifestations.

Secondary syphilis - stage 2 of infection. It is characterized by the appearance of a papular rash. At this time, the patient experiences inflammation of the lymph nodes, damage to the nervous and musculoskeletal systems.

Tertiary syphilis develops in people who have not received treatment or have not completed treatment for the disease. Syphilitic granulomas appear on the mucous membrane, skin, bones, and internal organs, which destroy these structures. Currently, this stage is rare, since at stages 1 and 2 the disease can be successfully treated.

Latent syphilis is considered the most dangerous because the patient has no symptoms, but it poses a danger to others. Syphilis is classified as late if more than 2 years have passed since infection and symptoms have just appeared. Syphilis, which has developed over decades, is called chronic; it slowly destroys the body, and is not always accompanied by symptoms.

Necklace of Venus (syphilitic leucoderma)

It is a specific sign of syphilis. It forms in the neck area and appears as light, round lesions on the skin that look like a necklace.

Photo

The photograph shows a large number of light spots on the brown surface of the patient's skin, forming a characteristic Venus necklace .

Photo

The photograph shows a patient with a roseola rash , a characteristic manifestation of secondary syphilis.

Symptoms of syphilis

Since the disease goes through 3 stages, replacing each other, the symptoms at different stages will vary:

1. The appearance of chancre. This is a round ulcer with smooth edges and a dark red bottom. When rubbed, a liquid may be released from the formation, which contains live and active pale spirochetes. A couple of weeks after the appearance of chancre, inflammation begins in the lymph nodes. At this time, the pathogen has already spread throughout the body and multiplies in the internal organs. At the end of the first stage, a general intoxication syndrome occurs.
2. The appearance of a rash on the body. The rash most often appears after the ulcer has healed. Red-brown spots appear on the neck, chest and upper back. They are called the necklace of Venus, they do not hurt, do not itch and, apart from aesthetic discomfort, do not cause any inconvenience. At this stage, fever, sore throat, swollen lymph nodes, headache and muscle pain, patchy hair loss, fatigue, and weight loss appear. In every 10 patient, pathologies of the joints, bones, and nervous system are detected in stage 2.
3. Pallor of the rash. There are more of them in places of friction. Serious pathologies of the gastrointestinal tract, heart, respiratory tract, and brain occur. Since the pathology affects internal organs, it can be fatal.

Important! Without treatment, syphilis affects the eyes (ocular syphilis) and the brain and nervous system (neurosyphilis).

Chancre

It is formed, as a rule, at the site of penetration of Treponema pallidum (with genital contact - in the genital area, with oral-genital contact - in the oral cavity, in the lip area, etc.).

The formation of chancre occurs in several stages:

• formation of a small spot, pink-red color;
• formation of an erosive defect;
• compaction of the erosion bottom, color change to bright red. The erosion is covered with a transparent or brown film.

With timely treatment or, on the contrary, transition to the next stage of syphilis, the chancre again enters the spot stage and then completely disappears. As a rule, such a tumor does not cause discomfort in an infected person. Slight itching may occur in the area of ​​erosion.

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Chancre is classified according to the following criteria:

• by quantity (single, multiple);
• according to the depth of the skin lesion (erosive - affects only the superficial layers, ulcerative - the lesion affects the deep layers of the skin);
• by size (dwarf - less than 10 mm, medium - 10-20 mm, giant - more than 40 mm).

There are also atypical forms of chancre, which are extremely rare.

These include:

• chancre-amygdalid : a hard chancre located on the tonsil (in the ulcerative form of this process, a single tonsil is affected, it becomes compacted and a bright red ulceration with smooth edges is formed on the surface; in the angina-like form, a tissue defect does not form, the tonsil is dense, painless, pale treponema are found on its surface);
• chancre-felon (the clinical picture is similar to streptococcal felon, however, with a syphilitic nature, acute inflammation does not develop);
• indurative edema manifests itself in the genital area in the form of sharp swelling and changes in tissue turgor.

As a rule, diagnosing a typical chancre does not cause much difficulty. Its distinctive feature is the enlargement of regional lymph nodes, which remain dense and painless throughout the course of the primary stage.

Complications of chancroid:

• balanitis;
• balanoposthitis;
• phimosis;
• paraphimosis;
• phagedenism;
• gangrene.

Photo

The photograph shows the typical shape of chancre. There is a clear demarcation of this formation from healthy skin, a hyperemic surface of erosion, covered with a thin transparent film.

Diagnosis of syphilis

It is very important to identify syphilis at its first stage, at which time it is easier to treat and does not leave complications. Diagnostic measures begin with a visual examination of the skin and mucous membranes. During the examination, the doctor discovers dense purulent foci. You can differentiate chancre from other formations using palpation - it is painless.

For accurate diagnosis, a number of laboratory tests are required:

• RSKk;
• RMP;
• RPR;
• RSKt;
• RPGA;
• ELISA.

For research take:

• discharge from erosions, ulcers and papules;
• lymph;
• blood serum;
• cerebrospinal fluid;
• umbilical cord and placenta tissue.

A venereologist diagnoses and treats syphilis.

Ureaplasmosis

Ureaplasmosis is considered an insidious and dangerous disease due to the vagueness of its symptoms and its similarity to many other diseases. The incubation period can last several months: it all depends on the body’s reaction to the pathogen. At this time, the infection is actively developing in the body of a man who does not even suspect its presence.

In most cases, the first signs appear a month after infection. These include:

• scanty transparent or cloudy discharge from the penis (usually in the morning);
• itching, burning and pain during urination.

If left untreated, the infection can spread to the prostate gland. In this case, the symptoms of the disease include:

• increased body temperature;
• intense pain in the perineum and groin;
• difficulty and frequent urination (especially at night);
• in advanced cases - purulent discharge from the urethra.

Symptoms may subside, but may soon appear with renewed vigor. As a rule, a man is prompted to consult a specialist not by ureaplasmosis, but by the consequences to which it leads. The most common complications are urethritis, prostatitis, epididymitis and infertility.

Treatment of syphilis

Treatment of syphilis is based on the impact on the cause of the disease, that is, on the pathogen. This treatment is called etiotropic therapy.

Drug treatment consists of taking antibiotics:

• penicillins;
• tetracyclines;
• cephalosporins;
• macrolides.

Local treatment consists of using ointments, creams or gels, the action of which is aimed at mitigating the skin manifestations of the disease.

To generally strengthen the body and combat neurological symptoms, physiotherapy is prescribed, but it, of course, cannot be the main thing in the fight against infection.

Adjuvant treatment may also be used. The patient is prescribed:

• vitamin complexes;
• dietary supplements;
• immunomodulators.

Treatment tactics for pregnant women will depend on the duration of pregnancy and the severity of the disease. In some cases, when the disease threatens the child with dangerous pathologies, it is recommended to terminate the pregnancy. But most often, pregnant women are prescribed antibiotics.

There are no traditional methods for treating syphilis. Self-medication will not lead to a positive effect; therapy should only be selected by a doctor.

Vesicular syphilide

Vesicular syphilide occurs in severe syphilis. The main places of localization of syphilides are the skin of the extremities and torso. On the surface of the formed plaque, which is red in color, many grouped small vesicles (bubbles) with transparent contents appear. The vesicles quickly burst. In their place, small erosions appear, and when they dry, crusts form on the surface of the rash. When cured, a pigment spot with many small scars remains at the site of the lesion.

The rashes are resistant to therapy. With subsequent relapses they appear again. Vesicular syphilide should be distinguished from toxicerma, simple and acute herpes.

Consequences and prognosis

Regardless of whether syphilis manifests itself or not, in any case it has a negative effect on internal organs. The list of complications of syphilis includes the following:

• damage to the cardiovascular system;
• damage to the central nervous system;
• neurological deficits;
• impairment of intellectual abilities and memory;
• blindness;
• hearing loss;
• meningitis.

Development is possible:

• IHD;
• gastritis;
• hepatitis, up to coma and death;
• osteoarthritis;
• syphilitic pneumonia.

In the primary form of syphilis in men, the following may appear:

• phimosis;
• balanoposthitis;
• gangrene of the genital organ;
• balanitis

As for the prognosis of the disease, it depends on the stage of the disease and the effectiveness of treatment. With primary and secondary syphilis, the treatment prognosis is favorable; the third stage can lead to disability of the patient.

With congenital syphilis, the prognosis for treatment is positive, but only if adequate treatment is started immediately.

Chlamydia

In 46% of men, the disease does not manifest any symptoms. In this case, the man is potentially dangerous because he is a carrier of the infection and can infect his partner.

The incubation period is about 2-4 weeks. The clinical picture of chlamydia is as follows:

• scanty transparent discharge from the urethra. As the disease develops, they acquire a yellowish or greenish tint, and the unpleasant odor intensifies;
• periodic pain in the scrotum, testicles, lower back and urethra;
• pain, discomfort and burning during urination;
• swelling and redness of the external urethra;
• increased sensitivity during sexual intercourse;
• weakening of potency, premature ejaculation;
• deterioration of general condition: decreased performance, weakness, increased temperature to 37.50C, increased fatigue;
• there may be cloudiness in the urine, the presence of blood or pus in it;
• if the rectum is infected - burning and itching in the anus, discharge from it.

The severity of symptoms may vary. As a rule, these signs do not appear clearly. After some time, the symptoms disappear completely, which indicates that the disease has become chronic.

The chronic form is characterized by symptoms appearing only occasionally in the morning. The clinical picture is still poorly expressed.

Chlamydia often affects not only the genitourinary system, but also other internal organs and systems: cardiovascular, lymphatic, respiratory, organs of hearing and vision, liver, joints and teeth.

In this case, additional symptoms may be observed:

• pain in the right hypochondrium;
• swelling and hyperemia of the eyelids;
• increased photosensitivity;
• mucopurulent or bloody discharge from the anus;
• severe pain in the affected joints;
• sore throat, nasal congestion;
• bleeding gums;
• swelling and pigmentation of the skin over the affected joints.

Prevention

It is enough to see at least once what syphilis looks like to forever decide to give up promiscuous sexual intercourse. This is the most effective way to prevent this disease.

If a person has to live with a sick person, strict hygiene rules must be observed. Despite the fact that the risk of household transmission of infection is minimal, it still exists. Also, a person living with an infected person must periodically visit a doctor and undergo diagnostics to make sure that infection has not occurred.

If you have sexual contact with an infected person, it is recommended to immediately urinate, wash your genitals with laundry soap, and wipe your private parts with a disinfectant solution. This treatment is effective only in the first 48 hours after possible infection, since during this period of time the pathogen is still on the skin and mucous membrane. After more than 3 hours, such treatment is useless.

Syphilis is a dangerous disease that in the vast majority of cases is transmitted sexually. The disease is insidious in that even in the absence of symptoms, it can affect any organ of the human body and provoke various ailments. It is important to understand that cure for syphilis does not guarantee protection against re-infection. Immunity to Treponema pallidum is not developed. Therefore, you should always adhere to preventive measures, and at the first suspicion of a disease, immediately consult a doctor. With timely treatment, syphilis can be successfully treated. But untreated syphilis will destroy the body for years and can be fatal.

Follow-up

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

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