The first signs and treatment of syphilis in men and women

Syphilis is a dangerous venereal disease of a chronic nature that causes severe consequences. Its first signs do not appear immediately and are often masked under the manifestations of other diseases, which greatly complicates the diagnosis. The duration of syphilis treatment depends on the stage of its development and may last for years.

• reasons
• How is
• first signs
• disease Chancre
• regional lymphadenitis
• Classification
• Stages and symptoms
• incubation period
• Primary period
• Secondary period
• Tertiary period
• Consequences
• Diagnostics
• Treatment
• Treatment
• home during pregnancy
• In children
• Prevention of

Causes of

The causative agent of the disease is a bacterium of the species Treponema pallidum( pale treponema).One of the stages of its maturation is intracellular development, with the death of the cell, many treponemes emerge into the intercellular space and spread along the tissues of their host.

Outside of the human body, the bacterium quickly dies under the influence of antiseptic and disinfectants, as well as high temperatures, however, carriers of syphilis can be dangerous to others - infection occurs through wounds on the skin and mucous membranes, blood, saliva.

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How is

transmitted Among the ways of infection with syphilis are the following:

• Sexually transmitted is the most common form of transmission, accounting for up to 70% of cases.
  

  
  

• Household - the transmission occurs when you are in direct contact with the patient during an active form of the disease. It is carried out through household items on which traces of excretions from the carrier's body containing treponem( pus, saliva, breast milk) have been preserved.
• Transplacental is a method of infection in which a disease is transmitted from a pregnant woman to a fetus. The born child will have congenital syphilis.
• Transfusion - involves the transfer of bacteria from blood transfusion from a sick donor. Most often it affects consumers of drugs sharing injecting syringes.
• Professional is a fairly rare method of infection, which affects medical personnel who perform examination and treatment of a patient or come into contact with his organs during autopsy( dentists, obstetrician-gynecologists, surgeons, pathologists).

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The first signs of the disease

Manifestationssyphilis begins about a month after infection. Most often this occurs at the site of infection in the body - on the genitals, in the anus, mouth and lips, as well as on the fingers, cervix and nipples in women.

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Hard chancre

Deep, almost always painless and necrotic ulceration of the correct round shape is the main symptom of the disease. Hard chancre is called for its density, it is also characterized by a stable size( about 1 centimeter, rarely - up to 3-4 centimeters) and lack of adhesion with surrounding tissues.

Sometimes, with a hard chancre, or atypically its forms may appear:

• Multiple chancre - the appearance of several ulcers.
• Indurative edema is a painless increase and cyanosis of the skin of the scrotum in men or the clitoris and labia in women.
• Shankr-panaritium - a painful purulent inflammation of the tissues, affecting the nail phalanges of 1-3 fingers( usually right), and characteristic for physicians.
• Shankr-amygdalite - an increase in one of the palatine tonsils in the oropharynx without defects on its surface. The tonsil protrudes into the throat, causing pain and difficulty swallowing. Often this condition is accompanied by a fever, a general malaise and resembles a sore throat.

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Regional lymphadenitis

Also an early manifestation of syphilis. It is characterized by an increase and consolidation of regional lymph nodes that are close to chancroid, with their painlessness, non-solubility with surrounding tissues and absence of temperature.

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Classification of

The following types of syphilis are distinguished according to the peculiarities of the disease:

• classic( stage) - with severe symptoms according to the stages of the disease;
• asymptomatic( latent or latent) - signs of the disease do not appear visually;
• serore-resistant - the presence of treponema in the analysis is preserved even after the course of treatment.
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Depending on the mode of infection:

• congenital( early and late);
• purchased.

According to the flow period:

• incubation;
• primary - is divided into seronegative( in which standard serological reactions are negative) and seropositive( begins 3-4 weeks after the incubation period, gives a positive response to the reaction);
• secondary - it can be fresh( or early), relapsed( recurrent) and hidden;
• is tertiary.

Depending on the affected organs:

• neurosyphilis is a lesion of the central nervous system, divided into early( up to 5 years from the time of infection) and late( over 5 years);
• visceral - damage to the internal organs( heart, liver, kidneys, lungs, stomach), is also early and late.

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Stages and symptoms of

There are several stages of the disease that are characterized by different manifestations:

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The incubation period

Is asymptomatic and lasts from the moment of infection with syphilis until the appearance of the first signs of the disease. Its duration is about 3-4 weeks, but, depending on the health of the body and taking antibiotics, it can grow to 1.5 months, in extremely rare cases - up to 6 months.

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Primary period

The duration of the stage is on average 6-8 weeks, but deviations can occur in either direction. The beginning of it is the appearance of a solid chancre and regional lymphadenitis.

Approximately 1-1.5 weeks before the end of the primary period, a person is enlarged with groups of lymph nodes distant from the source of infection. Perhaps the appearance of weakness, dizziness, increased body temperature, muscle pains, in rare cases - nervous disorders and depression, indicating a massive spread of bacteria in the body.

At this time, there is an active development of antibodies to treponema - first in the blood, then in the tissues. When they are enough to kill tissue treponem, local inflammatory reaction begins in the form of rashes on the skin and mucous membranes, which means the transition of syphilis to the second phase of development.

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Secondary period

The duration of the second stage in the absence of treatment is 2-5 years. The peculiarity of the course of the disease at this time is the alternation of exacerbations and latent periods with complete absence of symptoms. Secondary syphilis is the most dangerous from the point of view of contamination of others.

Among the characteristic symptoms of this phase are the following:

• Rashes - do not cause discomfort in the form of pain and itching. Often represented by leukoderma - numerous depigmented spots, including on the surface of the neck( the "necklace of Venus").They can also appear as pink-red roseola, papules rising above the surface of the skin, and pustules.
• Lymphadenitis - enlarged, but practically painless lymph nodes, when probed, there is an infiltration.
• Partial alopecia - hair loss with the appearance of a rash on the scalp.
• Wide condylomas - red or purple growths, in shape resembling cauliflower. Covered with a whitish coating and produce a serous liquid with a high content of treponem.
• Early neurosyphilis is a lesion of the vessels and membranes of the brain, expressed by meningitis.
• Early visceral syphilis is a lesion of internal organs of an inflammatory nature, similar to skin manifestations.

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Tertiary period

Asymptomatic chronic stage of the disease, which lasts up to 20 years and more. It is characterized by the following manifestations:

• Hocks are round, dense subcutaneous formations that have a dark red color with a bluish tinge, and a size of 1 millimeter to 1.5 centimeters. Develop asymmetrically and most often affect the extensor surfaces of the upper limbs, trunk, face.
• Guns are dense, painless knots located in deeper layers of the skin. Usually occur on the head, chest, forearms and lower legs. They can merge with each other, grow and break through, forming ulcers that emit a few drops of a sticky yellow liquid.
• Late neurosyphilis - degenerative-dystrophic processes in some parts of the brain and spinal cord( dorsal, progressive paralysis), mental disorders.
• Late visceral syphilis is a serious lesion of internal organs( heart, vessels, digestive, respiratory, musculoskeletal system), often irreversible.

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Consequences of

The syphilis flowing without treatment negatively affects the whole organism:

• From the side of the nervous system - brain damage leading to the appearance of such diseases as meningitis, neuritis, hydrocephalus. There may be headaches, nausea, vomiting, epileptic seizures, speech and mental disorders( hallucinations, paranoia, dementia), paralysis.
• Organs of the senses - visual and hearing impairment manifested by pupil abnormality, optic nerve atrophy, deafness. It is possible hoarseness or loss of voice.
• Musculoskeletal system - inflammatory, including purulent-necrotic lesion of bones, bone marrow and adjacent tissues. Cartilage structures are rotted and erased( deformation of the nose), the bones coalesce, causing the joints to remain immobile.
• Cardiovascular system - gums can occur in the region of the heart muscle, causing pain, dyspnea, rhythm disturbance, aortic compaction, coronary artery disease, myocardial infarction.
• Respiratory system - except for cough and bronchitis there are signs of tuberculous pneumonia.
• Liver - syphilis causes yellow atrophy of the liver, manifested by a decrease in its size, jaundice, hepatic colic, convulsions and hallucinations until the development of the hepatic coma and the death of the patient.
• Gastrointestinal tract - when affected, the symptoms are similar to gastritis and a stomach tumor.

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Diagnosis

To identify the disease, a specific method is used:

• Anamnesis collection - examination of patient complaints, a survey of aspects of sexual activity, the presence of venereal diseases in the past.
• Inspection - involves the study of mucous membranes and skin( especially on the genitals and in the mouth), palpation of the lymph nodes.
• Laboratory research - helps to detect in the body treponemu and the immunological changes caused by its activity.

Directly the causative agent of syphilis help to identify the following methods:

• Darkfield microscopy is the study of a material taken directly from the focus of infection( solid chancre, rash, lymph node biopsy) under a special microscope.
• A direct fluorescence reaction is the processing of a biomaterial by fluorescent serum, allowing a luminous bacterium to be seen by microscopy.
• PCR( polymerase chain reaction) - reveals the DNA of the infectious agent.

Serological studies of immunological indicators suggest a patient's blood test:

• Precipitation microretection( VDRL) - determines the presence of antibodies to cells damaged by pale treponema. The advantage of the analysis is that if the patient heals, it becomes negative, although other studies can show a positive result for a long time.
• The Wasserman reaction( RW, RV) is based on the phenomenon of complement binding, one of the mechanisms for the implementation of an immunological response. Depending on the result, there is a sharp positive, positive, weakly positive, negative.
• The reaction of immunofluorescence( RIF) - reveals antibodies of the human immune system to treponema.
• Immunoenzyme analysis( ELISA) - shows the presence of antibodies of various classes( IgA, IgM, IgG) and their number, which allows to determine the duration and dynamics of the disease, the activity of bacteria and the immune system of the patient.
• The reaction of passive hemagglutination( RPHA) - is based on immunologically induced gluing of erythrocytes. The reaction becomes positive 4 weeks after infection and can remain so even after successful treatment.

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Treatment of

The following measures are taken when the disease is detected:

• Preventive treatment is applied to persons who have had sexual or intimate contact with the patient in the last 2 months( with early forms of syphilis).It is also used to prevent re-infection.
• Preventative therapy - is given to pregnant women who have syphilis or who have recovered, but who have not been taken off the register. Also necessary for children born from sick mothers who were not treated during the gestation period.
• Trial treatment - used for the purpose of additional diagnosis if it is impossible to confirm the diagnosis in the laboratory.
• Specific therapy is the use of medications to which pale treponema is sensitive.

The main drugs for the treatment of the disease are the antibiotics of the penicillin group:

• Durant( prolonged) - ensure the presence of active substance in the body for 18-23 days, have the common name benzathine benzylpenicillin( Extensillin, Retarpen, Bicillin-1).
• Medium durance - remain in the body for up to 2 days( Procaine-Benzylpenicillin, Novocaine Salt of Benzylpenicillin).
• Preparations of water-soluble penicillin - are the most effective, but are excreted from the body after 3-6 hours( benzylpenicillin sodium salt).
• Combined penicillin preparations - their duration is 3-6 days( Bicillin-3, Bicillin-5).

In case of intolerance to penicillin group drugs, reserve broad-spectrum antibiotics - Doxycycline, Tetracycline( Unidox Solutab), Ceftriaxone( Rocefin), Erythromycin, and semi-synthetic penicillins( Ampicillin, Oxacillin) are used. The effectiveness of taking drugs such as Azithromycin( Sumamed), Safocid, Metronidazole has not been proven.

With resistance of the pathogen to antibacterial drugs in the Tertiary period and a good general condition of the patient, the use of bismuth or arsenic derivatives is possible.

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Treatment at home

Folk methods of therapy are directed mainly at symptomatic treatment of cutaneous manifestations. Antiseptic effect is possessed by honey and decoctions of herbs( chamomile, St. John's wort), which can be used as applications or rinses in the presence of rashes in the oral cavity.

Treatment of such a complex and dangerous disease as syphilis should be conducted under the supervision of specialists. Doing self-medication and uncontrolled using the methods of traditional medicine, you can worsen your condition and cause irreparable harm to the body.

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In pregnancy

Lack of necessary treatment during pregnancy can lead to the transmission of syphilis from a sick mother to the fetus. The probability of infection is higher at the initial, active stage of the disease, and a woman suffering from syphilis for more than 2 years can give birth to a healthy child.

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In children

Manifestations of child syphilis depend on its form:

• Early congenital - is found in newborns or children 3-4 months of life who have received the disease from the mother. Such children are poorly developed, have a small body weight, flabby folded skin of earthy or yellow hue. There are also changes in the shape of bones, including hydrocephalus( an increase in the size of the head), and various lesions of the nervous system, often leading to death.
• Late congenital syphilis is usually seen between 7 and 14 years old in patients who have had signs of early congenital syphilis, or if they are latent. Symptomatology is similar to the tertiary period with the formation of tubercles and hums, damage to the nervous system, internal organs, and the musculoskeletal system.
• Acquired syphilis - an active form of the disease in parents is especially dangerous for young children because of their tendency to lick their fingers. Most often, the first symptoms appear in the oral cavity.

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Prevention

You can protect yourself from the disease by following some rules:

• Only get in touch with a proven sexual partner.
• Avoid any contact with persons at risk( prostitutes, drug addicts).
• Use condoms during intercourse.
• Within 2 hours after an accidental unprotected contact, preventive treatment should be given.
• If you have a syphilis patient in your family, you need to provide him with personal hygiene products( towels, bed linen, toothbrush, comb), utensils. Also, avoid any physical contact( even touching).
• Test for STDs every 6 months.