The first signs of syphilis, its diagnosis and treatment approaches

In the old days, tertiary syphilis was confused with leprosy and was considered a heavenly punishment for the ability to destroy the central nervous system and brain. Now it remains extremely dangerous due to its secrecy and the high prevalence of antibiotics. Modern medicines "stifle" its manifestations, but they are not always bright. And more than half of patients learn about it belatedly, when examined for a completely different reason.

As venereologists sometimes complain, with respect to sexually transmitted diseases, a sexually mature population tends to go to extremes: or they run to the doctor five minutes after the first unprotected sex with a stranger, demanding to find signs of the disease, and demanding to say: “What are the symptoms of girls ( or young men) with syphacus? ” Or vice versa, even suspecting the presence of syphilis in themselves or their wife, they postpone the visit to a specialist until the last, in the hope that "it will pass by itself." As a result, the disease is detected too late. For those who still doubt and ponder whether it can “pass by itself” immediately we make a reservation - it will not pass by itself.

The reasons

The cause of syphilis is pale treponema, a spirochete bacterium. She is poorly adapted to survive in the environment. For reproduction, it must be required:

• high humidity;
• lack of oxygen;
• suitable temperature conditions without significant fluctuations.

For transmission from person to person, she needs favorable conditions - damage to the skin or mucous membranes. Over the centuries of parasitism in the human body, which even antibiotics were unable to stop, it gained resistance to most drugs and "learned" to better hide its presence.

The main biological weakness of pale treponema in the ability to reproduce only at a temperature close to 37 ° C. It is equally effectively destroyed by dryness, freezing or boiling, chlorination. And her “strength” is in belonging to anaerobes. Pathogens of this type do not need oxygen and survive well in bone, cartilage, connective and other tissues lacking blood supply. Most bacteria cannot do this.

Transmission ways

How many transmission routes for syphilis are there? The answer to the question of how syphilis is transmitted has been mercilessly exploited by moralists for more than a century, since the main route of infection with it is through the sex. But the more direct the physical contact of a healthy person with a patient is, the higher the chances of infection, and such contact can be any. Sex is simply one of its closest and most traumatic options. You can get pale treponema in the following ways.

• During coitus. At any stage of the course of the disease, the partner, with all types of sex, including protected.
• At home. With hugs and kisses, the use of common hygiene items and utensils.
• In the hospital. With blood transfusion, other violations of the integrity of the skin with a reusable, poorly sterilized instrument.
• At the hairdresser or tattoo parlor. As in the hospital, due to the low hygiene of the instrument and manipulations.
• In utero. Due to the ability of pale treponema to overcome any biological barriers of the body, including placental and blood-brain-related. Sometimes children become infected with syphilis from their mother during childbirth (this depends on the stage of the disease in the mother during pregnancy).

Stages and symptoms of syphilis in women

Syphilis is dangerous by the ability to quickly switch to a latent course (often without an acute period) and manifest in cycles, from exacerbation to remission, creating the illusion of recovery. Its symptoms are associated with developmental stages.

Incubation

The incubation period is in any infection, bacterial or viral. Pale treponema has a long stage of almost asymptomatic reproduction. In the old days, it rarely exceeded a month. But now it is artificially prolonged by taking antibiotics and their presence everywhere in everyday life. Thanks to them, syphilis sometimes "ripens" for six months or longer.

A woman can early suspect infection with something on the purulent (yellow, with brown streaks of blood and unpleasant smell) vaginal discharge, inflammation and swelling of its walls, skin of the labia minora and labia majora. But with non-sexual infection or with sex that does not affect the vagina, discharge is often absent.

Primary or early

At this stage, the first signs of syphilis appear. Their selection is meager and often limited to the formation of chancre - a painless, dense ulcer the color of raw meat. The syphilitic chancre is usually hard (cartilaginous) to the touch, with a "varnished" surface, with protruding edges (it seems slightly concave). It is round, although when formed in the folds of the skin, it can take on a different shape and a large size (reaches 3 cm in diameter).

Skipping this is not easy, but it is formed at the pathogen’s entrance under the skin, and it is not always located on the visible surfaces of the body. Sometimes syphilis in women is manifested by the appearance of chancre on the walls of the vagina, between the labia minora, on the cervix. In both sexes, it can occur in the mouth - on the lips, on the tongue, mucous membrane of the palate, tonsils and even the wall of the esophagus. It also occurs on the anal sphincter, under the nails, anywhere on the body - depending on the circumstances of the infection.

After infection during classic sex, it can be found on the labia or the glans penis. And infection in everyday life, during medical and other manipulations, non-standard sexual intercourse (oral, anal sex) makes the place of its appearance unpredictable.

Secondary

This stage begins with the spontaneous disappearance of the hard chancre. It happens that the patient himself “helps” to disappear without understanding what the matter is - if the ulcer was located in a prominent place, and the patient decides to remove it with some antibiotic.After several days of relative “lull”, body temperature rises, inflammation of the lymph nodes rapidly spreads from the primary focus.

Secondary syphilis is characterized by rashes throughout the body - syphilis. Syphilitic rash is distinguished from allergies and other skin infections by the absence of itching or soreness, the correct round shape of the plaques, their separate, uniform location on the skin (there are exceptions depending on the age and characteristics of the skin). In its pure form, a syphilitic rash resembles an initial chancre, only soft and multiplied to infinity.

In addition to rashes, patients experience a loss of strength, severity and “fog” in the head, aches in the joints and along the bones (which distinguishes syphilis from influenza, gonorrhea and other infections that only joints respond to). Secondary syphilis appears, lasts for several days (maximum week) and disappears along with the remaining symptoms. Scars after them have not yet formed, but the necklace of Venus is already “looming” - spots of discolored skin where the rash is most often observed (neck, chest, inguinal region). The places of their location on the head are balding, this species alopecia irreversible.

Tertiary

Tertiary syphilis and its consequences look worse than secondary. The syphilides that occur with it already look like not a rash, but necrotic foci. They are not as numerous as secondary ones, but pass with the appearance of scars. The third stage often leads to disability or death because similar neoplasms can occur on internal organs. It is also characterized by infectious destruction of the bones and cartilage of the nose, upper palate, eye sockets, ears, cheekbones.

The third stage of syphilis is the last. On it, pale treponema affects even the most protected systems and organs of the body, such as the brain and spinal cord.

Hidden forms

This is what “classic" syphilis looks like. But over the centuries of coexistence with humans, the pale treponema has learned a lot. And now medicine is increasingly registering latent forms of infection that do not give vivid manifestations for decades in a row, detected by chance, according to typical lesions of the brain and spinal cord, bones, internal organs. Syphilis can quickly "go underground" for several reasons.

• Due to taking antibiotics. Especially strong in the incubation period. Usually this is just a coincidence: the patient still does not suspect that he has a spirochete and is being treated for something else. But she, like many other anaerobes, has even better protection against antibiotics than resistance, starting to multiply in tissues lacking blood supply. That is, they immediately "drive" it deep into.
• Due to folk remedies. This is a mercuric chloride, toxic herbs. Traditional medicine does not have truly effective drugs against bacteria, fungi, viruses and protozoa, since they are antibiotics. Alkaloids and tannins of poisonous plants possess such properties, but only with direct contact with the pathogen. Unlike antibiotics, the liver processes them too quickly for delivery to internal organs and tissues. And by means of traditional medicine, it is possible to achieve only a deceptive disappearance of symptoms, which does not affect the prognosis for the further development of pathology or the degree of contagion of the patient.
• Just because". Due to the nature of the immune response to the pathogen or spirochete itself.In some cases, the latent course of syphilis in patients cannot be explained, as well as episodes of spontaneous cure for it. This behavior is not observed in all bacteria, but it is not unique to pale treponema (the Koch’s stick behaves in a similar way). The most likely explanation is that not all spirochetes are pathogenic, and some of them enter the normal microflora of the skin, mucous membranes, etc. Many scientists believe that the question of whether or not to be their pathogenic colony is solved by the interaction between different types of spirochetes and the immune response on them.

Early latent syphilis is manifested by periodic ailments with aches in the bones, unmotivated fever and weakened immune defenses, especially of the skin and mucous membranes. The latter can be manifested by the addition of other genital infections, vulvites andvulvovaginitis in women, episodes of balanitis in men, eczema. The latent distribution of spirochetes does not cause serious immune disorders. Late latent syphilis can be expressed in increasing anomalies of the central nervous system:

• emotional instability;
• alternating depressions down to suicidal thoughts, with periods of euphoria and violent but meaningful activity;
• progressive headaches;
• disorders of intestinal peristalsis (acute cramping and pain, alternating constipation and diarrhea, indigestion, nausea and vomiting);
• insomnia;
• periodic “outages” of connected thinking and motor activity.

The process often ends with paralysis (complete or partial), dementia, an extensive stroke, the formation of an aneurysm (with the typical consequences of its breakthrough in the form of a hemorrhagic stroke). On average, patients with untreated syphilis go from the moment of infection to death in 15-20 years.

How to confirm the diagnosis and features of therapy

Diagnosis of syphilis in an open form and during an exacerbation is not difficult. At the slightest suspicion, according to the results of the external examination, a dermatovenerologist or gynecologist will definitely offer to take an analysis for syphilis. It is prescribed more often than it is found, due to the spread of a latent course with erased or atypical symptoms. Syphilis tests are performed on a sample of venous blood. Preparation for them requires the following measures from the patient.

• Empty stomach. It is necessary to refrain from eating for eight hours before the study, to exclude fats of all kinds from the diet - the day before it. Venous blood is always taken on an empty stomach for research. An exception is the suspicion of diabetes when measuring glucose levels before and after meals.
• No antibiotics. Their treatment of any pathologies should be stopped at least a week before analysis for syphilis.
• Abstinence from bad habits. Alcohol intake less than a day, and smoking less than two hours before blood donation can lead to false positive results of the study.

The effectiveness of studies of cerebrospinal fluid or arterial blood in cases of suspected treponema pallidum in scientific circles is estimated to be low. But they may be required to confirm or refute a positive result of a blood test, which left the doctor in doubt. A negative result, especially a nonspecific one (which determines only clearly high levels of antibodies in the blood), is also not a guarantee - the error with any of the methods for diagnosing syphilis is now about 10%. Most often, their accuracy is reduced:

• other viral or bacterial infections;
• malignant processes in the body;
• autoimmune processes, especially in the acute stage;
• pregnancy;
• successful disposal of syphilis in the anamnesis.

Immunity to pale treponema is not produced. Re-infection with it is a common situation, and antibodies remain in the blood until the end of life, stably giving false-positive results in a number of studies. The later the analysis, the higher its accuracy.

Drug approach

Pale treponema is resistant to macrolides - "Erythromycin", "Azithromycin"," Clarithromycin. " Now the treatment of syphilis in women and men of childbearing age is based on taking antibiotics of the penicillin series - from penicillin and bicillin to Amoxicillin (trade analogues of Ospamox or Augmentin). As part of adjuvant therapy, it is prescribed:

• antihistamines - “Claritin”, “Diazolin”, which are especially relevant during the period of skin rashes;
• tetracyclines - "Doxycycline" and others;
• cephalosporins - include in the treatment regimen with resistance of the pathogen to penicillins and tetracyclines, use "Cefazolin", "Ceftriaxone".

Folk methods

It is impossible to cure syphilis on your own at home. But the patients infected by him have two powerful moral blocks that reduce the desire to address their problem to an official medical institution.

1. Registration in the skin and venereologic dispensary. Not as serious as registration with law enforcement agencies, but sufficient to “tarnish” the patient’s reputation in the family and at work.
2. The need to bring a few more people. These are sexual partners who are believed to be the source of infection, as well as family members. If the patient is legally married, but not with a source of infection, the reluctance to destroy the family usually causes a complete rejection of treatment in the hospital.

When planning therapy yourself, you need to remember that folk remedies for syphilis such as mercury preparations, moderately (burdock, hop cones) and highly toxic plants (periwinkle, aconite, sedge, celandine, hemlock), wines with garlic are useless both when applied externally and ingestion. The main antibiotic in the treatment of syphilis is penicillin. Adults are prescribed it intravenously or intramuscularly, diluted with saline:

• with primary syphilis - 600,000 units daily for one to three injections per day, the course of treatment is ten days;
• in the second stage - 600,000 units daily for one to three injections per day, the course of treatment is 15 days;
• with tertiary damage to the central nervous system - 1,000,000 units every four hours for a month;
• with tertiary damage to the cardiovascular system - 600,000 units per day for one to three doses, the duration of therapy is 20 days.

It is strictly forbidden to independently treat a child from syphilis. The harm from the side effects of therapy can exceed that of the disease itself, even death. Antibiotics and bismuth are also contraindicated for use at any age with pathologies of the liver and kidneys, peptic ulcer, pregnancy and lactation.

Treatment of syphilis in women or men should include penicillin immunity, often found in pale treponemas, as this is an old antibiotic (used for more than 30 years). In the presence of such suspicions (low effectiveness of therapy, despite the shock dose), you can replace it, for example, with amoxicillin. Reviews indicate the high efficiency of the latter, the lack of resistance to it in most pathogens. Among its side effects, nausea and candidiasis are most often called.

Reviews: “Like hepatitis, it’s a trace for life”

Only today they were discharged from the hospital, lying with a sore throat. They took blood from a vein and said that they discovered syphilis. The doctor tried to reassure that with angina, there is often such an erroneous result and therefore they sent blood for a deeper analysis. I don’t know what to do now and how to tell my husband I didn’t cheat on him, but here it is ...

Nika, http://www.tiensmed.ru/news/post_new1406.html#comments

Get tested. Then you will panic. I have a lot of friends who in my youth have had this kind of illness. Everyone now has families and healthy children. Twenty years ago it was treated with retarpen. Now I do not know. I have not been working in medicine for 11 years already. He is very very very ill. Men fainted during injections.

Ai, http://forum.littleone.ru/showthread.php?t=7950963

My ex-husband got sick with syphilis in his youth, even before we met. We had a completely healthy child, the doctors knew about the husband’s biography and generally didn’t react to this. The main thing is that 5 years have passed. So this does not affect the child in any way. But like hepatitis, it’s a trace of a lifetime.

Solnce http://medservices.info/forum/threads/izlechim-li-sifilis.78/