How chancre appears. How long does it take for chancroid to appear in men? Syphilitic chancre, features of the disease. Appearance on genitals

They become the scourge of modern society. Is it possible to identify them at an early stage? Yes, if, for example, we are talking about syphilitic chancre. What it is?

This article will examine in detail the question of how syphilitic chancre is smoothed out and what are its features. You will also be able to find out how to treat this infection. And, of course, photos of syphilitic chancre and its manifestations will be given.

How it appears

Syphilis is a serious and severe sexually transmitted disease. In the first stages (during the first weeks after infection) it manifests itself in the form of chancre.

What it is

From what is written above, it becomes clear that syphilitic chancre is the initial stage of syphilis. Externally, it manifests itself as a purulent neoplasm, compacted inside and covered with a crust on the outside. Most often, these ulcers do not cause inconvenience or discomfort to patients, that is, they do not hurt, do not itch, or cause inflammation.

On the other hand, if you do not contact a specialist in time, such skin pathologies can develop into malignant formations or erosion, as a result of which not only skin covering, but also lymph nodes.

Sometimes syphilitic chancre can go away on its own, without treatment. However, this does not mean that the disease went away on its own. The disappearance of chancre indicates that syphilis has passed into a deeper form or has found a new place to localize the infection.

A little about the main disease

Since syphilitic chancre is the initial stage of a sexually transmitted disease such as syphilis, you should learn more about it.

Syphilis is a sexually transmitted infectious disease caused by the entry into the body of pathogens such as treponema. They are thin spirals that can move and bend in all directions.

Microbes multiply at a temperature of +37 °C, that is, at normal body temperature. It is noteworthy that they have a protective shell (or capsule) and feel comfortable in cold temperatures. But when boiled, treponemes die instantly, and at +60 °C they can self-destruct after fifteen minutes.

How can you become infected with this disease?

Methods of infection

Most often, syphilis is transmitted sexually. However, there are precedents when the disease was transmitted through a simple kiss on the cheek or due to the use of the same household items (towels, bed linen, toothbrush, dishes, medical instruments that have not undergone special treatment). In such cases, syphilitic chancre may appear on the arms, neck, and shoulders of the infected person.

In addition, syphilis can be contracted through blood transfusion.

How do doctors classify skin manifestations of the disease?

Types of anomalies

Most often, syphilitic chancre, which is the first sign of syphilis, has a solid base. It can appear anywhere - in the mouth, on the genitals, stomach, arms, and so on.

Skin manifestations of the disease can be isolated or localized in groups.

According to the depth of damage to the epidermis, the following chancres are distinguished:

• Ulcerative (relatively deep).
• Erosive (located on the surface of the dermis).

Based on the size of the wounds, experts distinguish the following categories of syphilitic chancre:

• Dwarf (up to one centimeter inclusive).
• Medium (from one to two centimeters).
• Gigantic (up to five centimeters in diameter).

Where it all begins

How to determine that an infected person does not have an ordinary skin rash or ulcer, but a syphilitic chancre? First of all, you need to know that the primary manifestation of syphilis on the skin of the body looks like a slight red spot found on the skin or in the area of ​​mucous tissue. Therefore, it is important to take a close look at it. A syphilitic neoplasm looks like this:

• The diameter varies from two millimeters to five centimeters, although sizes from one to two centimeters are most common.
• The shape of chancre is oval or round, with smooth, dense edges.
• The bottom is dark red in color and has a firm density.
• Sometimes the outer surface of the chancre has a purulent yellowish coating.
• The skin around the tumor is most often not inflamed, does not change color or thicken.
• If you press on both sides of the chancre, a clear, light yellow liquid will come to the surface. Be careful: it contains treponemes.

Progression of symptoms

The chancre may remain on the skin for several weeks and then completely disappear or heal. This means that syphilis has taken a latent form.

After this, the patient will begin to be bothered by other symptoms indicating a deterioration in general health:

• Muscle or joint pain.
• Numerous occurrences of syphilitic ulcers (scleradenitis).

This is due to the fact that treponemes are actively developing and spreading throughout the body.

Atypical (atypical) skin manifestations

Syphilitic chancre does not always have the characteristics described above. In some cases, syphilis can be complicated by other infectious diseases such as gonorrhea, genital herpes, and chlamydia. Then the chancres can change. The most common manifestations of syphilis on the patient’s body are:

• Felon. It occurs on the hands, most often on the fingers of the infected person. These are mainly occupational diseases that affect gynecologists or surgeons due to careless actions or other reasons. Such neoplasms cause a lot of pain and can provoke swelling of the dermis around the wound, suppuration, and a feverish state of the patient.

• Amygdalite. In other words - syphilitic chancre in the mouth. Affects one or two tonsils. It rarely bothers a person in the form of painful symptoms. Most often it manifests itself in an enlargement of one tonsil; the condition is not accompanied by an increase in body temperature or pain in the lymph nodes.
• Indurative edema. Appears on the genitals of an infected person. As a result, painful sensations arise, provoked by enlargement of the genital organs.
• Syphiloma-herpes. Most often, such syphilitic chancre in men manifests itself in inflammation of the head of the penis and the inner foreskin. This disease is also accompanied by the fact that the foreskin, moved away from the head, does not return back. It is even possible that the head may be pinched by the pericutaneous ring.

Such atypical manifestations of chancre can complicate the diagnosis of syphilis and lead to rapid progression of the disease, as a result of which blood circulation is impaired, which, in turn, can lead to tissue necrosis, gangrene, and so on.

Appearance on genitals

Localization of syphilitic chancre in men on the head of the penis or in women on the genitals is most common. This is due to the fact that in ninety percent of cases, syphilis is transmitted sexually, that is, during sexual intercourse.

In women, the initial stage of syphilitic chancre appears on the posterior commissure of the labia or cervix.

These neoplasms do not always look scary. The fact is that they may be no different from ordinary erosion or minor damage. At the same time, such chancres can hurt and bleed.

In women, syphilitic chancre in the vagina is extremely rare. But near the opening of the urethra or on the labia - quite often.

Sometimes areas of the skin located in close proximity to the genitals - the pubis, abdomen or thighs - can be affected.

Non-genital localization of syphiloma

Most often, chancre can be found in the oral area. Sometimes, especially at first, it is confused with candidiasis. However, with the latter disease, erosions have whitish, loose edges, while with syphilis, the wounds are red and dense, and can sometimes become covered with a yellowish crust.

Most often, chancre is observed on the lips, mucous membranes, tip of the tongue, and less often on the gums, tonsils, and palate. Sometimes they can appear on the mucous membranes of the eyelids, most often this is associated with kissing the eyes.

There are also anal syphilomas that form in the anus and inside the rectum.

A few general words about treatment

Here it should be noted that if skin neoplasms similar to syphiloma appear, you must immediately contact a specialist to prescribe urgent and comprehensive treatment.

The basis of drug therapy will include, first of all, treatment of the infection that provoked the appearance of skin formations, and not their cosmetic removal.

How to detect syphilis? To do this, you will need to take the necessary blood tests, as well as submit a chancre smear for examination.

How is the treatment carried out?

You should also know that both partners will need to undergo drug therapy at the same time.

Moreover, during the treatment period you will need to avoid any sexual contact with anyone.

If the patient did not have regular partners, then preventive treatment should be carried out on everyone with whom he came into intimate contact three months before the onset of chancre. Sometimes drug therapy may be needed for partners with whom there has been intimacy for six months or even more.

Also, during the treatment period, you should adhere to sanitary and hygienic standards as strictly as possible. This refers to regularly and carefully treating household items, personal hygiene items, and so on. It is also recommended that partners share personal items - bed linen, dishes, and so on. This is especially important when the places of manifestation of chancre are the mouth, fingers, and the like.

Drug therapy

What does treatment for syphilis include? First of all, this is antibacterial therapy, carried out under the supervision of a knowledgeable specialist and regular tests that will show whether the treatment is effective or not.

Treponemas are very sensitive to antibiotics such as penicillin, tetracycline, cephalosporin and their derivatives. Thus, the most commonly prescribed drugs are:

• “Estencillin.” Usually used in the form of intramuscular injections. The product is used twice, together with 0.5 percent novocaine. Sometimes one injection is enough.
• “Bicillin-5”. It is also administered intramuscularly, twice (the period between injections is five days).
• "Erythromycin". A tablet taken at a dose of 500 mg four times a day, half an hour before meals or an hour and a half after.
• “Doxycycline.” Also a tablet drug, taken four times a day, five hundred milligrams during or immediately before meals.

For local treatment, specialized ointments and gels may be prescribed. These include products based on erythromycin (one or three percent), mercury (ten percent), syntomycin (five or ten percent) or levorin (five percent). Baths or lotions can also be used on the affected areas. In such cases, benzylpenicillin or dimexide is used, due to which the drugs penetrate into the dermis and have a therapeutic effect.

If syphilitic chancre is found in the oral cavity, then in this case the attending physician may prescribe rinsing the mouth with furatsilin (diluted with water in a ratio of 1:10,000), boric acid(two percent solution) or gramicidin (also a two percent solution).

Of course, the specific dosage and duration of the course of a particular drug is prescribed only by the attending physician, who knows the entire clinical situation and has more detailed information. Most often, the treatment period can exceed more than two months, and in some cases it can last two years or more.

Don't forget about immunity

Since syphilis significantly reduces the body’s protective function, an important part of therapy for such a disease is to increase the patient’s immunity. This can be done using both traditional methods and pharmacological drugs.

For example, immunostimulating drugs may be prescribed, as well as vitamins and a complex of useful microelements that help improve immunity.

Other treatment factors

An important factor in successful drug therapy is maintaining a correct lifestyle during the treatment period. First of all, you should get rid of bad habits such as smoking and alcohol abuse.

Also, attending physicians most often prescribe a certain diet to patients with syphilis. The essence of it is to consume large amounts of protein and minimize the consumption of fat, especially animal fat.

Moreover, during the treatment period it is very important to monitor the patient’s psycho-emotional state. A patient with syphilis should not overexert himself either mentally or physically. It is recommended to avoid all kinds of stress, worries, and stress. To do this, it is recommended, if necessary, to use medications prescribed by a doctor.

We looked at what syphilitic chancre looks like and how to treat it.

Chancre is the first manifestation of the introduction of Treponema pallidum into the skin.

The asymptomatic period of syphilis upon infection usually lasts 3-4 weeks.

In the place where the treponema has penetrated the skin or mucous membranes, a small nodule appears, shaped like a circle or oval, colored reddish, initially vaguely demarcated from healthy skin. Soon the nodule gradually changes its consistency; it becomes dense and sharply demarcated from the surrounding parts. Then, upon palpation, a sharply demarcated hardening is felt, in typically pronounced cases of cartilaginous, densely elastic consistency.

Signs of chancroid

That's what it is syphilitic sclerosis – .

Subsequently, sclerosis, having existed for several days, becomes covered with whitish scales, which, peeling off, disappear. Gradually, sclerosis resolves, initially leaving a pigment spot, which then disappears. In other cases, sclerosis erodes, forming an erosive chancre. Sometimes sclerosis, gradually developing, begins to disintegrate from the surface, followed by the formation of ulcerative chancre. Thus, the primary syphilitic lesion can be in the form of a single round or oval surface erosion, non-painful, with sharply defined, smooth edges, or in the form of an ulcer, and the bottom of the ulcer is saucer-shaped, even, smooth, shiny, the color of living meat. It is located at the level or slightly higher than the surrounding parts, due to the deposition of a specific infiltrate in the bottom and edges. The discharge from the ulcer is mostly not purulent, but serous-sucrose, not profuse.

When the bottom of the ulcer is compressed between the large and index finger, you get a feeling of density, hardening. Where did the name of this lesion come from - chancroid or primary sclerosis.

Typically, erosions or ulcers of primary syphilis are single. However, in cases where the infection occurs simultaneously through several lesions, multiple erosions or ulcers are formed. They are at approximately the same stage of development, which is very typical for such lesions.

The size of erosions or ulcers of chancre varies. On average, it ranges from a few millimeters in diameter (dwarf chancre) to a centimeter in diameter or more (giant chancre).

Most often, their size reaches an average of ½ cm - 1 cm. If erosions or ulcers are located in skin folds, they lose their characteristic round or oval shape and become oblong, in the form of cracks.

The average duration of existence of hard chancre is from 3 to 6 weeks. Then it begins to heal, leaving temporary pigmentation after erosion or a permanent mark in the form of a scar after an ulcer. This is, in general terms, the usual course of chancre.

In typical cases, the appearance and development of hard chancre occurs without noticeable inflammatory phenomena along the periphery. However, sometimes it can be complicated by acute inflammatory phenomena, gangrene, phagedenism and associated chancroid.

Acute inflammatory phenomena can complicate the course of chancroid. Both due to contamination by pyogenic microbes, and from the introduction of chancroid sticks.

Uncleanliness and inappropriate treatment in the form of excessive cauterization with irritating substances, for example, lapis, copper sulfate, etc. also often contribute to the appearance of acute inflammatory phenomena.

The picture of chancre in these cases will differ from the usual one: redness appears around the chancre, the sharpness of the boundaries is lost, and the nature of the erosion may change - it becomes painful and separates a lot of pus. In appearance, it becomes similar to a chancre ulcer. The healing of such an ulcer is delayed.

And only after the source of inflammation has been eliminated, it again takes on the typical picture of chancre. As a result of sometimes developing inflammatory phenomena, men may develop phimosis and paraphimosis. And women have sharp, dense swelling of the lips major and minor. In some cases, with hard chancre, regardless of its size, a special peculiar swelling develops around the chancre, which does not have the character of acute inflammatory edema. This is the so-called indurative edema - oedema indurativum, which is extremely characteristic of the primary period of syphilis. With this swelling from pressure, there is no pitting and there is no redness (the color is dark red, with a bluish tint).

The swelling exhibits a special dense elastic consistency. Most often, indurative edema develops in men on the foreskin and scrotum, in women - on the labia majora and minora. When complicated by gangrene, a small area of ​​superficial necrosis forms in the center of the chancre, in the form of a dense grayish-black mass.

If the course is favorable, after a few days the area of ​​necrosis is cleared, the ulceration granulates, scars and heals. In other cases, necrosis quickly spreads, the ulcer is covered with a solid black scab, tightly fused to it. Then the scab becomes mobile, falls off and the ulcer heals with the formation of an irregular, ugly scar. The course of such chancre is long and painful for the patient. When the causes that caused gangrene are eliminated, healing, although it will be slow, does not cause major tissue destruction and ugly scars.

Phagedenism (necrotization) It also begins with gangrenization of the surface of the ulcer, and the ulcer can heal on one edge and spread further on the other.

Once the gangrenous scab falls off, the process does not stop. Gangrenous outbreaks are repeated and, as a result, deep tissue destruction occurs. So, for example, the entire labia majora, the entire foreskin, etc. may be destroyed.

Phagedenism develops mainly in severely malnourished people, alcoholics, the elderly, and tuberculosis patients. When simultaneous infection with chancroid and syphilitic infection occurs, the so-called mixed chancroid – ulcus mixtum – develops. In this case, on the second or third day, one or more typical deep ulcers of the chancre are formed.

With undermined soft edges, a greasy bottom, with copious purulent discharge, with noticeable inflammation along the periphery, very painful.

After two to three weeks, when the first incubation period expires, phenomena characteristic of syphilis appear, and the edges and bottom of the ulcers acquire a specific cartilaginous density. After the ulcer heals, it leaves scars that are located on the seal. The latter disappears after some time.

In some of these cases, the disease is accompanied by the formation of an inflammatory bubo, characteristic of chancroid. But subsequently the glands acquire changes typical of syphilis.

Atypical chancroid

Hard chancre can be localized on any part of the human body, depending on where the infection penetrates. Most often, the primary syphilitic lesion is localized on the genital parts, resulting from infection during sexual intercourse.

Atypical chancre(extragenital sclerosis) can be localized on the lips, mouth, pharynx, and tongue.

On the cheeks, on the gums, on the wings of the nose, on the eyelids, on the breast nipples, on the arms, on the legs and other places.

Histologically, with the primary syphilitic phenomenon - chancre, the most significant changes occur in the vessels - lymphatic, arterial and venous.

The spirochete penetrates through damaged skin or mucous membrane, first into the intercellular spaces and then into the lymphatic crevices and capillaries of the skin itself. It causes inflammatory phenomena of varying degrees, with the release of lymphocytes from the vessels, changes in the walls of blood vessels and the formation of a special cellular infiltrate around them.

The latter consists of lymphocytes, plasma cells, proliferating connective tissue cells, as well as a few epithelioid and giant cells.

The vascular endothelium multiplies, desquamates, blood clots appear, blockage of the lumens of blood vessels, and tissue breakdown.

The density of chancre depends on the sharply developed limited cellular infiltration of blood vessels, and also, apparently, on their hyaline degeneration. Some also associate this density with the development of a finely looped network of lattice fibers in the infiltrate.

The pale spirochete is found between epithelial cells. And also in the lumen of blood vessels, especially lymphatic ones, in their walls and along the periphery.

The rapid spread of the spirochete depends on its early penetration into the lumens of blood vessels and intercellular spaces, on its rapid entry into the lymphatic system, glands and epidermis, from where it can also serve as an easy source of infection.

The presence of the spirochete causes significant changes in the skin itself, as well as in the epidermis. Where vacuolar degeneration develops, the death of a number of layers, rejection of the horny, granular, spiny, erosive chancre occurs. If there are changes in the blood vessels, endo-meso-peri-vasculitis leads to blockage of blood vessels, causing disorders in tissue nutrition and tissue breakdown, destruction of the skin itself, and ulcerative chancroid occurs.

With erosive chancre, the death of the skin itself and underlying tissues does not occur. Therefore, the process ends without a lasting trace; the epidermis from the periphery of the erosion, growing, compensates for the former defect.

With ulcerative chancre, not only the papillary layer is destroyed. But often also the deeper parts of the skin and subcutaneous fat. Therefore, after an ulcerative chancre there is always a permanent mark, a scar.

A constant companion of chancroid is the so-called primary lymphadenitis. It develops 1-2 weeks after the appearance of chancre.

Depending on the location of the chancre, the corresponding lymph glands thicken and swell. So, for example, when sclerosis is localized on the genitals, the inguinal glands are affected earlier than other glands.

When sclerosis is localized on the chest or arm, the axillary or ulnar glands are affected.

If sclerosis is located on the tonsil, then the submandibular or anterior ear gland is affected.

If on the lips, then the submandibular glands, etc., swell; with syphilitic primary adenitis, one gland swells. Later, other glands of this group enlarge.

The glands gradually acquire a special density, different sizes, and are not fused to each other, neither to the skin, nor to the underlying tissues. The glands are painful, round or oval in shape, often arranged in a row in a distinct manner.

Swelling of the lymph glands in syphilis is not limited to the location of the primary sclerosis. 3-4 weeks after the appearance of the latter or 7-8 weeks after infection, all other lymph glands swell and enlarge. General polyadenitis develops. This is a progressive enlargement of the lymph glands. It, like a number of other characteristic painful symptoms, precedes the appearance of secondary syphilis - general polyadenitis develops at the end of the primary period.

Diagnosis of chancre

Hard chancroid is diagnosed based on the clinical manifestations described above and the presence of a pale spirochete in the discharge of erosions or ulcers. Some blood reactions are not important in the diagnosis of primary sclerosis, because they become positive only 4-6 weeks after infection.

When making a differential diagnosis, one should first of all keep in mind chancroid.

The clinical picture of a typical hard chancre differs sharply from that of a soft chancre.

A developed soft chancre is an ulcer; a hard chancre can be in the form of erosion, disappearing without a lasting trace. If you are dealing with ulcerative chancroid, it usually does not have inflammatory phenomena along the periphery, but soft chancroid does.

The edges of an ulcer of a soft chancre are undermined, while with a hard chancre they are dense, not undermined, and go directly into the bottom, which is usually smooth, shiny, and the discharge of the ulcer is scanty. In addition, with a soft one, the bottom of the ulcer is uneven, has separate depressions, and abundant purulent discharge.

An ulcer of a soft chancre is painful, a hard one is usually painless.

The number of ulcers with syphilis is always less.

Soft chancre is usually multiple - new ulcers gradually form, since their secretion is easily released. With syphilis, new ulcers do not appear - their secretion does not appear in the patient, or more precisely, it appears only during the first 10-12 days of the existence of the primary phenomenon.

Objective data are supplemented with chancroid by the presence of characteristic painless primary lymphadenitis or polyadenitis.

In mild cases, the glands are painful, welded together, with subcutaneous tissue, skin, and have a tendency to produce buboes.

When examining discharge from ulcers or punctate lymph glands in syphilis, a pale spirochete is detected, and in chancre, streptobacilli.

Anamnesis complements the clinic – with chancroid incubation period short - 2-3 days, for syphilis - 2-3 weeks.

Primary lymphadenitis is always observed with hard chancre; with soft chancre, adenitis may be absent. Lymphangitis does not always occur with syphilis, for example, along the back of the penis.

If it is present, unlike soft-chancroid lymphangitis, there is no inflammatory swelling of the skin - it is not fused either to the skin or to the underlying parts.

With chancre, there are usually severe inflammatory phenomena. And sometimes the transition of lymphangitis to suppuration, then the so-called bubonulus is formed - a small bubo. In many cases, it is practically important to promptly distinguish erosive chancroid from erosions of herpes, which often recurs on the genitals. However, a careful examination usually reveals that erosion after herpes resulted from the merger of a group of erosions after former blisters. Since about the periphery there are scalloped outlines of the lesion and the inflamed background on which they arose. When palpating the erosion of herpes, they do not detect compactions or infiltrates, which are so characteristic of chancroid.

Concomitant lymphadenitis, if it occurs with herpes, is usually of an acute inflammatory nature. Bacterioscopic examination facilitates diagnosis.

If you suspect syphilis, contact the author of this article, a venereologist in Moscow with 15 years of experience.

When diagnosing syphilis in a victim, experts mean a chronic venereal disease that affects the skin and mucous membranes of the body, internal organs, bone tissue, and the central nervous system.

The formation of the disease is provoked by a pale spirochete, which, being outside the human body, is characterized by weak resistance to alcohol, soapy water, and high temperatures. At the same time, syphilis is a very dangerous condition, since the pathogen is able to penetrate the human body through damage even invisible to the eye.

Pathology transmission routes

Let's look at syphilis and its spread. It is not for nothing that the disease is called a venereal disease, since the disease is transmitted from the carrier to the victim, with the exception of only 5% of cases through sexual contact. In this case, infection occurs not only during vaginal contact, but also during anal and oral intercourse.

Syphilis can also be:

• - this form is extremely rare, because even if treponema gets on personal hygiene items? She quickly dies.
• Congenital (observed in infants) - infection occurs either during gestation or during labor. The lactation period is also quite dangerous if the mother is sick with syphilis.
• Another rare method is blood transfusion. Modern medicine carefully examines donors; moreover, when the substance is preserved, the pathogen dies within five days. Only direct transfusion from a carrier poses an increased danger, which occurs infrequently.

But even if contact with a carrier has taken place, manifestations of syphilis may be absent in 20% of cases - infection does not occur because the necessary conditions for this do not exist. In particular, the amount of viral agents in an infected biomaterial can be very small; the absence of microtrauma or individual immunity plays a role.

The risk of infection increases when the carrier experiences primary or secondary manifestations of syphilis, accompanied by erosive and weeping elements of pathological rashes. If we are talking about late pathology - latent or tertiary - infection occurs very rarely during contact with a carrier.

Since a syphilitic rash can form in any area of ​​the skin or mucous membrane, condoms cannot be considered reliable protection; they only reduce the risk of infection, also protecting against urogenital infections that usually accompany the underlying disease.

As for how long it takes for syphilis to manifest itself, it is important to have an idea of ​​the incubation period. On average, its duration is from three to four weeks, but the interval can decrease to two weeks or increase to six months if the victim takes antimicrobial drugs for any reason.

It should be understood that even in the case of active development of pathology, symptoms may be absent at first. Laboratory tests can determine the presence of the disease only two to four weeks after its primary period begins. Accordingly, all partners of the carrier who had sexual contact with him during this period are at risk of infection, hence the need to test for syphilis.

First diagnostic symptom

The standard primary manifestations of syphilis are the formation of hard chancre along with an increase in the size of the lymph nodes. A chancre is an ulcer or erosive lesion of a round shape, distinguished by clear boundaries. Usually it has a red tint, secretes a serous substance, thus acquiring a “varnished” appearance. The discharge contains an increased amount of pathogens; when examining the fluid, they can be detected even in cases where nothing suspicious is found in the blood during laboratory tests.

The base of the chancre is hard, its edges are slightly raised, forming a shape similar to a shallow saucer. Syphiloma is usually not accompanied by pain or other uncomfortable symptoms.

There are many places for the formation of syphiloma - it can be the genitals or the anus, it all depends on the type of sexual contact.

The formation of primary symptoms occurs in stages:

• From the moment the pathogen enters the body until the symptom is formed, it usually takes from two to six weeks.
• Enlargement of the lymph nodes that are located closest to syphiloma usually begins after seven days.
• After another three to six weeks, the ulcers have healed so that there are no visible symptoms.

There are a number of additional signs that accompany the formation of chancre, in this case the first manifestations include:

• problems with sleep, development of insomnia;
• fever (increased body temperature);
• headache and joint pain, bone discomfort;
• general malaise;
• swelling of the genitals.

Atypical symptoms of the pathology include the appearance of amygdalitis chancres in areas of the tonsils, the formation of chancre felons on the fingers, indurative swelling in the labia area, regional lymphadenitis and lymphangitis.

Signs at different stages of the disease

The development of syphilis occurs in three periods - primary, secondary, tertiary. They are preceded by a three-week asymptomatic incubation period. Let's consider how syphilis manifests itself in different periods of formation.

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Primary process

We discussed the incubation and primary periods above. It should perhaps be added that during the incubation period the carrier is not infectious, so the Wasserman reaction will show a negative result. As for primary syphilis, at this stage of the development of the disease the patient becomes infectious.

Now about chancre - its disappearance occurs without any treatment, and a scar is formed at the site of syphiloma. At this stage, increased attention is required - even in the case when the chancre completely disappears, it is impossible to talk about healing, since the development of the disease continues.

After the treponemes enter the lymph nodes, they are carried throughout the body along with the bloodstream. The presence of a primary period of pathology can be indicated by either unilateral or bilateral enlargement of the lymph nodes, usually observed in the groin area. They are distinguished by their dense elastic consistency, mobility and painlessness.

In the first half of this period, the Wasserman reaction, along with other blood tests, continued to remain negative. However, in the second half of the period - usually the sixth or seventh week from the onset of infection - blood tests show a positive result, revealing the presence of syphilis in the body.

The above weakness, fever and pain occur at the end of the primary stage of syphilis - these signs can be considered harbingers of the formation of a generalized rash, which marks the beginning of the secondary stage of the pathology.

Secondary form

About ten weeks after infection of the body - which implies the typical development of pathology with syphilis - signs appear on the skin indicating a fresh secondary stage of the disease. We are talking about a syphilitic rash, including pustules and spots, nodules. None of the listed elements causes discomfort. The rash disappears after a few weeks without requiring any treatment. medicines. After it passes, we can talk about the beginning of secondary latent syphilis.

It is characterized by certain manifestations, including:

• syphilitic rash;
• hair loss;
• discolored spots on the skin of the neck;
• positive Wasserman reaction along with other tests performed for syphilis.

Any of the elements of the rash at this stage are highly contagious, but completely painless.

A feature of the secondary period of syphilis is an increased risk relative to the possibility of domestic infection. The duration of this stage is usually from two to four years.

Tertiary form

Let's see how tertiary syphilis manifests itself. Typically, this stage occurs five or more years after infection. The main features characterizing the tertiary stage include:

• The formation of gummas - foci - in bone tissue, skin, liver and brain, lungs and heart muscle and even eyes. Gummas are subject to decay, resulting in the destruction of the area in which they were formed.
• The appearance of ulcers on the mucous layers of the palate and back of the pharynx and nasal cavity.
• Possible damage to the nasal septum and its gradual destruction.
• The symptoms of this stage are closely related to the destruction of nerve cells and the spinal cord and brain; they manifest themselves in dementia and the appearance of progressive paralysis.

At this time, visible lesions practically do not include the pallidum spirochete, and accordingly they are rarely infectious. When carrying out the Wasserman reaction and other laboratory tests, a weakly positive or negative reaction is noted.

Regardless of the syphilitic symptoms, each stage of the pathology is curable. However, at the third stage, the disease not only affects, but can also destroy many human organs, making cell restoration impossible. Quite often in such a case, the victim becomes disabled for the rest of his life.

Features of a syphilitic rash

The main symptom of syphilis is a rash, the appearance of which is not accompanied by unpleasant sensations. At the initial stage of the pathology, it is a hard chancre; at the secondary stage, syphilis can manifest itself with a variety of elements, from pink spots to papules and pustules. In this case, all types of rash can form simultaneously, most often localized on the hands or sole of the foot. Usually there is no pain or itching at all. An unpleasant sensation occurs in very rare cases when palpating papules.

Given the almost complete absence of discomfort, victims often ignore the rash. In addition, it goes away on its own, and therefore therapeutic measures are used with considerable delay. Nevertheless, syphilitic rashes have a number of characteristic signs:

• The rash is copper colored.
• The lesion that accompanies the rash is peeling or the formation of dirty brown, gray scabs.
• The rash can both disappear and reappear - here the ratio of treponema pallidum and antibodies contained in the blood plays an important role.
• If a relapse occurs, the rash can change. It becomes larger, ovals or circles form on the skin and mucous membranes. This development can be observed over a period of four or five years - all the time that secondary syphilis continues.
• In the presence of tertiary syphilis, subcutaneous compactions occur. Their diameter can reach 1.5 cm. Such compactions transform into ulcers over time. Lumps may form on the skin, forming circles, in the center of which ulcerative lesions appear and necrosis forms.

Considering all the dangers of the disease, if suspicious symptoms appear, it is necessary to immediately contact a venereologist to make an accurate diagnosis and develop a therapeutic regimen.

Features of the location of rashes in men and women

When comparing the signs of pathology developing in representatives of different sexes, it can be noted that the main differences lie in the localization of foci of syphilis. In men, lesions are concentrated on the scrotum or head of the genital organ, in women - on the labia minora and the mucous layer of the genital organ. If anal and oral sexual intercourse takes place in lovemaking, the negative phenomena are concentrated on the sphincter, the mucous membrane of the mouth, throat, lips and tongue. The skin of the neck or chest may be affected.

Syphilis may long time proceed in a hidden form. In order to prevent transmission of the disease, it is worth knowing how syphilis manifests itself, the characteristics of its course, symptoms and treatment rules. Sexually transmitted diseases are dangerous pathologies that can lead to serious health complications. The fact is that many of them are not accompanied by symptoms at the initial stage, for this reason the disease can simply not be noticed, and at this time it gradually affects the internal organs. One of these diseases is syphilis. It can occur in women and men.

• Causes
• Symptoms
• Syphilis rash
• Forms
  • Primary
  • Secondary
  • Tertiary
• Diagnostics
• Features of treatment
• Prevention

Causes

The development of syphilis can occur due to various reasons, but sexual contact is considered the most important. Infection often occurs during sex with an infected sexual partner. The causative agent of the disease, Treponema pallidum, penetrates the mucous membrane and damaged skin.

Subsequently, the bacteria quickly enter the structure of the lymph nodes, where they instantly multiply and, together with the blood flow, spread throughout the body. As a result, they settle in internal organs, bones, joints and the central nervous system.

The manifestation of syphilis can also be provoked by other reasons:

• It can appear in women and men after using contaminated personal hygiene items - shower and bath products, towels, linen, brushes, washcloths, dishes with residual saliva particles;
• the risk of infection is increased during professional contacts. This disease can be caught while working in a laboratory or in hospitals. Infection occurs especially often through careless handling of medical instruments, cutting and piercing objects, which can damage the skin of the hands, fingers and come into contact with dangerous microflora of the virus.

The disease is especially dangerous during pregnancy and for women who are planning childbirth. The fact is that an infection in the body (treponema pallidum) can develop for a long time without signs, during which time it can have Negative influence on the development of the unborn child.

Symptoms

The main danger of syphilis is that at the initial stage this disease does not manifest itself in any way and is not accompanied by symptoms. For this reason, many simply do not notice the presence of a pathological process, and meanwhile the infection spreads to internal organs, systems, and bone tissue.

The incubation period of the disease takes on average from 2 to 6 weeks. However, sometimes it may not develop for years; this can happen when taking antibiotic drugs, during the treatment of infectious colds. During this period, laboratory tests will not be able to give reliable results.

Syphilis manifests itself by internal and superficial lesions. Common symptoms include the following:

• chancre and enlarged lymph nodes - these are the most important symptoms. They are the ones who 100% confirm that a pathogen has entered the body. A chancre is a smooth, painless ulcer with a dense infiltrate. The formation has rounded, slightly raised edges with a diameter of about 1 centimeter. Accompanied by a bluish-red color, may have painful sensations. Within a week after the onset of chancre, an increase in lymph nodes is observed;
• headaches and symptoms of general malaise are observed;
• pain in the muscles and joints;
• temperature increase;
• decreased hemoglobin level;
• increase in leukocytes in the blood;
• indurative edema may form;
• felon. Accompanied by an inflammatory process of the nail bed. The condition may last for several weeks;
• amygdalitis may occur. During it, swelling of the reddened tonsils and difficulty swallowing are observed.

It is important not to forget that syphilis infection can occur through any form of sexual intercourse. Therefore, oral sex is especially dangerous when infected, during which condoms are rarely used.

Thus, primary syphiloma is formed at the site of the introduction of pallidum treponema; with oral infection, the chancre will be located in the mouth or throat. Moreover, if your partner has a chancre in the mouth, you can become infected without sex, just through a kiss.

If the infection occurs during anal sexual intercourse, the chancre is localized in the anal area. At the same time, it often looks atypical and, in shape, is not round, but slit-like.

For infection to penetrate, contact of the pathogen with the mucous membranes is not always necessary. The skin can also become an entry point for infection, especially if it is damaged. Chancroid in such situations is often localized on the skin of the thighs, face or abdomen.

Syphilis rash

Approximately 3-4 weeks after the incubation period, skin rashes may be observed. They are not accompanied by itching or pain. Skin manifestations of syphilis are dark red in color, have a dense consistency, and straight edges without peeling.

The rash can be of different types:

1. Rosaceae. During a rash of this type, small oval or round spots (about one and a half cm) form. They are located over the entire surface of the body, arms, legs. Their boundaries are not clearly defined, do not blur and do not rise above the skin;
2. Papular. Round formations with a pale pink color. The size of the rash is 1 centimeter. The surface is smooth, there are slight peelings. The main locations are the area of ​​the soles of the feet, on the palms, on the surface of the mucous membranes of the genitals. Sometimes a pale rash appears all over the body;
3. Condylomas. These are connected papules that have ulcers;
4. Leucoderma. This condition is characterized by the appearance of white spots against the background of darkening of the skin. Over time, they acquire a brownish-yellow color. The rashes are localized on the neck, armpits, chest, arms;
5. Arthematous sore throat. Rashes appear on the oral mucosa, near the pharynx, and on the surface of the hard palate. The Treponema pallidum bacteria themselves are located inside the cavity of the papules;
6. Alopecia. A large number of rashes with a diameter of 1-2 mm are formed on the surface of the scalp. Over time, hair loss occurs in these areas.

In order to understand how the types of rash can manifest themselves and what they look like, it is worth looking at the photo.

Forms

Syphilis can occur in several forms, and each of them can have distinctive features. For this reason, it is worth taking a closer look at the manifestations of each.

Primary

The primary form is early latent syphilis. It is usually observed several weeks after the moment of infection.

Patients with primary syphilis do not immediately notice its manifestations. For this reason, the disease can spread to internal organs, tissues, systems and cause serious health complications.

During the initial form of syphilis, symptoms appear:

• the appearance of specific ulcers with rounded shapes, which are also called chancre;
• After about 2 weeks, the chancre completely disappears. This means that pathogenic bacteria have entered the body;
• damage to the lymph nodes appears, and their enlargement is also observed;
• the primary form affects internal organs and systems.

Secondary

At the 11th week of infection, symptoms of secondary syphilis appear. This form is accompanied by the appearance of syphilitic infectious lesions in the form of spots, rashes, ulcers, and nodules on the skin.

The formations have no pain or discomfort. If treatment is not carried out in a timely manner, they will disappear completely over time. This means that the disease goes into a latent form. Over time, secondary syphilis may reappear, during which all the characteristic symptoms may reappear.

The secondary stage can last for 4 years. However, it is accompanied by serious health complications.

Tertiary

Approximately 5 years after the secondary stage, the disease becomes tertiary. It is considered the most severe, during which the following complications may occur:

• severe damage to internal organs;
• the appearance of lesions (threshing floors) on the skin;
• lesions can be observed on the mucous membranes and internal organs - on the heart, liver, lungs, brain. They also attack bones and eyes;
• Often the disease affects the nasal mucosa. Lesions lead to complete destruction of the nasal septum;
• At this stage, dementia and progressive paralysis appear.

Diagnostics

Diagnosis should be carried out as soon as the first symptoms of syphilis appear. Of course, this disease can occur in a latent form for a long time, but still, if you start treating it at the initial stage, you can quickly eliminate all its unpleasant manifestations.

It is also worth starting the examination if you have recently had sexual contact with a carrier of the disease. In these cases, infection is most likely to be confirmed. And in order to get the most accurate results, laboratories conduct blood tests, which are taken from a vein.

Modern serological and immunological blood tests make it possible to identify the disease with maximum accuracy within a few weeks of infection. The test allows you to detect the disease with an accuracy of 99.8-100%.

There are many types of tests that can detect the presence of a pathogen in the body. However, the diagnostic criterion for syphilis is usually serological tests.

The principle of serological reactions is to detect antibodies to Treponema pallidum in the blood. Moreover, if little time has passed since the moment of infection, the body may not yet have time to produce antibodies. This type of syphilis is called primary seronegative and is difficult to diagnose. In this case, in the presence of hard chancre, a preliminary diagnosis is made based on the clinical picture and survey data. In the future, the patient needs to be tested again to confirm the infection.

At the stage of tertiary syphilis, the body's immune response may be low. However, standard research methods do not detect the presence of antibodies in the blood. This happens in about a third of cases of tertiary syphilis. To establish an accurate and definitive diagnosis in this situation, additional tests are required.

Types of tests for diagnosing syphilis

Diagnosis may require the following blood tests:

• RPR and MP;
• Linked immunosorbent assay;
• Immunofluorescence reaction;
• Treponema pallidum immobilization reaction;
• Passive hemagglutination reaction.

The previously popular classical Wasserman reaction is not used today due to its low efficiency in comparison with RPR. In the old fashioned way, this test can continue to be called RV.

Tests are divided into non-treponemal (RPR and microprecipitation reaction) and treponemal (RIF, RIBT, RPGA, ELISA).

Non-treponemal ones, that is, those that do not determine the presence of the pathogen itself, are cheaper than treponemal ones. However, such tests are less effective and require additional checks if the reactions are positive. Let us consider the principles of each of the analyzes and the degree of their effectiveness for diagnosis.

RPR– screening research method. It is used to diagnose early asymptomatic forms of the disease. It is this study that is used in preventive tests.

RPR is not accurate enough for a definitive diagnosis.

A positive RPR is not a diagnostic criterion and requires additional testing. In some cases, such an analysis can give false positive results:

• Diabetes;
• Tuberculosis;
• Malignant neoplasms;
• Alcohol and drug abuse;
• Viral hepatitis;
• Acute inflammatory diseases;
• Recent vaccination;
• Pregnancy.

Eating fatty foods and alcohol before the test can also cause a false positive result.

ELISA– the most accurate analysis for seropositive forms of syphilis. It detects the presence of antibodies, which is a clear criterion for diagnosis.

REEF, or the immunofluorescence reaction detects the presence of pale treponema themselves in the blood. This is a complex and expensive test, so it is used only when there is a clear indication. For example, with severe symptoms and negative RPR and ELISA.

RIBT- another complex study that most accurately determines the presence of infection. During this procedure, the blood is examined under a microscope for the presence of pathogens, which are previously immobilized with special antibodies.

RIBT is highly effective against syphilis. It is used even if other tests did not give a positive result.

RPGA- an accurate treponemal test, quite often used to diagnose the disease. When it is carried out, sheep red blood cells, processed in a special way, are introduced into the serum. Red blood cells stick together and settle to the bottom if the result is positive.

Features of treatment

Syphilis that appears on the skin is usually treated with penicillin-based drugs. Treponema pallidum, unlike other bacteria, has not lost its sensitivity to this substance; for this reason, penicillin and its derivatives are prescribed to treat this disease.

Features of treatment:

• if there are ulcers with a hard frame on the skin, then penicillin preparations are prescribed. Injections are given daily;
• Injections are given in two buttocks at once. First, injections of Penicillin are given, and then Bicillin-3;
• the use of antihistamines is additionally prescribed;
• in the primary form, injections are given within 16 days;
• during the secondary form, injections of water-soluble Penicillin or Doxycycline are prescribed, and it is also recommended to use Ceftriaxone;
• in the secondary form, injections are given for 32 days, while antibiotics are taken.
• the tertiary form is treated with injections of Penicillin with Bioquinol. The course is long, it is determined by the doctor.

Syphilis therapy requires monitoring.

The effectiveness of antibiotics is checked using ELISA - the criterion is a decrease in antibody titers to Treponema pallidum.

If the titer does not decrease, this means that the antibiotic is ineffective against this strain of pathogen. In this case, the attending physician changes the drug and treatment regimen.

After completing the course of therapy, the patient takes tests again to confirm the absence of infection. Sometimes there are cases of so-called sero-resistant syphilis. This is a form of the disease in which, despite complete recovery, serological tests remain positive. Such cases require special attention to the level of titers: if they are reduced by less than four times, additional treatment is required.

If, after six months of therapy, tests show an infection, but the reagin titer is reduced by four times or more, they speak of a slowdown in seroreactions. Observation of such patients continues for another six months.

Restorative treatment may be recommended at the discretion of the physician. In general, additional therapy for true or relative seroresistance can last from six months to one and a half years. Additionally, such patients undergo consultations with an immunologist - seroresistant syphilis can be a consequence of pathologies of the immune system.

Prevention

It is imperative to follow preventive measures that will help protect against this dangerous disease. This also applies to women who are planning to have children; a successful pregnancy and childbirth depends on this. Otherwise, in the future we can expect congenital syphilis in children, which can cause serious harm to a fragile child’s body.

The following preventive measures must be observed:

• maintaining personal hygiene;
• protected sexual intercourse, use of barrier contraception (condoms);
• you should not lead a promiscuous sex life;
• use of personal hygiene items;
• regular visits to the doctor.

People who are sexually active are recommended to take an RPR screening test for syphilis at least once every six months. Since there is a great risk of infection through unprotected oral sex, it is important to remember the need for barrier contraception during any sexual contact.

If the giving partner is a man, regular condoms are used.

When it comes to a woman, you can use the so-called “female condoms”. They are a thin latex napkin that is used to cover the female genitals during oral sex.

Emergency prevention of syphilis

In addition to early prevention, there is also emergency prevention. It is aimed at preventing the development of the disease after dangerous contact has occurred.

The primary stage of such prevention consists of thoroughly washing and douching the mucous membranes. For douching, antiseptic solutions are used, for example, Chlorhexidine and Miramistin.

The next stage requires antibiotic therapy and is carried out strictly as prescribed by a venereologist. In this situation, a specialist prescribes a loading dose of antibacterial drugs, which are taken once. Treatment can be done with tablets or injections.

Remember! You should not take antibiotics on your own or without advice.

A person without medical education does not know the exact and correct dosages of drugs. Not all antibiotics are effective against Treponema pallidum. In addition, uncontrolled use of antibiotics is associated with the risk of developing allergic reactions and complications from their use.

Prevention of syphilis in pregnant women

If a woman is at risk of contracting syphilis during pregnancy, prevention is necessary. In this case, the possible negative impact of antibiotics on the fetus is lower than the potential harm of syphilis for the unborn child.

In this case, antibiotics are taken strictly under the supervision of doctors. To prevent syphilis in pregnant women, drugs with the least toxic effect on the fetus are used.

It is imperative to remember that syphilis is a dangerous disease that causes serious health problems. This disease can be cured at almost any stage, but the sooner the better. Especially on early stages the disease is eliminated with maximum accuracy without health problems.

The incubation period lasts about 3-4 weeks, which makes it difficult to determine the carrier of the disease, however, if a person takes antibacterial drugs for some reason, the period can last up to six months or be shortened to 2 weeks otherwise.

The important point is that that the infection can actively develop in the body, the manifestations are not yet visible and laboratory tests cannot detect the disease within 2-4 weeks after the start of the primary period. Based on this, all sexual partners after infection have a high chance of becoming infected and must undergo laboratory testing.

To accurately determine the disease, photos from textbooks or the Internet are not suitable, because a beginning chancroid can easily be confused with a large pimple or an allergic rash, but how soon you discover the disease in yourself depends on how the treatment process will proceed. We advise you to immediately consult a doctor at the first signs of illness, who can accurately diagnose.

Periods of syphilis

• Before selecting the correct treatment for syphilis, it is worth knowing at what stage of the disease the disease develops.
• The disease itself has 4 stages – let’s look at them in more detail.
• Treatment of the disease is quite possible at each of its stages, with the exception of the last, when all organs and systems are affected and cannot be restored - the only difference is the duration and intensity of the course.

Incubation period

Symptoms of syphilis during its incubation, latent period do not manifest themselves as such - in this case, the disease is diagnosed not by its external manifestations, but based on the results of tests carried out using the PCR technique. The duration of the incubation period is 2-4 weeks, after which the disease passes to the stage of primary syphilis.

Syphilitic sore throat

One of the reasons for the development of tonsillitis is syphilis, or rather, one of the external manifestations of infection with Treponema pallidum is symptoms that are characteristic of tonsillitis, but have certain differences.

For example, against the background of a sore throat, enlarged tonsils, lymph nodes and dry mouth, patients will experience the following signs of infection: an inflammatory process in only one tonsil, the manifestation of erosions followed by transition to small red wounds, absence of temperature, painlessness of the lymph nodes , gray plaque in the oral cavity and the presence of one or more large ulcers with smooth edges.

• In addition, one of the first signs that it was treponema that caused the patient’s condition, similar to a sore throat, is the duration of the disease, which in this case lasts several times longer than a regular sore throat.
• The first manifestations of syphilitic tonsillitis can only be observed in people who engage in oral sex, since treponema pallidum first manifests itself at the site of the entrance gate.
• Another method of infection is the use of the patient’s personal belongings for oral hygiene.

The smell of syphilis

Women may often experience a sign of infection such as an unpleasant odor in the discharge. This is especially typical for the second period of the disease, when the amount of hostile microflora is greatest.

Therefore, if a woman’s discharge begins to have a strong odor without any obvious reasons, for example, failure to observe basic personal hygiene, leading to mixing of the secretions of the sebaceous glands, uterine mucus and vaginal discharge, then herpes, chancroid or syphilis begin to be suspected, which inflame the tissue.

• In this case, in addition to unpleasant odor A change in the consistency of the discharge itself and a change in its color will also be observed.
• Such discharge can cause pain, burning and herpes.
• However, infection with treponema does not always lead to a combination of all these external manifestations of the disease, so no matter what signs, in addition to an unpleasant odor, are observed, it is worth contacting a gynecologist or virologist for advice and timely detection of the infection.

Pain

Pain is rare, especially in the initial stages of disease progression. The appearance of the first pain is usually a sign of the transition of the disease from the first period to the second. In this case, episodic headaches and joint pains appear a week before the first signs of the second period of spirochete infection. In later stages of infection, pain is usually associated with damage to the musculoskeletal system and ulceration of the gumma on the skin and mucous membranes of internal organs.

• If we are talking about musculoskeletal pain, the first manifestations can be observed in the primary period of infection in the form of aches and pains at night and in the evening, which are usually complained of by people with rheumatism.
• In the second period, bone damage may occur in the form of periostitis of the cranial or tibial obliques.
• Although joint damage occurs after infection, it usually does not lead to pain.

A sign of infection in the second stage may be calcific growths on the tubular bones on an x-ray, but only in case of repeated recurrent development of the disease. During primary infection, such changes are absent on x-rays.

Definition of disease

The severity of the disease depends on how much time passes after infection until the first correct diagnosis is made. However, the problem remains - how to determine syphilis? The problem of definition is associated not only with the variety of symptoms in the initial and other stages, but also with the frequency of infection, as well as the tendency of many citizens to self-medicate instead of seeing a doctor. It is easier to identify other diseases, but infection with Treponema pallidum is not so simple.

• Once the first signs appear, they may remain invisible or may be mistaken for another disease.
• In the second case, self-medication usually begins, the visible result of which is the disappearance external signs diseases, which should be associated not with healing, but with the body’s immune response to pathogens.
• The person, being fully confident that he was treated correctly, calms down, and when after some time other signs appear, they are no longer associated with chancroid.
• Therefore, you should not try to identify skin infections on your own; it is better to immediately contact a specialist so as not to miss the onset of a serious infection.

Itching with syphilis

It is also worth considering what signs are not typical for infection with spirochetes. For example, if, based on a “diagnosis” made independently using a reference book or after an authoritative statement from “Nyura’s neighbor,” it was established that the cause of the rash is secondary syphilis, you should not rush to your suitcases in a panic and pack your things to the venereal dispensary. The first thing you need to do is contact a specialist, answer his questions and, if necessary, take the appropriate tests.

Before that, you can calm down and think whether all the manifestations and their nature correspond to infection with spirochetes.

So, if a person’s rash itches, it’s worth thinking about whether syphilis itches?

And having searched for more detailed information on this issue, find out that rashes caused by spirochetes cannot be accompanied by itching, which means that itching is a clear sign of the absence of treponema pallidum in the body.

Therefore, if “syphilis itches,” then it is not syphilis and you can calm down.

Lymph nodes with syphilis

The first signs of syphilis are not limited to the formation of hard chancre at the entrance gate. Following this, regional inflammation of the lymph nodes should appear. In this case, the lymph nodes almost always become inflamed and increase in size, while remaining mobile and painless.

• Their size can reach a large walnut.
• As the first signs of syphilis, photos of inflamed lymph nodes will show a person with a large lump, not far from the site of infection, while the skin in the area above the nodes will not change its color.
• Such changes in the lymph nodes are associated with foci of spirochete proliferation in them.

Enlargement of all lymph nodes or their soreness indicates another type of infection, not associated with pallidum treponema.

Buboes or inflamed lymph nodes have been considered the main signs of syphilis since the Middle Ages, when it was believed that they simply could not exist without each other. However, due to people taking various medications in the last decade, the number of cases in which the presence of Treponema pallidum in the body was not accompanied by regional lymphodermitis has increased.

Detection of syphilis

• Testing for syphilis is important stage diagnosis, quality control of treatment, as well as mandatory regular monitoring for several years after successful therapy.
• Considering what the first signs of syphilis may be in a patient and how similar they are to the manifestations of other diseases, even an experienced doctor will not be able to make a diagnosis without undergoing an examination aimed at identifying treponema pallidum.
• In the course of identifying the causes of symptoms that appeared suspicious and atypical to the doctor, important role Anamnesis is collected, which will help clarify the number of sexual partners, the possible time of infection, as well as the presence or absence of factors that could give a false positive or false negative result when examining the patient.

Since diagnosis and treatment for treponema infection is a serious task, several studies are usually carried out at once, designed to complement and verify the data of other tests.

During the treatment process, repeated studies are designed to determine the success of therapy and, if necessary, adjust it to obtain a better result.
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Signs of primary syphilis

The following signs of primary syphilis can be distinguished:

Primary syphilis in its normal course appears three to four days after the treponema enters the body. This stage lasts on average for five to six weeks.

Currently, venereologists are noticing changes in the course of primary syphilis. If years earlier syphilis manifested itself through a single chancre on the patient’s body, now there are two or more such ulcers on the body. Also, if previously it was possible to feel a clearly defined compaction of chancre, now this compaction may not appear.

Primary

Naturally, people are primarily interested in the question of what are the first signs of syphilis. This information is really important, because the sooner you notice changes in your own body, the sooner you will see a doctor and receive appropriate help.

• In fact, there is a certain pattern according to which syphilis develops in most cases. The stages of the disease are as follows: primary, secondary and tertiary forms of the disease, which follow one after another. Moreover, each of these stages has a very characteristic clinical picture and is accompanied by a unique set of symptoms.
• First, treponema penetrates the body and migrates to the lymph nodes, where it begins to actively multiply. As a rule, the first manifestation of syphilis occurs four weeks after infection - this is the incubation period. At the site where microorganisms invade, a so-called chancre is formed, which opens as the disease progresses, forming a small ulcer. In this case, pain practically does not bother the sick person.
• Most often, chancre appears in the area of ​​the external genitalia. For example, in men it is often located on the head of the penis. However, the ulcer can be found on the skin of the thighs, abdomen, and sometimes near the anus. It is worth noting that sometimes chancre forms on the mucous membrane of the rectum, the cervix, or even on the tonsils - in such places it is almost impossible to detect it on your own, so infected people simply do not go to the doctor.

After some time, you can replace the enlarged lymph nodes next to the chancre - most often the infection invades the nodes located in the groin area. In most cases, a person himself can detect an enlarged node, which is usually hard to the touch. In some cases, due to impaired lymphatic drainage, swelling of the labia, foreskin, scrotum, and tonsils appears (depending on the location of the infection).

This stage of the disease lasts about 2 – 3 months. If left untreated, chancre disappears. Of course, this does not indicate recovery - the disease moves to a new, more dangerous level.

The first signs of syphilis of the secondary form

It should be noted that secondary syphilis can be of several varieties:

• Fresh- this type of syphilis is a consequence of the primary form. Symptoms - small polymorphic rash and chancre;
• Hidden- even the incubation period of syphilis does not manifest itself in any way externally, but can be detected through serological tests;
• Recurrent- with this form of secondary syphilis, relapses alternate, and during each relapse a rash appears on the body.

  But unlike fresh syphilis, the rash during relapses is less abundant, the spots are larger, and foci of rashes can be identified.

Secondary form of the disease: main symptoms of syphilis

This stage of the disease lasts about 2 – 5 years. It is characterized by a wave-like course - the symptoms of syphilis appear and disappear. The main signs at this stage include the appearance of a rash. Rashes can form on various areas of the skin, including the torso, legs, arms and even the face.

By the way, the rash in this case can be different.

• Most often it looks like small spots of red or pink color with clear edges. The formation of papules or pustules is also possible.
• Sometimes another bacterial infection is associated with syphilis - in such cases, pustules can form on the skin.
• In any case, the rashes, as a rule, do not cause physical discomfort - there is no itching, no pain, no fever.
• Therefore, sick people rarely seek help from a specialist, which, naturally, allows the disease to progress further.

As for the other signs, when a rash appears on the scalp, partial alopecia develops - the hair in these areas falls out. In addition, the patient may notice an increase in certain lymph nodes.

By the way, in some patients a rash appears on the body only at the initial stage - over the next years they do not have any visible signs syphilis. At the same time, other patients suffer from relapses constantly - rashes appear and disappear. It is believed that a weakened immune system, frequent stress, hypothermia, exhaustion of the body, etc. can trigger a new outbreak of the disease.

Tertiary syphilis

• The third stage of the disease, as a rule, begins 3 to 10 years after infection. It is accompanied by the appearance of so-called gummas. These are infiltrative tubercles with clear boundaries, formed on the tissues of internal organs. They are prone to decay and scarring.
• In fact, gummas can affect almost any organ system, leading to dangerous complications. For example, if such tubercles “grow” on bone tissue, then a person develops arthritis, periostitis or another disease.
• Damage to the intra-abdominal lymph nodes leads to the development of mesadenitis, which is accompanied by severe pain.
• No less dangerous are gummas in the central nervous system, since their appearance often leads to damage to certain parts of the brain and gradual degeneration of the personality.

If left untreated, syphilis is fatal.

If left untreated, tertiary syphilis develops in 30% of people with secondary syphilis. Tertiary syphilis kills one fourth of those infected. It is extremely important to recognize the signs of syphilis in women and men at least at this stage.

Signs of tertiary syphilis:

• In men, tertiary syphilis is diagnosed through the appearance of tubercles and gummas. The tubercles are quite small in size and quite a lot of them form on the body. Gummas are rare, quite large and located deep in the tissues. Inside these formations there is not such a large number of treponemes, so the risk of infecting another person is much lower than with secondary syphilis.
• In the tertiary form, the first signs of syphilis in women are tubercles and gummas as in men. Both tubercles and gummas eventually turn into ulcers, which will leave scars after healing. These scars have a detrimental effect on the condition of organs and tissues, severely deforming them. Gradually, organ functions are impaired, which can ultimately lead to death. If syphilis infection occurred from a partner through sexual contact, then the rash will primarily be in the genital area (on the vagina, etc.).
• In children, tertiary syphilis affects the skin, internal organs and nervous system with special tubercles - syphilides. Syphilides are formed due to the development of increased sensitivity of the child’s body to treponemes, which are contained in excess in the child’s body.

Tertiary syphilis can last for decades. The patient may suffer from the development of mental insanity, deafness, loss of vision, and paralysis of various internal organs. One of the most important signs of tertiary syphilis is significant changes in the patient’s psyche.

If previously a person was quite calm, then as a result of prolonged exposure to syphilis on the body, a person begins to panic, suffers from paranoia, attacks of rage and depression, which are followed by periods of euphoria.

Often at this stage of the development of the disease, the patient experiences hallucinations - this occurs as a result of the destruction of brain tissue.

Congenital form of the disease

As already mentioned, infection can also occur during pregnancy, since bacteria can easily penetrate fetal tissue through the placental circulatory system. As a rule, transmission of the pathogen occurs after the end of the first trimester. That is why pregnant women are strongly recommended to get tested for syphilis. The earlier the disease is detected, the easier it will be to eliminate the threat to the child’s health.

Of course, an infection can lead to disruption of the normal development of the fetus - in some cases, doctors even hold a consultation regarding termination of pregnancy. On the other hand, the child may be born quite viable. Congenital syphilis can be divided into several types:

• The early form of the disease, as a rule, manifests itself already in the first two months of the baby’s life. The first signs of syphilis are the formation of a papular rash, as well as damage to the nasal mucosa. More serious complications include partial or complete destruction of the nasal septum, hydrocephalus, hepatosplenomegaly, and retardation in mental and physical development.
• The late form of congenital syphilis is characterized by the so-called Hutchinson triad. Such children have corneal lesions, dental pathologies, and labyrinthine deafness.

In some cases, syphilis in children causes extremely severe complications, including death. However, if the presence of infection is determined in time and adequate treatment is started, the prognosis for the child can be favorable. Therefore, you should never ignore symptoms or self-medicate.

Signs of syphilis in men, women and children: how different types of syphilis manifest

Syphilis is quite diverse in its manifestations. This depends on a number of factors, ranging from the state of immunity of the person affected by treponema, and ending with the number of syphilis pathogens penetrating the body.

The following types of syphilis and their symptoms in men and women can be distinguished:

Atypical syphilis manifests itself in the form of an atypical chancre. These may be indurative edema, chancrapanaricium, chancre on the tonsils and paraphimosis. Indurative edema is characterized by development in the area of ​​the labia and preputial sac, and such edema is not accompanied by pain. The chancre looks like a rather large ulcer, dense when palpated.

• The skin takes on a purplish hue. Another sign of syphilis in men and women in an atypical form is chancre-felon, which can be found near the nail phalanx on the fingers.
• At the same time, the ulcer has uneven edges, creating painful sensations on the affected phalanx. At the same time, the lymph nodes in the elbows enlarge, but do not hurt. When hard chancre appears on the tonsils, erosion and ulcers occur, and the tonsil increases in size.
• Patients do not experience pain from an ulcer on the tonsil. Paraphimosis in atypical syphilis is an inflammation of the preputial sac that develops when the head of the penis is exposed. Long-term paraphimosis without proper treatment can lead to necrosis of the head.

Congenital syphilis

Congenital syphilis- a transplacentally transmitted disease, that is, infection of the fetus with syphilis through the mother’s blood. This disease is distinguished in two forms - early and late. The early form of congenital syphilis begins with fetal development and continues until early childhood. Late congenital syphilis manifests itself after the child has reached the age of 15, and before that it can be assumed that the child is healthy - the disease does not show itself in any way.

If syphilis affects the fetus (usually this occurs in the fifth month of pregnancy), then treponema begins to destroy the child’s internal organs and skeletal system. The chances of such a child surviving are negligible. According to official statistics, if a pregnant woman is sick with secondary form of syphilis, then in 90% of cases the pregnancy will end in the birth of a stillborn child or the death of the fetus.

• Signs of congenital syphilis are diagnosed in the fetus: they may be an increased weight of the placenta (1:3 instead of the norm 1:6), and the placenta itself increases in size and is easily ruptured. The amount of amniotic fluid decreases. The organs and tissues of the fetus are affected.
• If a child with syphilis is born and survives, the newborn will have loose and wrinkled skin (similar to senile skin), body disproportion (enlarged head), and specific rhinitis and other diseases will develop. Children with congenital syphilis lag behind their peers in development.

One of the varieties of syphilis, when the brain tissue, its membranes and blood vessels are affected by gumma. Neurosyphilis can be latent (diagnosed only through special studies, no external signs are observed), early (develops against the background of primary or secondary syphilis, affects the blood vessels and membranes of the brain, accompanied by syphilitic meningitis and meningomyelitis), late (occurs seven years after infection with treponema and develops against the background of tertiary syphilis, accompanied by tabes dorsalis, progressive paralysis and syphilitic gumma of the brain).

Neurosyphilis manifests itself through the following symptoms:

• syphilitic meningitis - syphilis is accompanied by meningeal symptoms (severe headaches, aversion to light, nausea and vomiting, high fever);
• syphilitic meningoencephalitis - essentially it is syphilitic meningitis, which is accompanied by mental disorders (hallucinations may occur);
• tabes dorsalis - with this manifestation, neurosyphilis affects the spinal cord, so the patient loses sensitivity in the limbs, has difficulty seeing, and has problems with urination and defecation;
• progressive paralysis - with neurosyphilis, a patient with paralysis loses reading and writing skills, develops dementia and complete personality collapse.

Hidden syphilis

Hidden syphilis- a type of syphilis when the disease is completely asymptomatic. Such syphilis can only be detected through laboratory tests. Diagnosis of latent syphilis is quite complex - it is a set of procedures based on the body’s specific reactions to syphilis.

Venereologists suggest that the development and spread of latent syphilis in the world is associated with the widespread use of antibiotics: patients mistake the symptoms of syphilis for signs of another sexually transmitted disease and try to cure it with an antibiotic. The drug suppresses the symptoms of syphilis, and the disease begins to be asymptomatic.

Latent syphilis can be early or late. Early latent syphilis is the period from primary syphilis to secondary syphilis, which usually corresponds to two years.

• Despite the fact that latent syphilis does not manifest itself in any way externally, a person infected with it is dangerous to others.
• Late latent syphilis is diagnosed more than two years after infection with treponema. Such patients are not dangerous to others.
• Most often in medical practice, latent syphilis is unspecified - the patient does not have any information about the expected date of infection with syphilis.

Household syphilis

Household syphilis can be obtained non-sexually. This usually occurs as a result of poor personal hygiene or lack thereof. It is enough for a person to use someone else’s towel or toothbrush, drink water from someone else’s glass - and treponema penetrates the body. In general, treponema is quite tenacious only at low temperatures - its ability to infect can persist for several years. However, at temperatures above 45-50 degrees, treponema dies.

Corresponding to the signs of sexually acquired syphilis, the differences are only in the location of the hard chancre on the body of the infected person: with sexual infection, the chancre most often appears in the genital area, and with domestic infection it can be found on any other part of the body.

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Other types of disease

Today in medicine there are several forms of this disease. The classic type of the disease is easy to notice and, accordingly, cure. But there are more dangerous types of syphilis that you also need to know about.

• Latent syphilis today is considered one of the main problems in venereology. Why? The fact is that in some people, treponema pallidum does not cause any visible symptoms after entering the body. In 90% of cases, this form of syphilis is discovered completely by accident, for example, during a routine examination or screening during pregnancy. At the same time, an infected person is not even aware of his problem, as a result of which he becomes a source of pathogenic microorganisms for everyone around him.
• There is another, no less dangerous type of the disease - sero-resistant syphilis. This form is spoken of in cases where, after a course of treatment, treponema is still present in the tests. Patients with a similar diagnosis require an additional course of antibacterial therapy. Unfortunately, it is not always possible to cure the resistant form of infection. And in some cases, the infected status remains with the person throughout his life.

Diagnostic methods

Today, there are many studies in which it is possible to determine the presence of treponema in the human body. When the first symptoms appear, you should go to the doctor. After a visual examination, the venereologist will decide which tests will be needed.

In case of primary syphilis, as a rule, bacterioscopic methods are informative, for which fluid from a chancre or a biopsy obtained from a lymph node is used as a test sample. A serological test for syphilis is considered no less accurate, during which the presence of a specific immunoglobulin IgM can be detected in the body. But it is worth considering that these tests are carried out only at the primary stage of the disease.

• Secondary and tertiary syphilis require other studies.
• In particular, the most popular is the Wasserman test (RW analysis) - this is the test that is used in clinics for mass examination of patients.
• Such testing makes it possible to determine the presence of bacteria at any stage of the disease.
• However, the possibility of a false negative or false positive result cannot be excluded.

The most accurate method today is considered to be the immunofluorescence reaction (RIF). This method allows you to identify even hidden forms of the disease. Naturally, there are other methods of laboratory research. For example, in some cases, to obtain more information, the doctor will refer the patient for a spinal tap, after which samples of the cerebrospinal fluid will be sent to the laboratory.

Modern methods of therapy

Treatment of syphilis is a long process.

At one time, a single injection of large doses of penicillin was used to eliminate the infection. Now such a treatment regimen is considered incorrect.

Only the attending physician can select medications for the patient. Moreover, the sick person is obliged to follow all the specialist’s recommendations and strictly follow the intake schedule. In most cases, the presence of such an infection requires taking fairly large doses of antibiotics - most often substances of the penicillin series (penicillin, erythromycin, tetracycline) are used for this purpose. Patients who are allergic to these antibiotics receive other antibacterial drugs.

• Since the doses of drugs in this case are really large, it is extremely important that treatment of syphilis takes place in a hospital setting under the constant supervision of medical personnel.
• In addition to antibiotics, immunomodulatory drugs are used.
• If there is a rash, the doctor may prescribe a special ointment that speeds up the healing process.
• To protect microflora, it is recommended to take products containing live strains of beneficial microorganisms.

If one of the sexual partners is diagnosed with syphilis, the other is also required to get tested and undergo a full course of treatment. Even if no signs of Treponema pallidum have been detected in the body, so-called preventive therapy is carried out. Compliance with this condition helps to avoid re-infection.

Primary and secondary syphilis is treated, as a rule, in 1.5 - 3 months. The tertiary stage of the disease requires longer therapy, which often lasts more than a year.

Course of antibiotic treatment

Each patient, man and woman, is prescribed antibiotics during the course of treatment - the causative agent of this infectious disease is sensitive to them. So the drug itself, the duration of its use and dosage are prescribed by the doctor on an individual basis, taking into account all the tests and results of the patient’s examination.

The disease is sensitive to the following groups of drugs:

• drugs containing penicillin.
• macrolides and the antibiotic ceftriaxone.

Thus, antibiotics containing penicillin act very effectively during treatment, having a detrimental effect on the causative agent of the pathology. When diagnosing primary syphilis, they provide excellent treatment dynamics. Today, dermatovenereologists do not practice the method of the first loading dose of penicillin administration; the method of intramuscular administration of the drug at intervals of every 3 hours is more effective, which ensures its constant concentration in the body.

PENICILLIN (A REMEDY FROM SOME TYPES OF MOLD)

Thus, drugs containing penicillin are excellent in combating the early stages of neurosyphilis, but so far the nervous system has not undergone irreversible changes in its functioning, and also given the congenital nature of syphilis damage to the body.

If the third stage of syphilis is diagnosed, before taking penicillin you should undergo 2 weeks of therapy with drugs such as tetracycline or erythromycin.

AZITHROMYCIN – A NEW GENERATION DRUG

Syphilis and its treatment with azithromycin, a new generation drug (antibiotic), and macrolides also show good results, being as effective as antibiotics of the penicillin group. At the same time, the side effects and negative effects from the drug are minimal.

• The only limitation for prescribing azithromycin is the diagnosis of HIV infection in the patient.
• Daily intake 2 g . Azithromycin allows you to cure even late forms of syphilis in a six-month course of treatment, but the congenital form of the disease is not treated with this drug.

Treatment of syphilis with a drug such as ceftriaxone also produces positive results and dynamics - it is prescribed even to pregnant women and in particularly advanced cases. All compounds that are part of this drug suppress the internal synthesis of division and growth of Treponema pallidum cells. The treatment regimen is simple - 1 injection per day, course of treatment for at least six months. The only limitation is that doctors do not treat the congenital form of syphilis with this drug.

If the doctor diagnoses a latent form of syphilis, the treatment regimen and medications are similar, supplemented by a course of immunostimulants and physiotherapeutic procedures.

To date, doctors and scientists have not yet invented special vaccines that are effective in preventing syphilis. If the patient has previously had this sexually transmitted infection, he can become infected and get it again. As a consequence - only preventive measures will help avoid infection and thereby prevent damage to internal organs and body systems.

• First of all, it is worth excluding promiscuous sexual relations with an untested partner, especially without a condom. If you have had such sex, immediately treat your genitals with an antiseptic and visit a doctor for a preventive examination and examination.

• It is enough to understand that not every person knows that he is currently a carrier of the infection and, if the patient has a regular sex life, doctors recommend regular examinations by highly specialized doctors, tests for STDs, thereby identifying the disease in its early stages currents.tvojajbolit.ru

Disease prevention

Unfortunately, today there is no vaccine that can permanently protect against such a disease. People who have had syphilis can become infected again. Therefore, the only effective preventative measure is to prevent infection. This means that you should avoid promiscuous sexual intercourse, especially without using condoms. If unprotected sex does occur, you should treat your genitals with an antiseptic solution and make an appointment with a doctor.

It should be understood that not all carriers of the infection are aware of their own problem. Therefore, doctors recommend that people who are sexually active regularly get tested for STDs, as this helps to identify the disease in the early stages and, accordingly, eliminate the likelihood of the infection spreading. In addition, the disease is much easier to cure in the initial stages.
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What is chancre?

Chancre in syphilis is a specific local reaction of the body to the penetration of Treponema pallidum. It all starts with a slight redness with clear edges, in place of which a painless scaly papule (nodule) appears, and later an erosion or ulcer (a deeper defect) forms, this is a chancre (that’s what ulcers were called in the old days).

Chancre has a number of features: it does not hurt, has a dense base, smooth edges, gentle walls (they resemble a saucer), and a red shiny surface. The size of the chancre is variable - from millimeters to centimeters, and the shape of the formation can also be different (round, oval, resembling a crack).

Primary syphiloma usually persists on the body for several weeks. Then the healing process begins, without any treatment. Features of healing depend on the type of chancre. So, after erosion, traces may not remain, but an ulcer always leaves a scar.

• The disappearance of primary syphiloma does not at all indicate recovery.
• The disease simply moves to the next stage, that is, secondary syphilis develops, during which the infection spreads to the internal organs.

Atypical forms of primary syphilomas

Chancroid is a typical manifestation of syphilis. However, there are other clinical forms of primary syphiloma. These include:

1. Chancroid felon is an inflammation of the extreme phalanx of the finger.
2. Indurative edema is dense swelling of the genitals.
3. Chancroid-amygdalitis is an enlargement and hardening of one palatine tonsil, but there are no ulcers, erosions or plaques on the lymphatic formation.

These manifestations of syphilis are very similar to diseases of a completely different nature, so doctors have a hard time making the correct diagnosis. Regional lymphadenitis prompts them to think about syphilis in such situations.

In addition, syphilis in the initial stages may not manifest itself at all or may have a smoothed clinical picture and a longer incubation period (for example, if a person takes antibiotics). Therefore, to clarify the diagnosis, a number of laboratory tests are always carried out.

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How is syphilis transmitted?

You can become infected with syphilis through direct contact with a syphilitic sore during vaginal, anal, or oral sex. You may find sores on or around the penis, vagina, anus, rectum, or on the lips and mouth. Syphilis can be transmitted from an infected mother to her fetus.

Image of a primary syphilitic ulcer.

How does syphilis manifest?

Syphilis is divided into several stages (primary, secondary, latent and tertiary) with different signs and symptoms associated with each stage. In a person with primary syphilis There is usually pain or ulcers at the original site of infection. Ulcers usually occur on or around the genitals, around the anus or rectum, or in or around the mouth. The ulcers are usually (but not always) firm, round, and painless. Symptoms secondary syphilis include skin rash, swollen lymph nodes and fever. Signs and symptoms of primary and secondary syphilis may be subtle and may not be noticed. During latent stage there are no signs or symptoms. Tertiary syphilis associated with serious health problems. A doctor can usually diagnose tertiary syphilis with several tests. It can affect the functioning of the heart, brain, and other organs of the body.

What are the signs and symptoms of syphilis?

Symptoms of syphilis in adults vary depending on the stage:

Primary stage

During the primary stage of syphilis, you may notice one or more sores. An ulcer is where syphilis entered your body. The ulcers are usually (but not always) firm, round, and painless. Because the ulcer is painless, it is easy to miss. The ulcer usually lasts 3 to 6 weeks and goes away whether or not you receive treatment.

Even after the ulcer goes away, you should still get treatment. This will stop your infection from progressing to the secondary stage.

Secondary stage

During the secondary stage, you may develop a rash and/or mucosal lesions. Mucosal lesions are ulcers in the mouth, vagina or anus. This stage usually begins with the appearance of a rash on one or more areas of the body. The rash may appear while the primary ulcer is healing or several weeks after it has healed. The rash may appear as rough red or red-brown spots on the palms of the hands and/or soles of the feet. The rash is usually not itchy, and sometimes it is so mild that you may not notice it. Other symptoms you may experience include fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle pain and fatigue. The symptoms of this stage will go away whether or not you receive treatment. But without proper treatment, the infectious disease will go into latent, and possibly into the late stage of syphilis.

Syphilitic rash on the body in the secondary period.

Hidden stage

The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. If you don't get treatment, you may continue to have syphilis for many years without showing any signs or symptoms.

Tertiary stage

For most people, untreated syphilis does not progress to the tertiary stage. However, when it does, it can affect many organ systems. These include the heart and blood vessels, as well as the brain and nervous system. Tertiary syphilis is very dangerous and can begin 10 to 30 years after infection. At the tertiary stage of syphilis, the disease affects internal organs and can lead to death.

Neurosyphilis and eye syphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (ocular syphilis). This can happen at any of the stages described above.

Symptoms of neurosyphilis include:

• severe headache;
• difficulty coordinating muscle movements;
• paralysis (inability to move certain parts of the body);
• numbness; and
• dementia (mental disorder).

Symptoms of ocular syphilis include blurred vision and even blindness.

Dark-field micrographic image of a pallid spirochete ( Treponema pallidum).

Can syphilis be cured?

Yes, syphilis can be cured with antibiotics prescribed by your doctor. However, treatment may not correct the damage already done by the infection.

https://www.cdc.gov/std/russian/stdfact-syphilis-russian.htm

Causes of primary syphilis

The causative agent of the disease is Treponema pallidum. The route of transmission of infection is predominantly sexual, through unprotected sexual intercourse with a sick person or a carrier of the infection. The disease relates to venereal diseases or sexually transmitted infections. A hematogenous route of transmission of infection is possible, through blood transfusions, also among injection drug addicts when using other people's syringes, or when using other people's razors and toothbrushes in everyday life.

The household route of infection is very rare, as it requires close contact with a person sick with tertiary syphilis. Possible intrauterine infection and infection through mother's milk.

Symptoms of primary syphilis

The first symptoms appear 10–90 days after infection. The site of infection appears as a hard chancre; most often, its appearance is typical on the glans penis in men, the labia or on the mucous membrane of the cervix and vagina in women. There is also an extragenital location of the chancre, for example, on the thighs, fingers, abdomen, lips, on the mucous membrane of the anus, pubis, and in the oral cavity.

Diagnosticsprimary syphilis

The doctor interviews and examines the patient, analyzes his life history and medical history. To confirm the diagnosis, a bacteriological examination of the chancre discharge is performed to detect the causative agent - treponema pallidum. Sometimes a biopsy of the lymph node is performed, and a number of serological tests are also performed (RIBT, RIF, RPR test).

Treatment of primary syphilis

Therapy must be completed by both sexual partners at the same time; during the treatment period, the possibility of any sexual contact is excluded. During drug treatment Antibacterial agents of the penicillin series are prescribed. If an allergy to penicillin develops, tetracycline or doxycycline is prescribed.

After the necessary treatment, all patients with seronegative primary syphilis are subject to mandatory clinical observation for a period of 12 months, and those with seropositive primary syphilis are under medical supervision for at least 3 years. The most common complications are: balanoposthitis, balanitis, phimosis, paraphimosis, gangrene.

Preventionprimary syphilis

In order to prevent infection, you should avoid casual sexual contact and, if necessary, use barrier methods of contraception. General recommendations include observing the rules of intimate and personal hygiene, maintaining healthy image life.

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