Syphilis occurs in women as a result of infection with a microorganism - pale treponema (Treponema pallidum). The infectious agent, once in the body, is introduced into the primary focus, penetrates into the blood and lymph and spreads to all organs and systems. In the early stages, the symptoms of syphilis in women are blurred, the disease flows sluggishly, often disguised as other diseases. In the later stages, the infection affects the internal organs, joints, nerve and bone tissues.

The reasons for the development of syphilis include:

• unprotected intercourse with an infected partner;
• transfusion of blood containing treponema;
• negligent observance of the rules of sterility in medical institutions;
• ignoring the rules of hygiene in everyday life: household items are in common use by sick and healthy people;

Representatives of the weaker sex 15-45 years old fall into the risk group. Most infected are detected among 20-30 year old women.

Features of the incubation period

Usually the incubation period lasts 2-6 weeks. In some cases, it is reduced to 7-15 days, or increased to 3-6 months. If syphilis in girls or women was preceded by a massive infection with treponema, then the incubation period is greatly reduced.

The incubation period may vary under the following circumstances:

• when infected in old age;
• in physically weakened patients with reduced immunity;
• when using corticosteroids, antibiotics and potent drugs prescribed for the treatment of other severe pathologies.

With a prolonged incubation period, the symptoms of the disease may not appear, the pathology in this case takes a latent form of the course.

An infected woman is dangerous to others, regardless of the length of the incubation period. She is able to transmit syphilis from the moment the treponema enters her blood and lymph.

Symptoms of the primary form

Symptoms of the disease appear several weeks after infection. Hard chancres (syphilomas, ulcers, erosions) form on the body. Pathological formations with a dense base and a smooth surface have the correct shape. The edges of the ulcers, up to 1 cm in diameter, are evenly defined and slightly raised. The bottom of the syphiloma is painted in bluish-red shades.

Chancres spontaneously disappear after a few weeks without any treatment for syphilis. Women do not pay much attention to them, as they often do not cause pain and discomfort. However, missing chancres are not a sign of a cure. The disease after their disappearance continues to progress. Treponemas, transported with blood and lymph, destroy the body, involving healthy organs and tissues in the pathological process. In this case, infected women feel only weakness.

Chancre is the first sign of primary syphilis. It is formed:

• on the external genitalia;
• cervix;
• near the anus;
• on the mucous membranes of the intimate zone and the rectum;
• pubis, thighs and abdomen;
• on the skin of the hands;
• on the mammary glands, next to the nipple.
• in health workers, the first symptoms of syphilis occur on the lips, tongue, fingers of the upper extremities.

Compacted infiltrate (chancre) resolves on its own in 1-1.5 months. Small erosions do not leave marks on the skin. In place of large formations, spots of black or cyanotic color appear. After ulcers, round scarring appears, framed by a pigment ring.

Other manifestations of the first stage

Instead of classic chancres on the skin, syphilis in a woman manifests itself with symptoms such as specific skin defects. They complicate the recognition of a syphilitic infection. The following abnormal manifestations occur:

• Felon. Syphiloma occurs under the guise of an inflamed nail bed. With the defeat of treponema, the finger swells, becomes bluish-red, hurts. The nail plate is rejected over time. The pathological process differs from the true panaritium (purulent inflammation of the soft tissues) in that it takes weeks to heal the wound.
• Amygdalitis. The tonsils swell, thicken, redden, make it difficult to swallow, and cause pain. Signs of amygdalitis are similar to those that develop with typical tonsillitis. Women get sick, get tired quickly, they have a high temperature, a headache in the back of the head.
• Inductive edema. A large syphilide of burgundy-red or pale pink color is formed on the labia. The same papule appears on the lower lip of the mouth. Seals go beyond the periphery of the erosive pustule. If a woman ignores the treatment of syphilis, the ulcer worries for months.
• Mixed chancre. At first, a mild ulceration occurs (it has a shorter incubation period), then a hard syphiloma forms. The detection of infection in this type of chancre is delayed by 3-4 months. Lymph nodes increase 7 days after the appearance of the papule. If it occurs in the oral cavity, the lymph nodes located on the neck, back of the head, under the jaw and chin swell.

Read also related

When does syphilis of the joints and bones occur, how is it manifested and treated?

At the end of the initial stage, the first signs of syphilis in women are supplemented by such manifestations: muscle pain, arthralgia, a decrease in hemoglobin, soreness in the bones, and an increased concentration of leukocytes in the blood.

Signs of a secondary form

Before the onset of the second stage of syphilis, an increase in lymph nodes occurs. Lymphadenitis appears 7-14 days after the formation of the chancre and indicates that treponemas have entered the lymphatic system, multiply freely in it. Spirochetes, picked up by the lymph flow, migrate throughout the body. If a woman is not treated, then the secondary form develops into phase 3 after 3-5 years of development.

In stage 2 syphilis, the following symptoms are observed in women:

• extensive pale rashes all over the skin of the body, including the palms and soles;
• headache;
• lack of appetite;
• weakness, fatigue;
• heat;
• disturbed sleep;
• loss of hair, eyelashes, eyebrows;
• extensive condylomas grow at the anus and on the external genitalia;
• pustules form in the mouth, on the tongue;
• if erosions have formed on the vocal cords, a specific hoarseness appears;

The rash disappears without a trace after 2.5 months, even if the woman does not take treatment. Syphilis again flows secretly. The asymptomatic period is short in duration, and soon a relapse occurs.

Signs of the tertiary form

Diagnosis - tertiary syphilis is made infrequently, since the disease is usually determined at earlier stages. When the disease is not treated, it passes into the 3rd degree within 3-5 years, in which the pathological process covers the internal organs, bone and nerve tissues, joints, endocrine glands, and sensory organs.

• The skin of the patients is completely covered with syphilides and gummas. In place of the opened and healed formations, ugly scarring remains. If ulcers form on internal organs, infection can lead to death.
• In the tertiary phase of the development of the disease in a woman, all organs and systems are affected. Cartilage tissues are deformed. They melt and degenerate into pathological tumors - gummas. During this period, patients are not dangerous to others. Since they are not contagious, syphilis is not transmitted.
• On the mucous membranes of the nasopharynx affected by ulcers, deep damage occurs. The palate and bones of the septa are perforated. The nasal bridge collapses. When a woman eats, food pieces are thrown into the nasal cavity.
• The soft palate with syphilitic nodes is devoid of mobility. It is compacted, painted in dark red color. Syphilomas, breaking through simultaneously in several places, form ulcers that are difficult to heal.
• Erosions on the tongue lead to gummy or sclerosing glossitis. In the first case, the surface of the tongue is covered with small sores, in the second case it is compacted and inactive. In the future, wrinkling of tissues occurs, they atrophy. Women have problems with speech, chewing and swallowing food.

Syphilis, a life-threatening pathology. It is able to flow asymptomatically, manifest itself in the last stage, when it is difficult to fight it. The first symptoms of syphilis are a serious reason to see a doctor.

During pregnancy

Infection of infants with syphilis occurs in the womb. Treponemas enter the fetus through the placenta. The primary symptoms of pathology appear within 2 years after the birth of the baby.

The disease affects:

• skin;
• organs of vision;
• oropharynx (causes pharyngitis);
• bone and nerve tissues;
• internal organs.

Symptoms of late congenital syphilis occur in children 2-5 years of age. Toddlers have improperly formed teeth, eye diseases and deafness.

In severe cases of syphilis, death occurs in children of the first year of life. 25% of infected pregnant women have miscarriages. If the pathology is not treated before conception and at the time of gestation, then there is a risk of premature delivery and the appearance of a stillborn baby.

Only 10% of pregnant women have a chance to give birth to a healthy baby. But, despite this, it is believed that syphilis and pregnancy are compatible. Timely therapy reduces the likelihood of having an infected baby.

Diagnostics

The choice of methods for examination depends on the stage of development of the infection. First, treponemal and screening tests, dark-field microscopy are done. Antibodies are detected using treponemal methods. From the moment of infection to the appearance of markers in the blood, 2-4 weeks pass.

A common sexually transmitted disease is syphilis. The causative agent of syphilis is the microorganism pale treponema, which enters the human body immediately after unprotected sexual contact.

This serious disease, which is chronic in nature, is especially dangerous for women. Contacting a specialist at an early stage is very important, since timely detection of a dangerous disease can prevent further complications.

Syphilis develops in stages, with characteristic signs and symptoms that may not appear immediately. Syphilis poses a threat to the health of not only the patient, but also those who are in contact with an infected person. This article will discuss the symptoms of syphilis in women (photo).

Syphilis occurs in three stages and with different symptoms for each phase. The disease is very dangerous, since for a long time the characteristic features of this disease may not appear. The duration of the latent (incubation) period can vary from two to six weeks. The duration of this period depends on various factors, such as the use of antibiotics to prevent another disease, the state of the patient's immune system and age.

The first manifestation of syphilis in women occurs a maximum of a month after unprotected sexual contact. The disease is transmitted not only sexually, but also by the patient's personal belongings. Such personal items include a washcloth, a towel, dishes, and even the patient's lipstick. It is very important to maintain personal hygiene, as white treponema multiplies in fluids, namely saliva, urine and blood.

The first symptoms of syphilis are expressed in the formation of ulcers on the genitals in women, differing in size and color. These ulcers are hard and coin-shaped. Despite the fact that these ulcers do not cause inconvenience, nevertheless, pain occurs when pressed. These ulcers can appear not only on the labia, but also in the uterus, vagina, which makes it difficult to independently identify the disease.

These symptoms include weakness throughout the body, malaise, swollen lymph nodes, rashes. Microorganisms circulate in the human body, multiply and cause the spread of a dangerous disease. The discharge in women becomes profuse, with purulent content and an unpleasant odor.

Often women do not pay attention to the symptoms of this disease, taking it for an ordinary rash, fatigue, a cold. This is because syphilis has similar symptoms to other diseases. This attitude towards syphilis makes it difficult for a specialist to identify it at an early stage.

Another important change in a woman's body is the first violation of the menstruation cycle, characterized by unpleasant sensations during bleeding. It is very important to consider that all these rashes and ulcers may disappear over time, and the disease will move into the second phase of development. All this leads to the fact that the disease will wear hidden nature and even improve the patient's well-being.

So, how does syphilis manifest itself in women in the second stage? The subsequent stage is characterized by an exacerbation of the disease by raising the temperature to 38 degrees, the appearance of pale spots that have localization of the palm and soles of the feet.

Most often at this stage, a woman suffers from deprivation of body hair, that is, eyelashes, hair on the head and in the inner thighs fall out. All this evidence of syphilis is difficult to ignore, as at this stage they are clearly expressed.

At the first stage, it was difficult to distinguish the rash or malaise associated with syphilis from ordinary fatigue. In the second stage, the rash does not cause discomfort, but if personal hygiene is not observed, it can develop into unpleasant purulent formations. This stage of the disease can last a long time and be characterized by complications.

Pathogenic microorganisms, spreading throughout the body, can lead to its violations and failures. All these complications in the second stage lead to the development of the disease and the flow into the next logical phase.

The third stage of syphilis in women is characterized by great danger, since white treponema develops and destroys the internal tissues of the female body. All those ulcers that appeared turn into scars. The danger lies in the fact that the pathogen, affecting the internal organs, leads to death. The risk of death is high, as the vital organs of a person stop working. At the last stage of the disease, the oral cavity and nasal membranes are also destroyed, which leads to the appearance of tumors.

Treatment

Thus, in this article we found out what are the symptoms of syphilis. Now it is important to consider what is the treatment of this disease. Given the devastating impact of this disease, treatment is urgently needed.

Specialists prescribe a treatment regimen depending on the stage of the patient's disease. Before starting treatment, the specialist takes into account all the factors of the patient. These factors include age, drug tolerance, and the woman's well-being. After establishing an accurate diagnosis, the patient is hospitalized in a dispensary and treatment begins.

It is quite possible to resolve this problem at the first stage if modern medicines are used, and most importantly, contact a specialist in time. At the first stage, the doctor prescribes a drug that is of penicillin origin. This drug is administered for 16 days. If no changes occur and the pathogen does not respond to the drug, then derivatives, additional drugs, also of penicillin origin, are also used.

Additional drugs include antibiotics such as benzylpenicillin used in sufficient quantity. The doctor prescribes the use of oral and B vitamins, drugs that increase the patient's immunity, as well as probiotics. All these drugs are prescribed strictly by prescription, as they have an increased level of toxicity.

In this case, it is necessary to periodically maintain the presence of antibacterial drugs in the blood of the patient.

Medicines are injected into the patient's body by injection into both buttocks. After completion of treatment at the first stage, a woman should be constantly examined by a gynecologist and venereologist for 6 months. The patient, in addition to the use of these drugs, should refrain from drinking alcohol and having sexual intercourse.

As a rule, patients with this terrible disease do not have the right to be blood donors. There were also situations in which a person infected with syphilis became a donor and infected another person, so it is very important to identify this disease at an early stage. The most important thing to remember is not to try to self-medicate, as this will only exacerbate the disease and lead to its latent form.

The disease is dangerous because it can lead to the development of a severe form of other diseases. These diseases can manifest as deterioration or loss of vision, paralysis, harm to those people with whom the patient comes into contact. With the development of the disease, the most important organs and even the human brain are affected, which leads to irreversible processes.

If the treatment at the first stage was unsuccessful, then the prescribed drugs continue to be administered and Ceftriaxone and Doxycycline are also added to them. In this case, the duration of treatment can reach up to a month. In the event that the disease has smoothly moved to the last stage, then treatment with penicillin drugs continues, including Biyonhinol. This drug can be used if there is no allergy.

At this stage, the knowledge and experience of the attending physician are important, since it is these factors that can affect a positive result in the treatment process.

The mood of the patient and timely treatment can give a positive result. In the future, in order to completely get rid of a serious illness, you need to constantly be examined and tested. In any case, you need to remember that you need to refuse unprotected intercourse, in time to identify symptoms that may appear at any time.

Only a careful attitude to your body and a timely visit to the doctor will help to cope with this disease.

Many people are interested in what the first signs of syphilis can be detected on their own. After all, its success depends on the timely start of treatment.

Ignorance of the symptoms of the disease leads to another trouble. An infected person becomes a source of its spread, which is a criminal offense under the laws of many countries of the world. The illiteracy of the population of the CIS countries in this matter is striking. In the era of digital technology and an avalanche of diverse information, syphilis infections have increased dramatically in Russia.

Syphilis (lues) is an infectious disease. Excited by pale treponema. It affects various parts of the body: the outer shell of the dermis, the liver, spleen, sometimes the kidneys, bones and nervous system. Basically, the infection is transmitted sexually, which is why the disease is referred to as a sexually transmitted disease.

You can get infected at the household level. Doctors, in this case, say: household lues is not a kind of disease, but a way of transmitting infection.

This becomes possible due to the characteristics of life and reproduction of the microorganism. It is anaerobic, lives well and reproduces without oxygen. But oxygen is not poison to him. Therefore, it is able to survive in the open air for 3 days, but, at the same time, it quickly dies when dried and exposed to high temperatures. It survives well in deep freezing. Withstands minus 78 degrees.

Those infected with lues, using household items: a mug, a glass, a towel, etc., and without treating them with antiseptic agents, are highly likely to infect households.

Pale treponema can also enter the human body through the blood. You can become infected when it is transfused, visiting a hairdresser or dental office. Even taking blood tests can lead to infection if laboratory technicians violated the rules of sterility.

Drug addicts are at risk. Reuse of syringes and needles leads to infection. One of the features of the disease, making it more dangerous, is a long incubation period.

Due to its small size, the causative agent of the disease cannot be examined under a laboratory microscope, or seen by color when special dyes are used. Therefore, before the first symptoms appear, the infection is latent, and cannot be diagnosed. The carrier of treponema during the incubation period is the source of infection.

Getting the causative agent of lues into the human body does not mean that he will definitely get sick. In half the cases, pale treponema disappears without a trace. Medicine cannot explain the body's reaction to its introduction.

Primary signs of the disease

The first external symptoms of syphilis in men and women are classic - a hard, round, bluish-red, painless ulcer (chancre) appears and the lymph nodes increase. However, in the diagnosis of the disease in women there is a great difficulty.

In men, chancre can be found most often on the penis, but it can also appear on other parts of the body: the groin, thighs, or abdomen. Much less often, abscesses appear on the lips, in the mouth, on the hands.

In women, the ulcer is, in most cases, on the cervix or labia. Very rarely, ulcers appear in the pelvis or abdomen. Naturally, it is almost impossible to see the first signs of syphilis in women when an ulcer is inside the vagina. Therefore, the diagnosis of infection in women is very difficult.

Firstly, 1 abscess appeared before, and now there are two or more ulcers. Secondly, a change in the structure of the abscess is very often observed. The name "hard chancre" is due to the presence of a dense infiltrate inside it. Now this seal may not appear.

Ulcers, if left untreated, disappear on their own in 4 to 6 months, and the induration resolves. In most cases, there are no traces on the body after them. Since their formation takes place without any painful symptoms, many men begin to be treated with brilliant green or potassium permanganate. Contribute to self-treatment and erroneously established, in society, the point of view that abscesses, with lues, appear only on the genitals.

Therefore, only with the formation of any ulcers on the penis or labia, a person sounds the alarm and goes to the doctors. Here, the most important thing is not to waste time. It makes it difficult to diagnose the disease, not only among the population, but also among venereologists, an atypical chancre. It usually manifests itself in the form of other diseases:

• Amygdalitis is an inflammation of the tonsils. An ulcer appears on the tonsil. The disease proceeds according to the scenario of a typical sore throat, with fever, headaches, weakness, difficulty swallowing. Lues can be distinguished by the low effectiveness of treatment and unilateral involvement of the tonsil;
• Panaritium is an acute, purulent inflammatory process of the fingers (less often the legs). It differs from the usual disease in that the abscess heals for several weeks;
• Regional lymphadenitis - inflammation of the neck or face. Occurs when the saliva of an animal enters the human bloodstream. It is very difficult to identify the treponema pallidum bacterium that caused inflammation of the lymph nodes in this case.
• Mixed - when an abscess without compaction first appears, and only then, a classic chancre. A soft ulcer covers a hard chancre, which is why the vast majority of infected patients do not have thoughts about another reason for their appearance.

Another sign of lues infection is swollen lymph nodes near the groin and throat. Changes occur about a week after the appearance of the chancre. Oddly enough, but it is the manifestation of thickening in the lymph nodes that leads, most of the infected, to the doctor.

In addition to the chancre, additional symptoms of syphilis appear in women and men. Both in the female and in the male body:

• Body temperature rises for no apparent reason;
• An increase in the number of leukocytes in the blood;
• Hemoglobin decreases (anemia sets in);
• There are headaches;
• Insomnia torments;
• Loss of appetite;
• Irritability, aggressiveness are manifested;
• Joints and bones hurt;
• Swell, sometimes, tonsils, larynx and genitals. In the latter case, pain appears when walking;
• The whole body is covered with a syphilitic rash.

Features of the manifestation of infection in newborns

It is very difficult to diagnose an infection in a newborn. Very few children are born immediately with signs of the disease. In many, the symptoms of primary syphilis appear after a month, in some after 3 years of life, and in most at 14-15 years old, this is a latent form of lues. It can be detected before manifestation only through various analyzes and tests. Practice shows that here, often, a laboratory test gives a negative result.

Immediately after birth, the presence of infection in newborns can be detected by pemphigus, runny nose, swollen lymph nodes, damage to internal organs and bones.

Pemphigus is a small rash with cloudy liquid on the soles of the feet and palms, in rare cases it can appear on the face, elbows and knees. Runny nose - persistent rhinitis without signs of allergy. If left untreated, the nasal septum collapses. Enlarged lymph nodes - in infants, seals form in the area of ​​\u200b\u200bthe elbow joints.

Damage to internal organs - the destructive effect of the infection affects all vital organs: hepatitis develops, increases to a dense state, the spleen, bronchi expand, sometimes the kidneys are affected.

Bone damage - the skull is deformed, cartilage becomes inflamed, osteochondritis develops. Damage to the nervous system - convulsions occur, there is a lag in physical development, lethargy and apathy occur.

To detect the first signs of syphilis in a timely manner means to quickly and successfully cure the disease. Otherwise, a secondary period of lues sets in, which is more difficult to treat and is more destructive for the body. Note, however, that the first symptoms of syphilis in men are much easier to identify.

Therefore, when abscesses appear on the body, examine them. If a seal is found inside, examine additional lymph nodes. Their increase also indicates infection with pale treponema. Do not feel ashamed, be sure to consult a doctor.

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

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

How can you get syphilis?

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

It is possible to infect the fetus in utero or in childbirth: then congenital syphilis is diagnosed.

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

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

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

Transmission of syphilis with blood transfusions(blood transfusions) almost never occurs. The fact is that all donors must be tested for syphilis, and those who have not passed the test simply will not be able to donate blood. Even if we assume that there was an incident and there are treponemas in the donor blood, they will die during the preservation of the material in a couple of days. The very presence of a pathogen in the blood is also rare, because Treponema pallidum appears in the bloodstream only during treponemal sepsis» with secondary fresh syphilis. Infection is possible if enough virulent pathogen is transmitted with direct blood transfusion from an infected donor, literally from vein to vein. Given that the indications for the procedure are extremely narrowed, the risk of contracting syphilis through the blood is unlikely.

What increases the risk of contracting syphilis?

• Liquid secretions. Since treponemas prefer a humid environment, mother's milk, weeping syphilitic erosions and ulcers, sperm discharged from the vagina contain a huge number of pathogens and are therefore the most infectious. Transmission of infection through saliva is possible if there is syphilides(rash, chancre).
• Elements of dry rash(spots, papules) are less contagious, in abscesses ( pustules) treponema can be found only along the edges of the formations, and in pus they are not at all.
• Disease period. With active syphilis, nonspecific erosions on the cervix and head of the penis, herpetic rash vesicles and any inflammatory manifestations leading to defects in the skin or mucous membranes are contagious. In the period of tertiary syphilis, the possibility of infection through sexual contact is minimal, and papules and gummas specific for this stage are actually not contagious.

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

• Accompanying illnesses. Patients with gonorrhea and other STDs are more easily infected with syphilis, since the mucous membranes of the genitals are already damaged by previous inflammations. Treponemas multiply rapidly, but the primary lues is "masked" by the symptoms of other venereal diseases, and the patient becomes epidemically dangerous.
• The state of the immune system. People who are debilitated by chronic diseases are more likely to contract syphilis; AIDS patients; in alcoholics and drug addicts.

Classification

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

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

chancre - an ulcer that develops at the site of introduction of the causative agent of syphilis

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

Primary syphilis

After the end of the incubation period, the characteristic first signs appear. At the site of penetration of treponema, a specific rounded erosion or ulcer is formed, with a hard, smooth bottom, “tucked” edges. The sizes of formations can vary from a couple of mm to several centimeters. Hard chancres can disappear without treatment. Erosions heal without a trace, ulcers leave flat scars.

Disappeared chancres do not mean the end of the disease: primary syphilis only passes into a latent form, during which the patient is still contagious to sexual partners.

in the figure: chancres of genital localization in men and women

After the formation of a hard chancre, after 1-2 weeks begins local enlargement of lymph nodes. When palpated, they are dense, painless, mobile; one is always larger than the others. After another 2 weeks it becomes positive serum (serological) reaction to syphilis, from this point on, primary syphilis passes from the seronegative stage to the seropositive stage. The end of the primary period: the body temperature may rise to 37.8 - 380, there are sleep disturbances, muscle and headaches, aching joints. Available dense swelling of the labia (in women), head of the penis and scrotum in men.

Secondary syphilis

The secondary period begins about 5-9 weeks after the formation of a hard chancre, and lasts 3-5 years. Main symptoms syphilis at this stage - skin manifestations (rash), which appears with syphilitic bacteremia; wide warts, leukoderma and alopecia, nail damage, syphilitic tonsillitis. Present generalized lymphadenitis: the nodes are dense, painless, the skin above them is of normal temperature ("cold" syphilitic lymphadenitis). Most patients do not notice any special deviations in well-being, but the temperature may rise to 37-37.50, runny nose and sore throat. Because of these manifestations, the onset of secondary syphilis can be confused with a common cold, but at this time, lues affects all body systems.

syphilitic rash

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

• The formations are dense, the edges are clear;
• The shape is correct, rounded;
• Not prone to merging;
• Do not peel off in the center;
• Located on visible mucous membranes and over the entire surface of the body, even on the palms and feet;
• No itching and soreness;
• Disappear without treatment, do not leave scars on the skin or mucous membranes.

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

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

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

Rash with secondary acute syphilis polymorphic: consists simultaneously of spots, papules and pustules. Elements group and merge, forming rings, garlands and semi-arcs, which are called lenticular syphilides. After their disappearance, pigmentation remains. At this stage, the diagnosis of syphilis by external symptoms is difficult for a non-professional, since secondary recurrent syphilis can be similar to almost any skin disease.

Lenticular rash in secondary recurrent syphilis

Pustular (pustular) rash with secondary syphilis

Pustular syphilis is a sign of a malignant ongoing disease. More often observed during the period of secondary fresh syphilis, but one of the varieties - ecthymatous- characteristic of secondary exacerbated syphilis. Ecthymes appear in debilitated patients approximately 5-6 months from the time of infection. They are located asymmetrically, usually on the shins in front, less often on the skin of the trunk and face. Syphilides number 5 - 10, rounded, about 3 cm in diameter, with a deep abscess in the center. A gray-black crust forms above the pustule, below it there is an ulcer with necrotic masses and dense steep edges: the shape of the ecthyma resembles funnels. After that, deep dark scars remain, which eventually lose their pigmentation and become white with a pearly tint.

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

Ecthymes can go into rupioid syphilides, with the spread of ulceration and disintegration of tissues outward and deep. Centered rupees multilayer "oyster" crusts are formed, surrounded by an annular ulcer; outside - a dense roller of a reddish-violet color. Ecthymas and rupees are not contagious, during this period all serological tests for syphilis are negative.

Acne syphilides - abscesses 1-2 mm in size, localized in the hair follicles or inside the sebaceous glands. Rashes are localized on the back, chest, limbs; heal with the formation of small pigmented scars. Smallpox syphilides are not associated with hair follicles, they are lentil-shaped. Dense at the base, copper-red color. syphilis similar to impetigo- purulent inflammation of the skin. It occurs on the face and scalp, pustules are 5-7 mm in size.

Other manifestations of secondary syphilis

Syphilitic warts similar to warts with a wide base, often formed in the fold between the buttocks and in the anus, under the armpits and between the toes, near the navel. In women - under the breast, in men - near the root of the penis and on the scrotum.

Pigmentary syphilis(spotted leukoderma literally translated from Latin - "white skin"). White spots up to 1 cm in size appear on the pigmented surface, which are located on the neck, for which they received the romantic name "Venus' necklace". Leukoderma is determined after 5-6 months. after infection with syphilis. Possible localization on the back and lower back, abdomen, arms, on the front edge of the armpits. The spots are not painful, do not peel off and do not become inflamed; remain unchanged for a long time, even after specific treatment for syphilis.

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

Syphilitic angina- the result of damage to the mucous membrane of the throat. Small (0.5 cm) spotty syphilides appear on the tonsils and soft palate, they are visible as bluish-red foci of sharp outlines; grow up to 2 cm, merge and form plaques. The color in the center quickly changes, acquiring a grayish-white opal shade; the edges become scalloped, but retain the density and original color. Syphilides can cause pain during swallowing, a feeling of dryness and constant tickling in the throat. Occur along with a papular rash during the period of fresh secondary syphilis, or as an independent sign of secondary exacerbated syphilis.

manifestations of syphilis on the lips (chancre) and tongue

Syphilides on the tongue, in the corners of the mouth due to constant irritation, they grow and rise above the mucous membranes and healthy skin, dense, the surface is grayish in color. May become covered with erosions or ulcerate, causing pain. papular syphilis on the vocal cords initially manifested by hoarseness of voice, later a complete loss of voice is possible - aphonia.

syphilitic nail damage(onychia and paronychia): papules are localized under the bed and at the base of the nail, visible as reddish-brown spots. Then the nail plate above them becomes whitish and brittle, begins to crumble. With purulent syphilis, severe pain is felt, the nail moves away from the bed. Subsequently, depressions in the form of craters form at the base, the nail thickens three or four times compared to the norm.

Tertiary period of syphilis

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

what can affect advanced syphilis

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

Serpinginous syphilides are grouped papules that are in different stages of development and spread to large areas of the skin. New formations appear along the periphery, merge with the old ones, which at this time already ulcerate and scar. The sickle-shaped process seems to crawl to healthy areas of the skin, leaving a trail of mosaic scars and pigmentation foci. Numerous tubercular seals create a colorful picture true polymorphic rash, which is visible in the late periods of syphilis: different sizes, different morphological stages of the same elements - papules.

syphilitic gumma on the face

syphilitic gumma. At first it is a dense knot, which is located in the depth of the skin or under it, mobile, up to 1.5 cm in size, painless. After 2-4 weeks, the gumma is fixed relative to the skin and rises above it as a rounded dark red tumor. A softening appears in the center, then a hole forms and a sticky mass comes out. In place of the gumma, a deep ulcer is formed, which can grow along the periphery and spread along the arc ( serping gummy syphilis), and in the "old" areas there is healing with the appearance of retracted scars, and in the new ones - ulceration.

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

gummas in the mouth and inside the nose disintegrate with destruction of the palate, tongue and nasal septum. Defects appear: fistulas between the cavities of the nose and mouth (nasal voice, food can get into the nose), narrowing of the orifice(difficulty swallowing), cosmetic problems - failed saddle nose. Language first increases and becomes bumpy, after scarring it wrinkles, it becomes difficult for the patient to talk.

Visceral and neurosyphilis

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

Dorsal tabes– Manifestation of syphilis of the spinal cord: the patient literally does not feel the ground under his feet and cannot walk with his eyes closed.

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

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

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

bone destruction in syphilis

Among the visceral forms predominates syphilis of the heart and blood vessels(up to 94% of cases). Syphilitic mesaortitis- inflammation of the muscular wall of the ascending and thoracic aorta. It often occurs in men, accompanied by an expansion of the artery and phenomena of cerebral ischemia (dizziness and fainting after exercise).

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

congenital syphilis

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

early congenital syphilis

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

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

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

Osteochondritis, periostitis- inflammation and destruction of bones, periosteum, cartilage. It is most often found on the legs and arms. There is local swelling, pain and muscle tension; then paralysis develops. During early congenital syphilis, destruction of the skeletal system is diagnosed in 80% of cases.

late congenital syphilis

late form manifests itself in the age period of 10-16 years. The main symptoms are visual impairment with the possible development of complete blindness, inflammation of the inner ear (labyrinthitis), followed by deafness. Skin and visceral gummas are complicated by functional disorders of organs and scars that disfigure the appearance. Deformation of teeth, bones: the edges of the upper incisors have semilunar notches, the legs are bent, due to the destruction of the septum, the nose is deformed (saddle-shaped). Frequent problems with the endocrine system. The main manifestations of neurosyphilis are tabes dorsalis, epilepsy, speech disorders, progressive paralysis.

Congenital syphilis is characterized by a triad of signs Getchinson:

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

How is syphilis diagnosed?

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

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

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

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

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

Direct Methods laboratory tests help to identify the causative microorganism, and not antibodies to it. With the help, you can determine the DNA of treponema in the biomaterial. Microscopy a smear from a serous discharge of a syphilitic rash - a technique for visual detection of treponema.

Treatment and prevention

Treatment of syphilis is carried out taking into account the clinical stages of the disease and the susceptibility of patients to drugs. Seronegative early syphilis is treated more easily, with late variants of the disease, even the most modern therapy is not able to eliminate consequences of syphilis- scars, organ dysfunction, bone deformities and disorders of the nervous system.

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

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

Assign nutrition with an increase in the proportion of complete proteins and a limited amount of fat, reduce physical activity. Prohibit sex, smoking and alcohol.

Psychotrauma, stress and insomnia adversely affect the treatment of syphilis.

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

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

course treatment: tetracyclines are added to penicillins ( doxycycline) or macrolides ( azithromycin), preparations based on bismuth - bismovrol, biyoquinol, and iodine - potassium or sodium iodide, calcium iodine. Cyanocobalamin (vit. B-12) and solution coamide enhance the action of penicillin, increase the concentration of the antibiotic in the blood. Injections of pyrogenal or prodigiosan, autohemotherapy, aloe are used as means of non-specific therapy for syphilis, which increase resistance to infection.

During pregnancy, syphilis is treated only with penicillin antibiotics, without drugs with bismuth salts.

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

Prevention of syphilis- Identification of the infected and the range of their sexual partners, preventive treatment and personal hygiene after sexual intercourse. Surveys for syphilis of people belonging to risk groups - physicians, teachers, staff of kindergartens and catering establishments.

Video: syphilis in the program “Live healthy!”

Video: syphilis in the encyclopedia of STDs

Unprotected intercourse with an unreliable or random sexual partner can cause syphilis, which is a chronic sexually transmitted infection. This disease proceeds in waves, with alternating periods of exacerbation and subsidence of the symptoms of the disease. In advanced cases of the disease, lesions of the internal organs, as well as the bone-articular and nervous systems, are observed.

Causes and symptoms of syphilis. primary syphilis.
The main culprit of syphilis is pallidum spirochete or, as it is also called, pale treponema. As a rule, infection occurs during unprotected intercourse with a sick partner. In addition to "venereal" syphilis, household syphilis can be found, the infection of which is carried out through household items common with a sick person (dishes, lipstick, cigarettes, etc.). There are a lot of symptoms of syphilis, their manifestation is different in each clinical period of the disease, which are distinguished by three: primary, secondary and tertiary.

The incubation period of this sexually transmitted disease averages from two to six weeks, but in some cases it can be reduced to eight to fifteen days or extended to one hundred and eighty days. The lengthening of the incubation period occurs when patients take antibiotics as a result of the treatment of other diseases after infection with syphilis. In these cases, manifestations of the primary stage of the disease may not be. In addition, this period is lengthened in sick elderly people, physically weakened people with reduced reactivity, in people who simultaneously suffer from syphilis and a venereal ulcer or mild chancre.

It should be noted that regardless of the length of the incubation period, an infected person is already becoming dangerous for his family members or his sexual partner. When infected, the first manifestations of the disease (hard chancre) in a woman occur on the external genital organs, on the cervix and vaginal mucosa. This usually happens a few weeks after infection. There are cases when a hard chancre appears on the chest near the nipple, on the skin of the abdomen, thighs, arms. Chancre has a dense base, smooth edges and a brown-red bottom. After a few weeks, it disappears even in the absence of treatment. That is why many patients do not attach much importance to the appearance of the disappearance of painless "sores", referring to an allergic reaction. Meanwhile, the disease continues its "dirty deed". The pathogen destroys the body, spreading through it through the circulatory and lymphatic systems. The patient will feel nothing but general weakness. The only thing from time to time on the body can be observed painless skin rashes.

The primary period of syphilis is divided into seronegative syphilis, when standard serological blood tests are negative (the first three to four weeks after the onset of hard chancre) and seropositive syphilis, when blood tests are positive. If the doctor suspects the patient has syphilis, and the serological blood tests are still negative, it is urgent to start treatment, because with seropositive syphilis, the treatment process will take a longer period of time and will be more intensive.

Secondary syphilis.
Often, with a latent form of the disease, an increase in lymph nodes is observed (usually this occurs one to two weeks after the appearance of the chancre). This is a sign that the causative agent of the disease has penetrated into the lymph, where it freely reproduces, spreading with the lymph flow throughout the body. One of the signs of lymph infection is the occurrence of a chancre in the mouth or anus. If an increase in lymph nodes is observed near the location of the ulcer, this indicates that the disease is at the first stage of its development. If an increase in lymph nodes (cervical, occipital, submandibular) is observed throughout the body, secondary syphilis occurs. As a rule, this period occurs six to nine weeks after the onset of the first signs of the disease (ulcers or chancre). Its duration without treatment is from three to five years, after which the disease flows into the third stage of development.

Secondary syphilis is expressed by the appearance of a pale rash all over the body, including on the palms and soles. In this case, the patient may experience headache, loss of appetite, malaise, fever up to 38 °, bone ache, insomnia. In this case, hair, eyelashes and eyebrows may fall out, which is quite unpleasant for a woman, and wide condylomas (bodily growths) may appear on the genitals and in the anus. In addition, in the second stage of the development of syphilis, papules may appear in the oral cavity and on the tongue, in the region of the vocal cords, resulting in syphilitic hoarseness. Usually after two and a half months, even in the absence of treatment, the rash disappears without a trace, and secondary latent syphilis begins. After a short period of time, a relapse of the disease occurs.

Tertiary syphilis.
Today, fortunately, syphilis in the third stage of development is rare. Usually the disease is diagnosed in time and optimal treatment is prescribed. If the disease is not treated, then in some three to five years it will flow into the third stage, when internal organs, bones and joints, the nervous and endocrine systems, and sensory organs are affected. In this case, the entire body of the patient is covered with tubercles or nodes (syphilides or syphilis gums), which form scars during opening and subsequent healing. It is good if syphilides cover only the body, and not the internal organs, otherwise it can cause death.

In tertiary syphilis, all organs and systems are affected. Soft tissues, namely cartilage, undergo deformation, melt, and degenerate into a kind of tumor - gumma. At this stage of the development of the disease, patients do not pose a danger to others, that is, they are not contagious.

If the mucous membranes of the nose and pharynx are affected by the disease, the palate, the bone part of the nasal septum may suffer, up to perforation. The bridge of the nose can sink, and during meals, food enters the nose.

Syphilis is a serious disease. It can proceed in a latent form and manifest itself only when the disease is at the most dangerous stage of development - the third. That is why, at the first alarming symptoms, you should consult a doctor.

Syphilis and pregnancy.
Syphilis can be congenital when the fetus becomes infected in the womb through the placenta. Early congenital syphilis manifests itself in the first two years after birth and is expressed in intense skin lesions, eye pathology, the presence of pharyngitis, damage to the bone, nervous system, and destruction of internal organs, late congenital syphilis - after two to five years and is characterized by abnormal formation of teeth, deafness, eye disease. Often there are particularly severe forms of the disease, in which newborns die in the first year of life. Twenty-five pregnancies out of a hundred end in miscarriage if the pregnant woman was sick with syphilis. If a pregnant woman did not treat the disease either before pregnancy or during it, there is a high probability of premature birth or the birth of a dead baby. The probability of giving birth to a healthy child in the presence of syphilis is ten percent. To date, this disease and pregnancy are compatible, timely treatment significantly reduces the risk of having an infected child.

Diagnostic methods.
This disease is detected by laboratory tests, since skin rashes cannot serve as a complete guarantee of the presence of syphilis. To diagnose the disease, a microprecipitation reaction is used, which makes it possible to accurately and quickly determine the presence or absence of syphilis. In addition, the presence of visible signs is taken into account: a rash, the presence of a chancre, an increase in lymph nodes, etc. Also, the following methods are used to diagnose the disease: RIF, ELISA, RIBT, RPGA, microscopy, PCR analysis.

The following reasons should prompt laboratory tests: unprotected sexual contact with a casual partner, a diagnosis of syphilis in a partner confirmed by doctors, the appearance of visible signs of illness on the skin (rash, chancre, etc.), swollen lymph nodes, etc.

Treatment.
The treatment of syphilis is approached comprehensively, taking into account many individual factors (age, sex of the patient, stage of development of the disease, the presence of concomitant diseases, the general condition of the body, etc.). In addition, all sexual partners of the alleged patient should also be examined for the presence of syphilis and, if necessary, undergo a course of therapy. If the patient has primary syphilis, then everyone who has had sexual relations with him over the past three months should be examined and tested. In the case of secondary syphilis, everyone who had contact with the patient in the last year. The timeliness of the therapy itself, as well as the correct selection of modern drugs, is important for achieving success in the treatment of this disease.

Patients with infectious forms and early latent syphilis are hospitalized in a venereal hospital or dispensary during the first day after diagnosis. Treatment of patients with late forms of syphilis is carried out in a venereological, neurological, cardiological, therapeutic or psychiatric hospital, taking into account the nature of the prevailing lesions. In addition, treatment is prescribed for persons who have had sexual or close household contact with patients with syphilis in an infectious form, preventive treatment for pregnant women who have had syphilis, and children born to mothers who previously had syphilis. These types of treatment are carried out in dermatovenerological dispensaries.

Throughout the therapeutic course of the disease, a constant level of antibacterial drugs is maintained in the blood.

In no case should you self-medicate this dangerous disease, this can lead to serious complications. The duration of the course of treatment for primary syphilis cannot be less than two weeks, for secondary - less than four weeks. Modern methods of treating syphilis make it possible to undergo therapy with a venereologist on an outpatient basis in the early stages of the disease. The advanced stages of the disease are treated in a stationary, venereal dispensary.

Before prescribing therapy, the degree of tolerance by the patient of drugs that are used in the treatment of syphilis is clarified. At the end of treatment, the patient passes the necessary serological control tests. In addition, he needs to be constantly observed by the attending physician. Patients with primary seronegative syphilis should be observed by a venereologist for at least six months, with primary seropositive syphilis and secondary syphilis - up to a year.

Timely treatment of syphilis is carried out within two to three months using the following means:

• Antibiotics. Today, penicillin derivatives in sufficient doses are used for antisyphilitic therapy. For example, benzylpenicillin. In secondary and tertiary syphilis, bismuth, bismoverol and iodine are added. With progressive tertiary syphilis, with a pronounced resistance of the pathogen to antibiotics and in the case of a good general condition of the patient, which allows for a certain toxicity in therapy, bismuth derivatives (biyoquinol) or arsenic derivatives (miarsenol, novarsenol) can be added to antibiotics. Today, these drugs are available only in specialized institutions due to high toxicity.
• Immunomodulators. As a rule, thymalin, T-activin are prescribed.
• Vitamins. As a rule, these are B vitamins and antioxidants.
• Probiotics. They are prescribed from the first days of antisyphilis therapy (Linex, Lacidophil, Hilak).
• During therapy, the patient is strictly contraindicated for any sexual intercourse and alcohol. In addition, they are prohibited from donating blood.
• Treatment of syphilis in pregnant women is carried out with penicillin until the 32nd week, after which preventive treatment is prescribed after the birth of the child.

Complications of the disease.
Syphilis, in the absence of optimal therapy, flows into the third stage of the disease, in which all systems and organs of the body are affected and the result of which is death.

Forecast.
It all depends on the stage of development of the disease and the method of therapy. If therapy was started in the early stages of the development of the disease (primary, secondary and early latent syphilis) and is carried out using treponemocidal antibiotics, then in almost all cases without exception, a complete clinical cure occurs, and relapses of early syphilis and the occurrence of late forms of syphilis are prevented.

Treatment of syphilis in pregnant women in the first half of pregnancy in most cases guarantees the birth of a healthy baby. In the case of congenital syphilis, the prognosis is favorable if the treatment of the disease was started in a timely manner. Treatment of late forms of the disease is less successful, since it only slows down the progression of the disease, but in all cases it can restore the impaired function of the affected organs and lead to negative serological reactions.

Prevention.
As a preventive measure for this disease, typical methods are used, as for most sexually transmitted diseases - condoms,