What is primary syphilis. Primary syphilis and features of its course in men and women. Symptoms of Primary Syphilis

Syphilism is one of the most common sexually transmitted diseases (STDs). The causative agent of the disease is the bacterium Treponema pallidum. Modern medicine can easily cope with this disease, but if the patient is not treated, he will face a slow and painful death with a wide range of symptoms.

According to 2014 data, 26 people per 100 thousand population of our country are sick with syphilis. The incidence of sexually transmitted diseases is decreasing at a slow pace, so the government is educating the population about STDs. Awareness about STD prevention helps to avoid serious health problems for both young people and adults.

Syphilitic infection symptoms

Once in the human body, the bacterium Treponema pallidum, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person is unaware of the infection, as he has no signs of illness. Even most tests cannot detect the disease at this stage. There is a high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of his actions.
The first signs of the disease appear after the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (cutaneous syphilides) and on the mucous membranes - chancre in the mouth, on the genitals, rash on the mucous membranes (syphilides of the mucous membranes).

Symptoms of syphilitic infection in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). A hard chancre forms where the bacterium enters. Its appearance indicates the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of Treponema pallidum. It is localized in the mouth, in the area of ​​the external and internal genital organs, and in the anus.

A chancre is an inflammatory growth of a round shape with a flat base. In the initial stages of its appearance there is practically no pain. Appears at sites of infection. If treatment is not carried out, then a syphilitic rash is added to the chancre on visible parts of the body and on mucous membranes.

Signs of syphilism in men

In men, as in women, the first noticeable sign of infection appears in the form of a chancre. Ulcers often form on the penis, at its base and on the head. However, it can also appear in the oral cavity, on the scrotum, and in the anus. The symptoms and course of the disease are practically no different in the male and female parts of the population. Further description of syphilism will be given without division by gender.

How does sifak manifest in women?

• The primary stage of sifak in women begins with the detection of hard chancre on the skin or mucous membranes. At the initial stage, this does not cause serious discomfort. Then a gradual inflammation of the chancre occurs, it takes on a red or bluish color, characteristic of a severe inflammatory process.
• During the first week after the first symptoms appear, women begin to experience inflammation of the lymph nodes and vessels near the chancre (regional scleradenitis). The lymph nodes become inflamed in the form of balls, forming significant edema and swelling around the chancre. If the sore is localized in the oral cavity, it threatens with inflammation of one tonsil and swelling of the throat, making it difficult to swallow and breathe. The symptoms cause significant distress with verbal communication and eating. Scleradenitis in the genital area makes walking and defecation difficult.

Photo: Jarun Ontakrai/Shutterstock.com

The end of primary and the beginning of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern diagnostic methods make it possible to detect syphilism immediately after the first symptoms appear. The most commonly used enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). These tests are prescribed by a therapist at a clinic or a venereologist at a dermatovenereal dispensary. The average cost of analysis is 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will not show anything other than a seronegative reaction, indicating the absence of Treponema pallidum in the body.

Symptoms of secondary syphilis

• The skin around the chancre becomes covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and unite into large areas on the skin and mucous surfaces, causing the patient severe discomfort. There are three types of syphilitic rash.
  Roseola rash - pink or red spots with clear or blurred boundaries 5-50 mm in diameter. There are no cavities. Do not protrude above the skin.
  Papular rash - small conical growths of pink color. May peel off at the top of the cone. This kind of cheese looks extremely unpleasant.
  Pustular rash - growths with purulent cavities.
• Along with the appearance of a rash, damage to the nervous system may begin. Degradation of nervous tissue negatively affects vision, memory, attention, and coordination of movements. Unfortunately, treatment of the disease will not lead to the restoration of lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
• Signs of partial or complete baldness appear. Hair falls out, usually on the head. First, the quality of the hairline deteriorates: the hair splits, becomes thinner, and thins out. Then the hair thinning intensifies and large bald patches of skin appear. After recovery from syphilis, hair growth does not renew.

Stages of syphilis

Nowadays, every person infected with Treponema pallidum can quickly and efficiently receive adequate and effective treatment. Only a few go through all stages of syphilis. Without treatment, a person lives in terrible pain for 10 or even 20 years, after which he dies.
Below is a brief description of the stages of syphilis.
Incubation stage

Stage of primary syphilis

Stage of secondary syphilis. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Stage of tertiary syphilis. It is divided into three stages of the disease. In the absence of adequate treatment, the order will be as follows:

Neurosyphilis begins towards the end of secondary syphilis. Usually manifests itself in the form of the following diagnoses:

• Asymptomatic neurosyphilis – in which there are no painful manifestations yet, but tests already show inflammation and infection of the cerebrospinal fluid. This stage of neurosyphilis usually begins a year and a half after infection.
• Gummy neurosyphilis is accompanied by the formation of gummas inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, and causes an increase in pressure inside the patient’s skull.
• Syphilitic meningitis is a lesion of the membranes of the brain at the base and in the area of ​​the cranial vault. Accompanied by severe symptoms, including disturbances of attention, thinking, memory, and the emotional sphere of a person.
• Meningovascular form of neurosyphilis - destroys the blood vessels of the brain, accompanied by chronic meningitis. In the absence of therapy, it leads to headaches, personality changes, behavior changes, sleep is disturbed, and convulsions begin. This ultimately leads to strokes.
• Taste dorsalis is a disorder of the nerve fibers of the spinal cord, their thinning and dysfunction. This leads to an irreversible impairment of the ability to move in space: the gait is bent, the patient may fall, losing the feeling of the ground under his feet. When you close your eyes, you lose orientation in space.
• Progressive paralysis - causes dysfunction of the central nervous system, accompanied by personality disorders, behavior dangerous to society, and all higher mental functions are degraded. A person turns into a madman and can easily end up in a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
• Optic nerve atrophy is degradation of visual function. At first, the vision of only one eye deteriorates, but gradually the infection approaches the second optic nerve. Leads to complete blindness if left untreated. Changes in the visual apparatus are irreversible.
• Late visceral syphilis is degradation of tissues of internal organs. Mainly the cardiovascular system and liver are affected. Other organs are rarely affected. Patients complain of deterioration in health at the slightest exertion, and they develop systolic heart murmurs due to dilation of the aorta. When late visceral syphilis is localized in the heart, a heart attack can occur.
• Late syphilism of bones and joints - causes local expansion of bones and large joints. Accompanied by the formation of gumma on the bones.

Atypical syphilis

In addition to hard chancre, others, so-called, may also appear at the stage of primary syphilis. atypical chancre. That is why this variant of the development of the disease is called atypical syphilis. Atypical chancres are of the following types:

• Indurative edema.
  Looks like a change in color of the scrotum in men, the clitoris and labia in women. The color varies from scarlet to bluish in the center, turning pale at the edges of the swelling. Women are susceptible to this symptom more often than men. Usually the patient perceives indurative syphilitic edema as an infectious-inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the true cause of the edema. It can be distinguished from another infection by the absence of an inflammatory process in the blood and the presence of inflammation of the lymph nodes.
• Chancre felon.
  It may appear in people caring for patients with syphilis: medical personnel, relatives. The thumb, index and middle fingers are affected. This is a very painful attack. The skin pulls away from the fingers, revealing large areas of bleeding, similar to second-degree burns. Panaritium is also accompanied by swelling and inflammation of the fingers, which interfere with normal human functioning. Often appears together with chancre of the genital organs.
• Chancroid-amygdalitis.
  It manifests itself in the form of inflammation of one tonsil, and its surface is not disturbed and remains smooth. The oral cavity is subject to severe pain, and the swallowing process becomes difficult. The patient experiences a fever, as if he had a sore throat. The difference from a sore throat is that with amygdalitis, only one tonsil becomes inflamed.

Congenital syphilis

It is highly undesirable for a mother to suffer from illness during pregnancy. The fetus is exposed to Treponema pallidum, which leads to irreversible morphological consequences and disruption of intrauterine development.
Medicine knows three main symptoms:

• • Parenchymal keratitis is a pathology of the external epithelium of internal organs and the eyeball. It manifests itself as severe redness and inflammation of the organ on the outside. Sometimes the inflammation penetrates a little deeper into the surface. After healing, scars remain and an eyesore may remain. The most common consequence for the eye is decreased visual acuity. Keratitis is accompanied by blurred vision, acute pain, and lacrimation.
  • Deafness from birth. The causative agent of syphilis actively destroys the nerve tissue of the fetus during pregnancy. One option may be a pathology of the auditory nerve, which leads to irreversible deafness.
  • Congenital dental anomalies. Occur due to underdevelopment of tooth tissue during fetal development. This pathology is called Hutchinson's teeth. The teeth grow in the shape of a screwdriver with a rounded notch on the cutting edge, and are set sparsely. Sometimes teeth are not completely covered with enamel. Which leads to their early destruction and unflattering appearance.

A child who has had intrauterine syphilis has poor health, even if the mother has successfully completed treatment. If adequate treatment is not followed, the child will have severe deformities and remain disabled for life. If a mother is infected with syphilis, breastfeeding the baby should be stopped immediately, since syphilis is transmitted through mother's milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for Treponema pallidum (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide to become pregnant.

The causative agent of syphilis

Treponema pallidum is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common venereal diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists found the key to quickly curing syphilis, and the way was also opened for them to invent methods for early diagnosis of the disease.

Properties of the pathogen

The bacterium was called pale due to the fact that for a long time scientists could not examine it under a microscope. The transparent color of treponema is difficult to stain in other colors for subsequent research. For staining, the Romanovsky-Gizma and silver impregnation methods are used, which make it possible to detect bacteria under a dark-field microscope for subsequent study.
It was found that under favorable conditions (it should only be a human or animal body), Treponema pallidum divides every 30 hours. The weak point of Treponema pallidum is that it lives and reproduces only at a temperature of 37 °C. This explains the effectiveness of archaic methods of treating syphilis, when, by artificially increasing the patient’s body temperature to 41 °C with the help of malaria, some relief of the symptoms of the underlying disease occurred.
The length of the bacterium is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, its body forms curls in the form of a ball. At the same time, it constantly changes the shape and number of curls due to the ability of the Treponema pallidum cell to contract.

Incubation period

Entering the body through microdamages of the skin and mucous membranes, the causative agent of syphilis begins the incubation period. Dividing at a rate of about once every 30 hours, it accumulates at the site of infection. There are no visible symptoms. After about a month, a hard chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means the transition from incubation to the stage of primary syphilis. The strength of immunity varies from patient to patient, which makes the length of the initial period of infection vary widely. It can last from 1-2 weeks to six months.

How is syphilis transmitted?

The process of transmission of the pathogen occurs in most cases through sexual contact. Infection is guaranteed through traditional, anal and oral sexual contact, even with a patient in the incubation period. Hard chancre forms where bacteria enter.

When caring for patients, infection is likely through contact with the patient's clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. This is one of the most painful symptoms in the stage of primary syphilis. Then hard chancre of the genital organs may appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when reusing a patient’s syringe, his razor, scissors, or utensils.

How to treat syphilis

Treatment should begin at the first signs of syphilis. This way the healing process will take place as quickly as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, drugs based on it are also used, since Treponema pallidum does not know how to adapt to this type of antibiotics. Sufficient doses of penicillin effectively fight the disease. To treat syphilis in patients with allergic reactions to penicillin, erythromycin or tetracycline is used.
If the course of the disease has progressed to neurosyphilis, then treatment becomes more complicated. Pyrotherapy (artificial increase in body temperature) and intramuscular administration of antibacterial drugs are added.

For tertiary syphilis, along with antibiotics, highly toxic bismuth-based drugs are used. Treatment occurs strictly in a hospital with multi-level supportive therapy.

If a patient is diagnosed with primary syphilis, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the last trimester.
If secondary syphilis is diagnosed, it is necessary to compulsorily treat all his sexual partners with whom he had contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing fixtures, dishes, bedding and underwear, clothing, etc.
Hospitalization in the initial stages of syphilis is not required; outpatient treatment is sufficient. Only in severe forms, starting from the secondary stage, the patient is admitted to the hospital. Treatment of syphilis under the compulsory medical insurance policy is free and anonymous.

It is highly not recommended to cope with the disease using folk remedies. Only well-designed treatment can defeat Treponema pallidum. Otherwise, there is a high probability of the disease progressing to more severe stages.

Which doctor treats sifak disease?

Since sifak is a disease transmitted primarily through sexual contact, treatment is carried out by a venereologist. The patient can contact a general practitioner and receive a referral to a venereologist. The option of direct contact with a skin and venereal disease clinic is possible.

After examination and receipt of test results, the patient is treated either by a venereologist himself, specializing in all STDs, or the patient is referred to a highly specialized specialist - a syphilidologist.

There is a syphilidologist in every major city at skin and venereal dispensaries. He can select the most effective dosages of medications and develop a treatment program that must be strictly followed. In case of complications in men (when the head of the penis is pinched), syphilis is treated together with a urologist.
In case of complications in women (chancre in the vagina, on the cervix), you need to go to a gynecologist.

How long to treat syphilis

The duration of treatment for the disease is determined solely by the doctor. Depending on the stage of the disease, complications and general condition of the body, healing may take from two weeks to six months.

It is very important to know that under no circumstances should you interrupt the course of treatment. If treatment is not completed, the patient will soon experience a relapse. Therefore, treatment must be taken extremely seriously.

22.06.2017

Primary Syphilis is the initial form of development of the disease syphilis, which is manifested by hard chancroid and inflammation of the lymphatic system.

Primary Syphilis lesions can be extragenital and atypical, but most oftensigns of syphilismanifest as syphilitic chancre in the genital area of ​​an infected person.

Symptoms of Primary Syphilis

According to the international classification todayprimary syphilisclassified as follows:

• Primary Syphilis of the genital organs;
• Primary Syphilis of the anal region;
• Primary Syphilis of other local places.

In some rare casessyphilis initial stagecourse of the disease, occurs without visible symptoms, which classifies it as a separate point in the classification.

Primary period of syphilisappears after the end of the incubation period. On average, the incubation period lasts from 21 calendar days to 50 days after the bacterium enters the human body. Within a period of up to 20 days from the moment of infection, even tests show a negative result for this disease.

The duration of the incubation period of syphilis disease is extended:

• a condition of the body that is accompanied by elevated temperature;
• treatment with a complex of antibiotics;
• age, the older the person, the longer this period.

During the incubation period, the spirochete infection manages to get into many organs and lymph, and begins to multiply, which causes an inflammatory process.

If a lot of treponemas enter the human body, in this case the incubation period is significantly reduced and the manifestation of the disease begins faster.

Even during the period when a person has a seronegative stage of the disease and tests show a negative result, it is possible to become infected from it through the blood.

Signs of primary syphilis

First stage of syphilismanifests itself in enlarged lymph nodes and chancre. Thissymptoms of syphilisduring the first period of the disease. Chancre is a round ulcer with a diameter of about one centimeter on the patient’s body. They are red and blue in color, sometimes they are painful, but generally the patient does not perceive pain at the site of erosion. Firstsigns of syphilisin men: formation of chancre on the head of the penis, and in womensigns of syphilisappear on the walls of the uterus and on the external genitalia. Also, these ulcers can manifest on the pubis, near the anus, on the tongue and lips.

Syphilis develops quickly, and the lymph nodes become inflamed and enlarged first, and then the formation of hard chancre.

Towards the end of this period the following symptoms appear:

• state of general malaise;
• constant headache;
• elevated temperature;
• pain in muscle tissue;
• aches and pain in the bones;
• decreased hemoglobin level;
• significant increase in leukocytes.

An undiagnosed disease in the first stage of development, and not started drug treatment, provoke the transition of syphilis to the second stage of development, which significantly aggravates the course of the disease.

Atypical chancre of primary syphilis

Signs of primary syphilisIn addition to hard chancre, atypical chancre can develop. Atypical chancre has many types:

• indurative edema is a large lump that forms on the foreskin of the penis, genitals in women and in the lip area on a person’s face;
• Panaritium is a chancre that develops on the nails and does not heal for several months. There may even be nail rejection;
• lymph nodes - increase in this period. Depending on which part of the body the chancre formed, the lymph nodes closest to the chancre become inflamed;
• a bubo is a lymph node that has a mobile shape and has no painful signs and is located closest to the chancre: on the patient’s neck, if the chancre is in the tonsils, and on the groin part of the body, if the chancre is in the genital area;
• polyadenitis is inflammation and hardening of all lymph nodes, from this moment we can assume that symptoms of secondary syphilis began to appear.

Complications of syphilis in the first period can be very serious both for the female body and also have serious consequences for the male body.

Ways of infection with syphilis

The sexually transmitted disease syphilis is transmitted in several ways:

• sexual contact not protected by a condom;
• through blood from a sick person to a healthy person;
• in utero from a sick mother to a newborn child;
• through mother's milk when feeding a baby;
• through general hygiene items;
• It is quite rare that the disease is transmitted through saliva.

The most common causes of syphilis are unprotected sexual contact and the use of one syringe among drug addicts. The best way to protect yourself from infection is to use a condom. Even if you used a condom during sexual intercourse with a casual partner, it is necessary to treat the genitals with antiseptics. In order to make sure that this sexual contact did not bring you “surprises,” you need to consult a doctor. Testing for syphilis takes place almost a month after exposure.

All ulcers and erosions on the body of a person suffering from syphilis are very dangerous, because the separated fragments of these wounds are contagious and can infect a healthy person through contact if he has abrasions and microtraumas on the skin.

From the very first day until the final period of recovery, the patient’s blood has an infectious form and there are possible ways to transmit syphilis through a shared razor, syringe, during procedures in beauty parlors, during manicures and pedicures.

Diagnosis of syphilis after the incubation period

In order to establish a diagnosis of syphilis, it is necessary to conduct an examination of the body for the presence of syphiloma in the body. It is necessary, first of all, to visit the office of a venereologist, who will examine the patient and refer him for tests. Only after a person’s skin, genitals and lymph nodes have been examined, as well as the results of laboratory tests, can a correct diagnosis be made and treatment prescribed.

For laboratory confirmation of syphiloma in the body, you need to submit for analysis a scraping from a chancre ulcer or a smear of syphilitic discharge from the genitals.

20-21 days after syphiloma enters the body, the seropositive stage of the disease begins, and tests show a positive result for the presence of syphilis.

Differential diagnostic testing of primary syphilis is carried out:

• with traumatic erosion of the genital organs;
• with allergic balanitis or trichomonas balanitis, with balanoposthitis, in people who do not maintain intimate hygiene;
• with balanoposthitis, which passes into the stage of gangrene, which can develop either independently or be a complication of diseases of the genital area;
• with chancre, genital lichen, staphylococcal infection, streptococcal infection or fungal diseases;
• with ulcers and erosions caused by gonococcal infection and Trichomonas;
• with ulcers on the labia of female adolescents.

Diagnosis of syphilis consists of several types of examinations and tests:

• serological diagnosis is the detection of Treponema bacteria from scraping of chancre. Based on the results of this examination, the doctor makes a diagnosis;
• Treponema immobilization reaction;
• immunofluorescence reaction;
• Wasserman reaction;
• microreaction on glass;
• linked immunosorbent assay;
• microprecipitation reaction;
• passive hemagglutination reaction.

Based on a diagnostic examination and laboratory results, a venereologist draws up a treatment regimen for syphilis in the primary stage.

Treatment of syphilis at the first stage of disease development

At the primary stage, the task is to cure the infection and prevent syphilis from moving into the second stage. Syphilis is a disease that takes a long time to treat. If syphilis was diagnosed at the first stage, in this case treatment can take up to 90 calendar days.

If the diagnosis showed syphilis at the second or later stage, then drug treatment can last for up to 2 years. All family members should undergo examination and undergo a complex of treatment for prevention.

The main drugs used in the treatment of primary syphilis are antibiotics of different groups and directions:

• penicillins;
• macrolites;
• tetracyclines;
• fluoroquinolones.

Together with antibiotics, the following are involved in the treatment of primary syphilis:

• antifungal drugs;
• immunomodulators;
• multivitamins;
• probiotics.

Treatment of primary syphilismethod: administration of penicillins every 3 hours for 24 days in a hospital setting. Patients with early hidden appearance are treated in the clinic for at least 3 weeks. After this, you can continue treatment on an outpatient basis. The duration of treatment depends on the stage of the disease and its severity. In case of allergy to penicillin, the patient is administered macrolides, fluoroquinolones and tetracyclines and medicines based on bismuth and iodine. This complex of drugs can increase the effect of the antibiotic in the body. Also, when treating a disease, in addition to antibiotics, vitamins and immunostimulants are prescribed to the patient.

When diagnosed with syphilis - treat both sexual partners are necessary.

At the time of therapy, the patient is prescribed a diet in which protein foods predominate and the consumption of fats and carbohydrates is limited.

At this stage Smoking and drinking alcohol are contraindicated, and it is also necessary to reduce physical stress on the body.

The main condition for quality treatment is to observe the rules of personal hygiene and refrain from sexual contact during the treatment period, even if they are protected by a condom.

Primary syphilis treatmentyou need to start with antibiotics:

• Josamycin 750 mg 3 times a day;
• Erythromycin - 0.5 mg taken 4 times a day;
• Doxycycline - 0.5 mg taken 4 times a day;
• Extensillin - intramuscular injections, two injections are enough;
• Bicillin - injections, two injections, every 5 days.

For local treatment of chancre with primary syphilis, lotions on the chancre using the drug benzylpenicillin and the drug dimexide are necessary.

It is necessary to lubricate the syphilitic chancre with heparin ointment, erythromycin ointment, ointment based on mercury and bismuth. Synthomycin ointment and levorin ointment help remove pus from the ulcer.

Chancres that are in the mouth must be rinsed with solutions:

• furatsilina;
• boric acid;

The earlier an infection is detected in the body, the sooner treatment of the disease will begin, and the duration of the course of drug treatment may be minimal. In this case, self-medication is unsafe for the body. Only a competent doctor can establish a diagnosis and prescribe the necessary treatment.

Compliance with all doctor’s instructions, a healthy lifestyle, and hygiene will give a positive result in curing syphilis at the first stage of the disease.

Primary syphilis- this is the initial stage of syphilis, manifested by chancre, often genital, with accompanying lymphadenitis. Extragenital and atypical primary lesions may occur. Previously, primary syphilis was divided into primary seronegative (the very initial stage with negative serological reactions) and seropositive (with positive serological reactions).

What causes Primary syphilis: The causative agent of syphilis is Treponema pallidum, belonging to the order Spirochaetales, family Spirochaetaceae, genus Treponema. Morphologically, treponema pallidum (pale spirochete) differs from saprophytic spirochetes (Spirochetae buccalis, Sp. refringens, Sp. balanitidis, Sp. pseudopallida). Under a microscope, Treponema pallidum is a spiral-shaped microorganism that resembles a corkscrew. It has on average 8-14 uniform curls of equal size. The total length of the treponema varies from 7 to 14 microns, thickness - 0.2-0.5 microns. Treponema pallidum is characterized by pronounced mobility, in contrast to saprophytic forms.

It is characterized by translational, rocking, pendulum-like, contractile and rotatory (around its axis) movements. Using electron microscopy, the complex morphological structure of Treponema pallidum was revealed. It turned out that the treponema is covered with a thick cover of a three-layer membrane, a cell wall and a mucopolysaccharide capsule-like substance. Under the cytoplasmic membrane there are fibrils - thin filaments that have a complex structure and cause diverse movement. Fibrils are attached to the terminal turns and individual sections of the cytoplasmic cylinder using blepharoplasts. The cytoplasm is finely granular, containing a nuclear vacuole, nucleolus and mesosomes. It was established that various influences of exo- and endogenous factors (in particular, previously used arsenic preparations, and currently antibiotics) had an impact on Treponema pallidum, changing some of its biological properties. Thus, it turned out that pale treponema can turn into cysts, spores, L-forms, grains, which, when the activity of the patient’s immune reserves decreases, can reverse into spiral-shaped virulent varieties and cause active manifestations of the disease. The antigenic mosaic nature of Treponema pallidum has been proven by the presence of multiple antibodies in the blood serum of patients with syphilis: protein, complement-fixing, polysaccharide, reagin, immobilisin, agglutinin, lipoid, etc.

Using an electron microscope, it was found that treponema pallidum in lesions is most often located in intercellular spaces, periendothelial space, blood vessels, nerve fibers, especially in early forms of syphilis. The presence of pale treponema in the periepineurium is not yet evidence of damage to the nervous system. More often, such an abundance of treponemes occurs during septicemia. During the process of phagocytosis, a state of endocytobiosis often occurs, in which treponemes in leukocytes are enclosed in a multimembrane phagosome. The fact that treponemes are enclosed in polymembrane phagosomes is a very unfavorable phenomenon, since, being in a state of endocytobiosis, treponema pallidums persist for a long time, protected from the effects of antibodies and antibiotics. At the same time, the cell in which such a phagosome has formed seems to protect the body from the spread of infection and progression of the disease. This precarious balance can persist for a long time, characterizing the latent (hidden) course of a syphilitic infection.

Experimental observations by N.M. Ovchinnikov and V.V. Delectorsky are consistent with the works of the authors who believe that when infected with syphilis, a long-term asymptomatic course is possible (if the patient has L-forms of Treponema pallidum in the body) and “accidental” detection of infection in the stage of latent syphilis (lues latens seropositiva, lues ignorata), i.e. i.e. during the presence of treponema in the body, probably in the form of cyst forms, which have antigenic properties and, therefore, lead to the production of antibodies; this is confirmed by positive serological reactions to syphilis in the blood of patients without visible clinical manifestations of the disease. In addition, in some patients, stages of neuro- and viscerosyphilis are detected, i.e., the disease develops as if “bypassing” the active forms.

To obtain a culture of Treponema pallidum, complex conditions are required (special media, anaerobic conditions, etc.). At the same time, cultural treponemes quickly lose their morphological and pathogenic properties. In addition to the above forms of treponema, the existence of granular and invisible filterable forms of pallid treponema was assumed.

Outside the body, treponema pallidum is very sensitive to external influences, chemicals, drying, heating, and exposure to sunlight. On household items, Treponema pallidum retains its virulence until it dries. A temperature of 40-42°C first increases the activity of treponemes and then leads to their death; heating to 60°C kills them within 15 minutes, and to 100°C kills them instantly. Low temperatures do not have a detrimental effect on treponema pallidum, and currently, storing treponemes in an oxygen-free environment at temperatures from -20 to -70 ° C or frozen dried is a generally accepted method for preserving pathogenic strains.

Pathogenesis (what happens?) during Primary syphilis: The reaction of the patient's body to the introduction of Treponema pallidum is complex, diverse and insufficiently studied. Infection occurs as a result of penetration of Treponema pallidum through the skin or mucous membrane, the integrity of which is usually compromised. However, a number of authors admit the possibility of the introduction of treponema through an intact mucous membrane. At the same time, it is known that in the blood serum of healthy individuals there are factors that have immobilizing activity against Treponema pallidum. Along with other factors, they make it possible to explain why infection is not always observed upon contact with a sick person. Domestic syphilidologist M.V. Milich, based on his own data and analysis of the literature, believes that infection may not occur in 49-57% of cases. The variation is explained by the frequency of sexual intercourse, the nature and localization of syphilides, the presence of an entrance gate in the partner and the number of pale treponemas that have penetrated the body. Thus, an important pathogenetic factor in the occurrence of syphilis is the state of the immune system, the tension and activity of which varies depending on the degree of virulence of the infection. Therefore, not only the possibility of no infection is being discussed, but also the possibility of self-healing, which is considered theoretically acceptable.

Symptoms of Primary syphilis: International Classification of Diseases X Revision International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2006 currently classifies primary syphilis as follows.
- Primary syphilis of the genital organs.
- Primary syphilis of the anal area.
- Primary syphilis of other localizations.

In exceptional cases, primary syphilis can be asymptomatic - the so-called "decapitated" syphilis.

The primary period of syphilis in the classical course begins 3-4 weeks after infection and lasts 5-6 weeks. Currently, there is a shortening (up to 2 weeks) or lengthening (up to 6 months) of the incubation period of syphilis. An extension of time may be associated with taking even a small dose of antibiotics from the tetracycline, erythromycin (macrolides), and penicillin groups.

7-10 days after the appearance of the primary affect (lesion), an increase in inguinal lymph nodes (syphilitic lymphadenitis) is observed. At the same time, positive serological reactions to syphilis become. Even in the absence of treatment, healing occurs within 1-2 months with a superficial scar that retains the shape of the chancre.

Clinical picture of primary syphilis characterized by the manifestation of primary syphiloma (hard chancre), regional lymphadenitis and sometimes lymphangitis, developing in the direction from the hard chancre to nearby enlarged lymph nodes.

Chancre is formed in patients after the end of the incubation period and is located at the site of penetration of pale treponema into the skin or mucous membranes. Hard chancre is most often localized on the skin and mucous membranes of the genital organs (head of the penis, area of ​​the preputial sac, anus in homosexuals, labia majora and minora, posterior commissure, cervical area), less often on the hips, pubis, and abdomen. Extragenital chancre, which is much less common, occurs on the lips, tongue, tonsils, eyelids, fingers and any other area of ​​the skin and mucous membranes where the penetration of pale treponema occurred. In these cases, they talk about the extragenital location of primary syphiloma. Extragenital hard chancres, as well as when they are localized on the cervix (according to some data, in 11-12% of cases) are often not detected, and primary syphilis is not diagnosed in a timely manner. The clinical picture of chancre is, as a rule, very characteristic. More often it is a single erosion of regular round or oval shape, saucer-shaped with sharp clear boundaries, usually the size of the little fingernail, but it can be larger. The color of the erosions is meat-red or similar to the color of spoiled lard, the edges are slightly raised and gently descend to the bottom (saucer-shaped). The erosion discharge is serous, scanty and gives the chancre a shiny, “varnished” appearance. The most characteristic sign of hard chancre is an infiltrate of dense elastic consistency, which is palpated at the base of the erosion (hence the name - ulcus durum). In ulcerative chancroid, the edges protrude higher above the bottom, the infiltrate is more pronounced. After healing, ulcerative chancroid leaves a scar, while erosive chancre heals without a trace. Much less common are several chancre. Primary syphiloma is characterized by slight pain or complete absence of subjective sensations. Treponema pallidum is easily found in the discharge of primary syphiloma when examined in a dark field.

In recent years, the number of changes in the clinical picture of chancroid has increased. If, according to many authors, previously one of the significant features of primary syphiloma was its solitary nature (80-90% of cases), then in recent decades the number of patients with two or more chancre has increased significantly. Along with this, there is a significant increase in the proportion of ulcerative chancre and their complication by pyogenic infection. The number of patients with chancre in the anogenital area has increased. A certain amount of chancre in the mouth and anus is associated with sexual perversion. Thus, the proportion of oral chancre is much higher in women. In men with extragenital localization, chancre is most often located in the anus. One of the features of the modern course of primary syphilis is the absence in some cases of a clearly defined compaction at the base of primary syphiloma.

Atypical forms of primary syphiloma are relatively rare; usually they can be of several varieties: chancre-amygdalitis, chancre-felon and indurative edema.

On the fingers, hard chancre can occur in the usual clinical form, but it can occur atypically (chancre-felon). This localization of chancre is observed mainly among medical personnel (laboratory assistants, gynecologists, dentists, etc.).

Chancre felon the clinical picture resembles a banal panaritium of streptococcal etiology (club-shaped swelling of the terminal phalanx, sharp pain), however, recognition is facilitated by the presence of a dense infiltrate, the absence of acute inflammatory erythema and, most importantly, the presence of characteristic regional (in the area of ​​the ulnar lymph nodes) lymphadenitis.

Indurative edema as a manifestation of primary syphilis, it is located in the area of ​​the labia majora, scrotum or foreskin, i.e. places with a large number of lymphatic vessels. Swelling of these areas is noted. Characterized by a pronounced compaction of tissues, when pressure is applied to them, indentations do not form.

The diagnosis of atypical chancre in the form of indurative edema is also facilitated by the presence of characteristic regional lymphadenitis, anamnesis, examination data of the sexual partner and positive results of a serological blood test for syphilis (in the second half of the primary period).

In a number of patients, primary syphiloma is complicated by an associated secondary bacterial infection. In these cases we speak of complicated chancre.

For chancre-amygdalitis characterized by enlargement and thickening of one tonsil in the absence of erosion or ulcer on it (if there is an erosion or ulcer on the tonsil from the primary period of syphilis, then they speak of primary syphiloma located on the tonsil).

When localized on the tonsil, hard chancroid can have one of three forms: ulcerative, sore throat-like (chancre-amygdala) and combined: ulcerative against a background of tonsillitis-like. In the ulcerative form, the tonsil is enlarged and dense; against this background, a fleshy-red oval ulcer with flat, smooth edges is observed. The mucous membrane around the ulcer is hyperemic.

At sore throat-like chancre There is no erosion or ulcer, there is a unilateral significant enlargement of the tonsil. It acquires a copper-red color and is painless and dense. The process differs from angina in the one-sidedness of the lesion, the absence of pain and acute inflammatory hyperemia. There are no general symptoms, body temperature is normal.

There are no pronounced inflammatory phenomena in the circumference of the tonsil, sharp boundaries are noted, there is no temperature reaction and no pain when swallowing. When palpating the tonsil with a spatula, its elasticity is felt. In these cases, a large number of pale treponemas are easily found on the surface of the tonsil (after lightly stroking with a platinum loop). Diagnosis is facilitated by the presence of regional scleradenitis, characteristic of the primary period of syphilis, in the neck at the angle of the lower jaw (lymph nodes ranging in size from large beans to hazelnuts, mobile, densely elastic consistency, not fused with the surrounding tissue, painless) and the appearance of positive serological blood reactions.

TO complications of chancroid include balanitis, balanoposthitis, phimosis, paraphimosis, gangrenization and phagedenism. Balanitis and balanoposthitis are the most common complications of chancroid. They arise as a result of the addition of a bacterial or trichomonas infection. In these cases, swelling, bright erythema, maceration of the epithelium appear around the chancre, and the discharge on the surface of the chancre becomes serous-purulent. The latter circumstance greatly complicates the detection of Treponema pallidum and, consequently, diagnosis. To eliminate inflammatory phenomena, lotions with isotonic sodium chloride solution are prescribed (for 1-2 days), which makes it possible in most cases to establish the correct diagnosis with repeated studies.

Balanoposthitis can lead to a narrowing of the foreskin cavity, which does not allow opening the head of the penis. This condition is called phimosis. With phimosis, due to swelling of the foreskin, the penis appears enlarged, reddened, and painful. Hard chancre, localized in these cases in the coronary sulcus or on the inner layer of the foreskin, cannot be examined for treponema pallidum. The diagnosis of syphilis is facilitated by the characteristic appearance of regional lymph nodes, in the puncture of which the pathogen is looked for. An attempt to forcibly open the glans penis in the presence of phimosis can lead to another complication called paraphimosis (“noose”), in which a swollen and infiltrated preputial ring pinches the glans. As a result of mechanical disruption of blood and lymph circulation, swelling increases. If measures are not taken in a timely manner, necrosis of the tissues of the glans penis and the cavity of the foreskin may occur. In the initial stages of paraphimosis, the doctor, having released serous fluid from the edematous cavity of the foreskin (for which the thinned skin is repeatedly pierced with a sterile needle), attempts to “reduce” the head. If there is no effect, the foreskin must be cut.

More severe, but also rarer complications of chancroid are gangrenization And phagedenism. They are observed in weakened patients and alcoholics as a result of the addition of fusospirillosis infection. A dirty-black or black scab forms on the surface of the chancre (gangrenization), which can spread beyond the primary syphiloma (phagedenism). Under the scab there is an extensive ulcer, and the process itself may be accompanied by fever, chills, headache and other general phenomena. After healing of a gangrenous ulcer, a rough scar remains.

Regional lymphadenitis (scleradenitis) is the second most important symptom of primary syphilis. It appears 7-10 days after the appearance of chancre. Since the time of Ricor, regional scleradenitis has been given the deeply meaningful name “accompanying bubo.” Ricor wrote: “He (skleradenite) is the faithful companion of the chancre, he invariably accompanies him, fatally he follows the chancre like a shadow... There is no hard chancre without a bubo.” Fournier noted the absence of regional scleradenitis in only 0.06% of 5000 patients with primary active syphilis. However, in recent decades, according to a number of authors, regional scleradenitis is absent in 1.3-8% of patients with primary syphilis.

The lymph nodes closest to the chancroid (most often inguinal) enlarge to the size of a bean or hazelnut, become densely elastic, they are not fused to each other, to the surrounding tissues and skin, and are painless; the skin over them is not changed. Regional lymphadenitis continues for a long time and resolves slowly, even despite specific treatment. When hard chancre is localized in the cervix and on the mucous membranes of the rectum, it is not possible to clinically determine regional lymphadenitis, since in these cases the lymph nodes located in the pelvic cavity become enlarged.

When primary syphiloma is localized on the genitals, inguinal lymphadenitis is most often bilateral (even in cases where the chancre is located on one side). This occurs due to the presence of well-developed anastomoses in the lymphatic system. Unilateral lymphadenitis is less common, usually observed on the side where the chancre is located, and only as an exception is it of a “cross” nature, i.e., located on the side opposite the chancre. Recently, the number of patients with unilateral lymphadenitis has increased markedly (according to Yu.K. Skripkin, they make up 27% of patients with chancroid).

Syphilitic lymphangitis(inflammation of the lymphatic vessels) is the third symptom of primary syphilis. It develops in the form of a dense, painless cord the size of a nug probe. Sometimes small, clear-shaped thickenings form along the cord. In approximately 40% of men, lymphangitis is located in the area of ​​the anterior surface of the penis (with genital chancre).

Lesions of the oral mucosa are the most common. Hard chancroid can occur on any part of the red border of the lips or the oral mucosa, but is most often localized on the lips, tongue, and tonsils.

The development of hard chancre on the lip or oral mucosa, as in other places, begins with the appearance of limited redness, at the base of which, within 2-3 days, compaction occurs due to the inflammatory infiltrate. This limited compaction gradually increases and usually reaches 1-2 cm in diameter. In the central part of the lesion, necrosis occurs and a meat-red erosion is formed, less often an ulcer. Having reached full development within 1-2 weeks, a hard chancre on the mucous membrane usually appears as a round or oval, painless flesh-red erosion or ulcer with saucer-shaped edges ranging in size from 3 mm (dwarf chancre) to 1.5 cm in diameter with dense elastic infiltrate at the base. In scraping the surface of the chancre, pale treponema is easily detected. Some erosions are covered with a grayish-white coating. When a chancre is located on the lips, significant swelling sometimes forms, as a result of which the lip sag, and the chancre lasts longer than in other places. More often one hard chancre develops, less often - two or more. If a secondary infection occurs, the erosion may deepen, resulting in the formation of an ulcer with a dirty gray necrotic coating.

When chancre is localized on the lips or oral mucosa, regional lymphadenitis develops 5-7 days after its appearance. In this case, the mental and submandibular lymph nodes usually become enlarged. They are of dense elastic consistency, mobile, not welded together, and painless. However, in the presence of a secondary infection or traumatic moments due to the development of periadenitis, the regional lymph nodes may become painful. Simultaneously with the submandibular and mental lymph nodes, the superficial cervical and occipital lymph nodes may enlarge.

Atypical forms of primary syphiloma are found when hard chancre is localized in the corners of the mouth, on the gums, transitional folds, tongue, and tonsils. In the corners of the mouth and in the area of ​​transitional folds, the chancre takes on the appearance of a crack, but when the fold in which the chancre is located is stretched, its oval outline is determined. When a hard chancre is located in the corner of the mouth, it can clinically resemble jams, which are distinguished by the absence of compaction at the base.

On the tongue, hard chancre is usually solitary and occurs more often in the middle third. In addition to the erosive and ulcerative forms, in persons with a folded tongue, when hard chancre is localized along the folds, a slit-like form may be observed. When a hard chancre is located on the back of the tongue, due to significant infiltration at the base, the chancre sharply protrudes above the surrounding tissue, and there is flesh-red erosion on its surface. Noteworthy is the absence of inflammation around the chancre and its painlessness. Hard chancre in the gum area has the appearance of a bright red smooth erosion, which surrounds 2 teeth in the form of a crescent. The ulcerative form of chancre of the gums is very similar to banal ulceration and has almost no signs characteristic of primary syphiloma. Diagnosis is facilitated by the presence of a bubo in the submandibular region.

Diagnosis of Primary syphilis: The diagnosis is made based on the clinical picture and laboratory confirmation by any of the following methods:
- Dark field research
- MR
- RIF, ELISA, RPGA
It must be taken into account that although in the modern classification there is no division of primary syphilis into seronegative and seropositive, within 7-14 days serological tests can be negative.

Treatment of Primary syphilis: The World Health Organization recommends that in case of a characteristic clinical picture, treatment of primary syphilis without laboratory confirmation of the diagnosis.

Treatment of syphilis consists in the use most often of durable penicillin drugs according to standard methods; in case of intolerance to penicillin, reserve drugs are prescribed.

Cure criteria: disappearance of clinical manifestations, seronegation within a year after treatment.

Sexual partners: are examined without fail, in the absence of signs of the disease and negative seroreactions, or are subject to clinical and serological control for 3 months, or receive preventive treatment.

Syphilis is a serious disease characterized by damage to the skin, mucous membranes and internal organs of a person.

It is classified as a classic sexually transmitted disease. Unprotected sexual intercourse with an unreliable or casual sexual partner can cause syphilis.

The symptoms of syphilis are very diverse, and the manifestations of the disease largely depend on its period. Previously, this infection was considered incurable, but nowadays it can be successfully treated with antibiotics.

How is syphilis transmitted?

In most cases, syphilis is contracted through sexual contact in the vagina, mouth or rectum. Treponema enters the body through minor defects in the mucous membrane of the genital tract.

However, there are cases of infection through domestic means - the disease is transmitted from one partner to another through saliva during a kiss, through shared objects on which there is a dry discharge containing pale treponema. Sometimes the cause of infection can be a transfusion of infected blood.

Pathogen

A mobile microorganism from the order of spirochetes, Treponema pallidum is the causative agent of syphilis in women and men. Discovered in 1905 by German microbiologists Fritz Schaudin (German Fritz Richard Schaudinn, 1871-1906) and Erich Hoffmann (German Erich Hoffmann, 1863-1959).

Incubation period

On average, it is 4-5 weeks, in some cases the incubation period of syphilis is shorter, sometimes longer (up to 3-4 months). It is usually asymptomatic.

The incubation period may increase if the patient has taken any antibiotics due to other infectious diseases. During the incubation period, test results will show a negative result.

Symptoms of syphilis

The course of syphilis and its characteristic symptoms will depend on the stage of development at which it is located. However, symptoms in women and men can be very diverse.

In total, it is customary to distinguish 4 stages of the disease - starting from the incubation period and ending with tertiary syphilis.

The first signs of syphilis make themselves felt after the end of the incubation period (it occurs without symptoms) and the beginning of the first stage. It is called primary syphilis, which we will talk about below.

Primary syphilis

The formation of a painless hard chancre on the labia in women or the head of the penis in men is the first sign of syphilis. It has a dense base, smooth edges and a brown-red bottom.

Ulcers are formed at the site of penetration of the pathogen into the body, it can be other places, but most often chancre is formed on the genital organs of a man or woman, since the main route of transmission of the disease is through sexual intercourse.

7-14 days after the appearance of hard chancre, the lymph nodes closest to it begin to enlarge. This is a sign that triponemes are spread throughout the body through the bloodstream and affect the internal organs and systems of a person. The ulcer heals on its own within 20-40 days after it appears. However, this cannot be regarded as a cure for the disease; in fact, the infection develops.

At the end of the primary period, specific symptoms may appear:

• weakness, insomnia;
• headache, loss of appetite;
• low-grade fever;
• pain in muscles and joints;

The primary period of the disease is divided into seronegative, when standard serological blood reactions are negative (the first three to four weeks after the onset of chancroid) and seropositive, when blood reactions are positive.

Secondary syphilis

After the end of the first phase of the disease, secondary syphilis begins. Symptoms that are characteristic at this moment are the appearance of a symmetrical pale rash throughout the body, including the palms and soles. This does not cause any pain. But it is the first sign of secondary syphilis, which occurs 8-11 weeks after the first ulcers appear on the patient’s body.

If the disease is not treated at this stage, then over time the rash disappears and syphilis flows into a latent stage, which can last up to 4 years. After a certain period of time, the disease relapses.

At this stage, there are fewer rashes and they are more faded. The rash most often occurs in areas where the skin is exposed to mechanical stress - on the extensor surfaces, in the inguinal folds, under the mammary glands, in the intergluteal fold, on the mucous membranes. In this case, hair loss on the head is possible, as well as the appearance of flesh-colored growths on the genitals and in the anus.

Tertiary syphilis

Today, fortunately, infection at the third stage of development is rare.

However, if the disease is not treated in a timely manner, then after 3-5 or more years from the moment of infection, the tertiary period of syphilis begins. At this stage, the infection affects the internal organs, and foci (threshing floors) form on the skin, mucous membranes, heart, liver, brain, lungs, bones and eyes. The bridge of the nose may become sunken, and when eating, food gets into the nose.

Symptoms of tertiary syphilis are associated with the death of nerve cells in the brain and spinal cord; as a result, in the advanced third stage, dementia and progressive paralysis may occur. The Wasserman reaction and other tests may be weakly positive or negative.

Do not wait for the development of the last stage of the disease, and at the first alarming symptoms, immediately consult a doctor.

Diagnostics

The diagnosis of syphilis will directly depend on the stage at which it is. It will be based on the patient’s symptoms and the tests obtained.

In the case of the primary stage, hard chancre and lymph nodes are subject to examination. At the next stage, the affected areas of the skin and papules of the mucous membranes are examined. In general, bacteriological, immunological, serological and other research methods are used to diagnose infection. It should be taken into account that at certain stages of the disease, test results for syphilis may be negative in the presence of the disease, which makes diagnosing the infection difficult.

To confirm the diagnosis, a specific Wasserman reaction is performed, but it often gives false test results. Therefore, to diagnose syphilis, it is necessary to simultaneously use several types of tests - RIF, ELISA, RIBT, RPGA, microscopy method, PCR analysis.

Treatment of syphilis

In women and men, treatment of syphilis should be comprehensive and individual. This is one of the most dangerous sexually transmitted diseases, leading to serious consequences if not treated correctly, so under no circumstances should you self-medicate at home.

The basis of treatment for syphilis is antibiotics, thanks to which the effectiveness of treatment is close to 100%. The patient can be treated on an outpatient basis, under the supervision of a doctor who prescribes comprehensive and individual treatment. Today, penicillin derivatives in sufficient doses (benzylpenicillin) are used for antisyphilitic therapy. Premature cessation of treatment is unacceptable; it is necessary to complete the full course of treatment.

At the discretion of the attending physician, treatment complementary to antibiotics may be prescribed - immunomodulators, vitamins, physiotherapy, etc. During treatment, any sexual intercourse and alcohol are strictly contraindicated for a man or woman. After completion of treatment, it is necessary to undergo control tests. These may be quantitative non-treponemal blood tests (for example, RW with cardiolipin antigen).

Consequences

The consequences of treated syphilis usually include decreased immunity, problems with the endocrine system, and chromosomal lesions of varying severity. In addition, after treatment of treponema pallidum, a trace reaction remains in the blood, which may not disappear until the end of life.

If syphilis is not detected and treated, it can progress to the tertiary (late) stage, which is the most destructive.

Late stage complications include:

1. Gummas, large ulcers inside the body or on the skin. Some of these gummas “resolve” without leaving traces; in place of the rest, syphilis ulcers are formed, leading to softening and destruction of tissue, including the bones of the skull. It turns out that the person is simply rotting alive.
2. Lesions of the nervous system (latent, acute generalized, subacute (basal), syphilitic hydrocephalus, early meningovascular syphilis, meningomyelitis, neuritis, tabes spinal cord, paralysis, etc.);
3. Neurosyphilis, which affects the brain or the membrane covering the brain.

If Treponema infection occurs during pregnancy, the consequences of the infection may appear in a child who receives Treponema pallidum through the mother’s placenta.

Prevention

The most reliable prevention of syphilis is the use of a condom. It is necessary to conduct timely examination in case of contact with infected people. It is also possible to use antiseptic drugs (hexicon, etc.).

If you discover an infection in yourself, it is important to inform all your sexual partners so that they also undergo appropriate examination.

Forecast

The prognosis of the disease is favorable in most cases. Timely diagnosis and adequate treatment leads to complete recovery. However, with a long-term chronic course and in cases of infection of the fetus in the womb, persistent irreversible changes develop, leading to disability.