Syphilis
What is syphilis?
Syphilis is one of the most common sexually transmitted infections. The causative agent of the disease is treponema pale (T. pallidum). Outside the host's body, it can exist for only a few minutes, so the transmission of syphilis occurs only with close contact between a healthy and a sick person. Newborn children can "catch" the disease in the womb (the so-called congenital syphilis). Since the pathogen enters the body through the mucous membranes of organs, it is quite possible to transmit it in a household way when using common household items and hygiene items. Most often, the genitals, mouth and pharynx serve as the transition point for syphilis. Within a few hours, the causative agent of syphilis infects regional lymph nodes, and then spreads through them to all vital organs and systems.
Etiology of syphilis
Syphilis is caused by treponema pale, which in most cases has a spiral shape. However, its atypical variants are not so rare. Due to the polymorphism of the pathogen, timely diagnosis of syphilis and its further treatment are significantly hampered. In addition, when a number of factors coincide, treponema can turn into an encystated form, characterized by excellent resistance to external influences and, as a consequence, greater survival. For this reason, any signs of syphilis should be considered as the basis for an immediate visit to a venereologist. Self-treatment is unacceptable, because without tests and determination of the type of microbe, the patient runs the risk of bringing the matter to serious complications. Note also that many antibiotics are most effective just before the encystation stage,which is another reason to contact specialized clinics in time.
The pathogenesis of syphilis
As we mentioned above, syphilis symptoms appear after close contact with an infected person. Particularly dangerous in this regard are patients in whom the infection caused the appearance of papules and chancre, which are the place of accumulation of treponemas. The infectiousness of urine has not yet been proven, but it is known that a small number of pathogens accumulate in saliva. It is also possible infection through mother's milk or through semen, and for the latter case, the presence of external signs of syphilis on the genitals is not at all necessary.
Symptoms of syphilis and the clinical picture of the disease
Primary syphilis
The initial stage of syphilis coincides with the appearance of the first chancre and syphilis. On average, they appear 3-4 weeks after infection at the site of treponema introduction. Initially, a small red spot appears on this area of the skin or mucous membranes, which changes over time and takes the form of a papule that turns into an ulcer or erosion. The patient does not feel any painful sensations when palpating the chancre.
Secondary syphilis
Syphilis symptoms appear 6-7 weeks after infection. They are quite diverse and are observed over a much larger area than the signs of syphilis in the primary period. Let us note the most characteristic features of syphilis symptoms:
- lesions of the skin are supplemented by evidence of violations in the work of other organs and systems;
- undulating course and the presence of hidden (asymptomatic) periods;
- rashes on the skin are brighter in color and small in size, but cover a large area;
- the rashes tend to disappear, but then they recur again, and each time they show an increasing tendency to group, over time forming roseola - inflammatory areas up to 1 cm in diameter;
- often secondary syphilis leads to the appearance of papular syphilis - lesions of the skin, which dissolve by themselves, but leave clearly visible pigmented areas.
Lesions of other organs and systems with syphilis are expressed in the form of fever, decreased appetite, general weakness, nausea, headaches, and an increase in regional lymph nodes. If the treatment of syphilis was not carried out or was insufficient, then the secondary form goes into the tertiary form 3-4 years after infection.
Tertiary period of syphilis
With the symptoms of syphilis at this stage, patients develop tertiary syphilis - tubercles and gums, which are formed both on the skin and on the surface of bones, internal organs, in the subcutaneous tissue and the nervous system. When they disappear, they cause numerous destructive changes in organs and tissues. The tertiary period of syphilis can last for several years, however, it is worth noting that as the medical care of the population increases, this form of syphilis is less and less common.
Congenital syphilis
Congenital syphilis is transmitted from a sick mother by the penetration of treponema through the placenta into the fetus. Infection with syphilis can occur both during conception and much later. Regardless of the time of infection, pathological changes in tissues are observed only in the VI-VII months of pregnancy, therefore, active prevention of syphilis in the early stages will help to give birth to a healthy child. The possibility of transmission of pathogens through the father's sperm has not yet been proven, therefore, all preventive measures usually concern the expectant mother. These include: identification of sick women in the early stages, full registration of pregnant women, control over the treatment of infected persons. In order to prevent the development of negative changes, mandatory regular examinations of pregnant women are carried out for the presence of treponemas and external signs of congenital syphilis.
Diagnosis of syphilis
When diagnosing syphilis, a microscopic method is used to identify pathogens, which allows treponema to be detected in tissue samples. This method of diagnosing syphilis is applicable if a person develops secondary syphilis. For the primary form, serological studies (Wasserman reaction, enzyme-linked immunosorbent assay) are more relevant for the detection of specific antibodies in the blood of a sick person.
Syphilis treatment
Currently, a huge amount of various materials has been accumulated, thanks to which the most effective mechanisms for treating syphilis have been developed, including in the later stages of infection. Preventive measures include taking penicillin drugs by all persons who have come into contact with an infected person.
If an unambiguous positive diagnosis of syphilis is made, doctors should determine the patient's tolerance to the action of penicillin, determine a list of topical drugs and their dosage. Nowadays, syphilis is treated with benzathine benzylpenicillin, erythromycins, tetracycline, doxycycline (used for intolerance to penicillins). The duration of therapy is 2-3 weeks, depending on the stage of development of the infection and associated complications.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
