A distinctive feature of Treponema pallidum - highly contagious, so it is important to conduct a survey of the population in order to avoid an epidemic of the disease.
Worst of all, when it is hidden within, and people do not even realize that he is a carrier of syphilis and is a danger to his family and associates.
What it is?
Syphilis - a systemic sexually transmitted infectious disease with skin lesions, mucous membranes, internal organs, bones, nervous system, with a succession of stages of the disease caused by the bacteria species Treponema pallidum (pale treponema) subspecies pallidum, belonging to the genus treponema (Treponema) order Spirochetes (Spirochaetales).
How it is?
Causes syphilis treponema pale, which is only 3 minutes in the living environment. Therefore, the main route of transmission of the disease - sexual. Possible infection of the fetus in utero (vertical path) or intrapartum, when the child passes through the mother's birth canal.
Household transmission is uncommon, infection is possible by persons with tertiary stage of syphilis, when the pale treponema hits the dishes, linens, towels, etc. from decaying gummas. Not ruled out syphilis transmission through hematogenous through blood transfusions.
Not so rare and cases of infection of health care workers in contact with the patient's blood. Infection infection through "blood" items: shared a toothbrush, razor, nail set and more.
Syphilis - the incubation period
The incubation period is the period of illness, extending from the instant of penetration into the body of Treponema pallidum before the first symptoms of syphilis (see. pictures), comprising Chancre combined with regional lymphadenitis. During its gradual increase in the amount of agent at the point of introduction of the cells into the patient. Treponema propagated by dividing the average once in 30-32 hours.
This period of the disease is characterized by the absence of recorded clinical and serological changes in the patient's body, he continues an average of 3-4 weeks, possibly shortening it up to 8-15 days or until the elongation 108-190 days. The shortening of the incubation period typically occurs, while infecting organism from 2 sources elongation when taking antibiotics after infection, for example, about a sore throat, although it should be noted that increasing the incubation period is not always due to the reception antibiotics.
After the end of the incubation period appear first characteristic symptoms of syphilis. The site of entry treponemes formed Chancre, specific rounded erosion or ulcer with a hard smooth bottom "podvornutymi" edges. Dimensions formations may vary from a couple of mm to several centimeters. Hard chancre can disappear without treatment. Erosions heal completely, ulcer scars are left flat.
Disappeared chancre does not mean the end of the disease: primary syphilis only goes into a latent form, during which the patient is still contagious to sexual partners.
After forming the solid chancre, local lymph node enlargement begins after 1-2 weeks. When the feeling they are dense, painless, mobile; one is always larger than the rest. After another 2 weeks becomes positive serum (serum), the reaction for syphilis, from this moment primary syphilis proceeds from step seronegative to seropositive step. The end of the primary period: may raise the body temperature to 37.8 - 380, there are sleep disorders, muscle and headaches, aching joints. Chance of a dense edema of the labia (in women), the head of the penis and scrotum in men.
Infection occurs generalization to 3 months after infection and lasts 3-5 years, this period is characterized by multiple different-looking rash in different organs and tissues, and therefore absolutely any symptoms depending on what organ / system amazed more and how he was before that is compromised, ie whether he was healthy at the time of the defeat - if so, then the manifestations of syphilis are minimal.
In this period there are prodromal symptoms (as for colds - malaise, muscle pain, joint pain, temperature, appearance), they continues 7-10 days until sifilom (rozeolozno-papular rash) - often small red spots, with clear boundaries, not merging between themselves. When pressed disappear, and then appear, or may turn yellow due to the destruction of red blood cells. These lesions do not destroy tissue, and if the treatment antisyphyllitic disappear instantly. These rashes are recurrent in nature, ie there again, but not as pronounced and much smaller amounts.
characterized by a long latent for tertiary syphilis. It can manifest itself in 3-4 years (in the absence of treatment or inadequate treatment). this form of disease often can be found in patients with chronic alcoholism, tuberculosis or other infections.
During this period, the skin and the mucous membranes of patients show a small amount of dense infiltrates localized in the subcutaneous tissue or deeper tissues. After some time they fall, and painless sores appear in their place, that scar is only a few months or years. It should be noted that such syphilides disorders not accompanied by subjective and do not violate the general condition of the patient. They contain very little of the pathogen, and therefore, they are practically not contagious.
Is transmitted from sick mother when the penetration treponem through the placenta into the fetus. Infection of syphilis can occur both during the conception and much later. Regardless of the time of infection, the pathological tissue changes observed only on VI-VII months pregnant, so the 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 is not yet proven, so that all preventive measures usually relate to the expectant mother. These include: the identification of female patients in the early stages, a full account of pregnancy, monitoring of treatment of infected persons. In order to prevent the development of negative change is a compulsory regular examinations of pregnant women for the presence of treponemes and external signs of congenital syphilis.
Especially syphilis symptoms in men and women
Secondary and tertiary period is almost the same symptoms. The differences in the symptoms for both men and women is only present in the initial period when the chancre appears on the genitals:
- gangrenous chancre on the penis - is likely samoamputatsii the distal part of the penis;
- chancre on the cervix. Symptoms of syphilis, at the location of the chancre on the uterus in women are virtually absent and can only be detected during a pelvic exam;
- chancroid in the urethra - the first sign of syphilis in males who manifested discharge from the urethra, penis and dense inguinal bubo.
How does syphilis: photo
The photo below shows how the disease manifests itself in humans.
Diagnose syphilis via inspection of characteristics and laboratory tests:
- Inspection dermatologist. He asks the patient in detail about the course of the disease, examines the skin, sex organs, lymph nodes.
- Detection of Treponema DNA or its contents Gunma chancre, syphiloderm methods darkfield microscopy, direct immunofluorescence, PCR.
- Instrumental investigations: search gummas using ultrasound, MRI, CT, X-rays, etc.
- Holding various serological tests: netreponemnye - search for antibodies against Treponema lipid membrane phospholipids and tissue collapsing pathogen (Wasserman, the VDRL, rapid test plasma reagin). The result can be a false positive, i.e. Syphilis show where it is not. Treponemal - find antibodies to Treponema pallidum (RIF, TPHA, ELISA, immunoblotting, RIBT).
Remember that for such a serious illness can not put himself "on the internet", reading about syphilis and its symptoms. The fact that the rash, and other changes may be visually replicate those at absolutely other diseases that even doctors occasionally misleading.
The consequences of syphilis
If left untreated, syphilis is gradually spreading throughout the body and affects more healthy tissue and organs. Sometimes temporary relief, after which the patient's condition deteriorates. Complications of syphilis depend on the stage.
Primary syphilis can be complicated by such states:
- tissue necrosis at the site of localization chancre;
In secondary syphilis notice such complications:
- syphilis lesion of internal organs;
- damage to the nervous system;
- bone loss.
Complications of tertiary syphilis include:
- the defeat of the internal organs;
- brain damage;
- treponemoy damage tissues of the neck and face;
- pathological bone fractures in their defeat of syphilis;
- bleeding as a result of vascular rupture.
How to treat syphilis?
For the treatment of syphilis in an integrated manner, taking into account a number of individual factors (age, sex, patient, stage of the disease, presence of concomitant diseases, general state of organism, and etc.). In addition, all prospective sexual partners of the patient should also be tested for syphilis and undergo therapy, if necessary.
If the patient has primary syphilis, all who had with him sex in the last three months should be tested and get tested. In the case of secondary syphilis - all who had contact with the patient during the last year. Essential for success in the treatment of this disease is the most timely treatment, as well as the correct selection of modern medicines.
The most effective treatment for syphilis is the introduction into the body of water soluble penicillins. Conducted such therapy in the hospital for 24 days with injections every 3 hours. The causative agent of syphilis is quite sensitive to the antibiotics penicillin group, but there is a chance of an allergic reaction to these medicines or the ineffectiveness of such therapy. In that case, penicillin was replaced with drugs tetracycline, macrolide, fluoroquinolone group. In addition to antibiotics, it is also shown in syphilis natural immune stimulators, vitamins, immunostimulants.
How much time is needed for treatment?
Syphilis require prolonged treatment. If the disease has been detected at the initial stage, the treatment takes about 2-3 months, it should be noted that the treatment must be continuous. If syphilis was diagnosed at the secondary stage, its treatment may take up to 2 years.
During treatment prohibited sexually active, and the whole family and close patient environment must undergo preventive treatment.
Standard preventive measures consist in avoiding casual sex, condom use, and for prevention of occupational syphilis - in putting on disposable latex gloves prior to inspection, manipulation and operations.
Condoms are not 100% protection - chancre may be disposed Extragenital (pubis, perineum) and secondary syphilis in the skin form a "necklace Venus". In these cases, the infection by contact with syphilides transferred to the skin of the partner.
When syphilis is not formed lifelong immunity. Successfully cured of the disease, can become infected and ill again. In this case, the disease will occur just as hard. Therefore, vaccination against syphilis is not, and can not be.
It all depends on the stage of development of the disease and therapy techniques. If therapy was initiated in the early stages of the disease (primary, secondary and early latent syphilis) and is carried out with the use of antibiotics treponemotsidnyh, then in almost all cases without exception, come complete clinical cure and recurrence prevented the occurrence of early syphilis and late forms of syphilis.
Treatment of syphilis in pregnant women in the first half of pregnancy in most cases ensures Zdorovenki birth of the baby. In the case of congenital syphilis prognosis is favorable, if the treatment of the disease was initiated in a timely manner. Treatment of advanced forms of the disease less successfully, because it only slows down the progression of the disease, but in all cases can restore impaired function of the affected organs and cause to negative serology reactions.