How to live with treated syphilis or is the disease incurable? What does a syphilitic rash look like Syphilis will appear in 20 years

Syphilis is a disease of a venereal nature, most often chronic, manifests itself in the form of a gradual destruction of the skin, some organs and bones, and also affects the nervous system.

The causative agent of such a common disease is treponema pale. Today, the most popular way of contracting this disease is the transmission of bacteria through sexual contact.

Today, syphilis is treatable, but on the condition that you do not start the disease.

A sexually transmitted disease (hereinafter simply STD) affects almost 50 people out of 100,000 people a year.

The government of each country is trying to contribute to a significant reduction in the number of cases by educating the population about prevention and methods of protection.

syphilis bacterium

We have known about syphilis since the beginning of the 20th century, when this disease was the most common, and every 5 people were infected with it.

At that time, this disease went under the more typical name for that time "French disease".

After a while, scientists summed up that this disease is bacterial in nature, and this greatly helped in its timely diagnosis and treatment.

Treponema pale even at first received such a name due to the fact that when studying it under a microscope, scientists simply could not identify it.

After all, its entire structure, in fact, had no color, was simply transparent and, at the same time, was very poorly stained by various methods.

Silver staining, the Gizma method, and a microscope with dark lenses were used to expose it.

With the help of further studies over time, it turned out that treponema can only function and replicate in a living organism.

The optimal temperature for the reproduction of this bacterium is the body temperature of a living organism 37 ° C, in the same optimal conditions She keeps dividing every day.

Thanks to these data, a new method of treatment was created: the forced increase in body temperature to the maximum mark, while using the malaria virus.

Thus, it was easier for the patient to endure the manifestations of the underlying disease.

What does syphilis look like?

Treponema pale getting into the body of each of us, passes the incubation period, which can last from 1 week to 1.5 months.

At this time, the disease does not manifest itself in any way, so we may not even guess who lives inside us.

With a simple examination during the incubation period, syphilis may not be found, all indications will be within the normal range.

During such a period, there is a high probability that one person who carries this disease in himself in the incubation phase and, not suspecting that he is its carrier, can transmit it sexually to his partners.

The disease begins to manifest itself after the expiration of the incubation period, when primary syphilis occurs.

The first signs of the disease appear on the skin, in the form of a rash, hard spots, dark Brown(ulcers), as well as on the genitals, in the oral cavity (precisely on the mucous membrane of these organs).

Transmission routes

Syphilis is a sexually transmitted disease (STD). Transmission is ensured through traditional intercourse, anal and oral sex, even if the carrier has syphilis in the incubation phase.

After the incubation period, a small ulcer will appear at the site of passage of the pale treponema bacterium, which will only grow if measures are not taken to treat the disease.

When caring for a patient, infection is possible through contact with his personal belongings and the carrier itself.

With this method of infection, signs of syphilis will initially appear on the skin of the legs and arms, and after the chancre they will form on the genitals.

This venereal disease can be transmitted, like everything else, through the blood. When reusing syringes, razors and other personal hygiene items.

The difference between syphilis by gender

As for women, after an asymptomatic period (about a month after syphilis entered your body), it is time for the disease to manifest in all its glory.

The first sign is the appearance of ulcers in the mouth, on the labia or anus. An ulcer (chancre) manifests itself in the form of a response of our immunity to the invasion of harmful bacteria.

A chancre is an inflammatory area of ​​the skin or mucous membrane, usually round in shape, with a flat base.

At first, the growth on the skin will not show painful spasms, but later a rash on the skin will definitely be added to it. different parts body and mucous membranes.

The course of syphilis in men is no different from the manifestations of the disease in women. Most often, in men, syphilis first appears on the penis, its base and head.

But, despite this, ulcers (chancres) can also occur in the above places (oral cavity, anus).

The subsequent treatment regimen is in no way divided according to genital characteristics; for men and women, the treatment is the same.

From the birth of syphilis to chronic disease

Not many with the capabilities of modern medicine go through all the existing stages of the development of this disease.

With the last stage, a person can live from 10 to 20 years, followed by death. Let us consider in more detail each stage of this disease.

Incubation period

Duration up to six months. During this period, there are no visible manifestations on the body or in the body itself. If infection occurs several times in different places, then this period is reduced to 7-14 days.

This stage is prolonged due to the adoption by a person of strong immunoprotective drugs, such as antibiotics for influenza.

For the end of the incubation period, you can take the appearance of an ulcer on the skin, followed by inflammation of the lymph nodes.

In the case when the penetration of syphilis bacteria occurred directly through the blood, then syphilis bypasses the primary stage and immediately passes into the second.

Primary syphilis

Symptoms of primary syphilis include the following:

• The appearance of ulcers on the skin and mucous membranes. Initially, it will not cause any problems or complaints. In the future, it will acquire a more bluish or even purple hue, which will mean inflammatory process, which will entail pain;
• After 7 days, inflammation begins in the lymph nodes and in the vessels near the previously manifested ulcers. Inflamed nodes are a growth with edema near the chancres. If the chancre is located in the mouth, then swelling of the tonsils and throat is possible, which contributes to difficulty breathing and swallowing saliva. The occurrence of these symptoms makes it difficult to walk, defecate, eat, and so on.

The transition to the second stage of syphilis can be considered the manifestation of a syphilitic rash on visible parts of the body.

Modern medicine can diagnose such a disease after the first signs appear.

For this, modern medicine uses specialized tests:

• ELISA - a method of qualitative and quantitative immunological method for the isolation of almost all combinations, molecules and viruses;
• PCR is one of the biological methods that allows us to multiply the density of our DNA in a single sample of genetic material.

These diagnostic methods can only be prescribed by your personal therapist or venereologist.

The cost of such tests will not hit your pocket hard, but it will certainly confirm or refute the diagnosis made earlier.

But do not forget that such tests will give results and show an accurate picture only at the primary stage of the disease.

Primary syphilis is characterized by the appearance of chancres (ulcers) of different diameters on the skin, by its nature it is hard and follows as a response of the immune system to the penetration of harmful bacteria into your body.

Places of its manifestation: the oral cavity (the tongue with syphilis can also be littered with ulcers), fingers, anus, genitals.

It does not particularly bring worries, which most often does not contribute to an early visit to specialists in the clinic. This is followed by the development of the chancre and inflammation of the lymph nodes near its location.

Concomitant symptoms are: frequent and severe dizziness, fever, painful condition.

When infected with treponema pale through the blood, after the incubation period, the second stage follows, or the disease passes into a latent stage.

Second stage

The main signs of the second stage of syphilis include:

• The skin near the chancre is dotted with spots, reaching up to 1.1 cm in diameter. Such a rash can grow over time and, increasing its area, turn into large spots. In this case, it is flat pink or red up to 5 cm in diameter, flat with conical growths along the entire diameter, or purulent pimples can form with syphilis. What these symptoms of syphilis look like can be easily found in photo reports on the World Wide Web;
• With the appearance of lesions on the skin, the central nervous system begins to suffer, mainly: vision, memory, attentiveness, ease and smoothness of movements. Rapid response and treatment of syphilis can stop further nerve damage, but not restore them;
• One of the last symptoms of the second stage is hair loss. First, the head: split hairs appear, then they become much thinner, and then they simply fall out. Even after intensive and timely accepted treatment, the hairline is not restored.

Its specialists divide it into 4 consecutive phases:

1. Early phase - begins after 2 months from the date of infection, duration up to 14 days. During this period, our immunity begins to actively respond to the release of toxins from syphilis bacteria, that is, multiple ulcers appear on the body. The main blow falls on the internal organs, the central nervous system and bone tissue. Concomitant symptoms: body temperature up to 38 ° C, cough, painful condition, rhinitis, inflammation of the mucous membrane of the eyes. Inflammation of the lymph nodes, the absence of pain, slight or complete loss of hair.
2. Latent phase - begins 2 months after infection. Throughout its life, the bacteria of treponema pale can be stopped by the human immune system. The chancre no longer spreads throughout the body, the rash is no longer observed. But this is not the end, each of us should know that always in the fight against this difficult disease, the return of syphilis is always possible.
3. Latent phase - during this period, a global renewal is possible primary symptoms diseases. This is possible with severe stress, colds, injuries, or simply with malnutrition throughout the day. In this case, absolutely all the symptoms are repeated, starting from the primary stage with a new formation of chancre.
4. Primary neurosyphilis - usually this period occurs no earlier than 2 years after the disease. Its main destructive effect affects the central nervous system, brain, heart, liver, bones and joints of the human skeleton. An accompanying symptom is necessarily meningitis. In the vessels of the brain, pressure increases, which leads to frequent and severe headaches. With damage to the central nervous system abilities such as memories, attentiveness, simplicity and ease of movement begin to weaken. Such changes do not return to normal.

Third stage

It is also divided into several phases:

1. Latent permanent syphilis - a period of manifestation up to 20 years. It often happens that people who are carriers of syphilis at this stage are not even aware of the development of such a disease within themselves. After the next resumption of the disease, when the immune system simply cannot cope, a person can get a lifelong disability or everything can end in death;
2. Tertiary form - during this period, almost the entire body suffers. There is an active formation of purulent tumors in the vessels of the brain. It is not uncommon that in the process, such tumors attract many other bacteria to themselves, which subsequently lead to gangrene and abscess.
3. The final stage - lasts from 10 to 20 years and leads to a serious degree of disability with subsequent death. Complete damage to the central nervous system, paralysis, mental disorder, tumors of the brain, bones.

Attention, abnormal!

After the incubation period, the time comes for the formation of ulcers and, accordingly, the disease passes into the first stage.

But, despite the presumptive outcome for each phase, abnormal phenomena on the skin are possible.

Based on this, unforeseen manifestations are divided into several categories:

• Damage to the skin vessels that occur near the syphilitic chancre. Such a symptom changes the color of the penis, scrotum of men and female genitalia, to a darker one with a blue tint. A woman is inherent in a more frequent occurrence of syphilis on the lips. It is often confused with other inflammatory processes in the gynecological direction. However, only syphilis is characterized by edema, which, when diagnosed, will not show any particular deviations from the norm, but the lymph nodes will be inflamed in a person.
• Idiopathic syphiloma is an inflammation that causes treponema pale on the three main fingers of the hand. Pieces of skin peel off at the affected areas, which leads to small blood loss, more like a moderate burn received recently.
• Syphilitic amygdalitis is an inflammation of the submandibular or cervical tonsil. With this anomaly, the structure of the tonsil itself does not change, only an inflammatory process is present that makes it difficult to swallow saliva and food. All associated symptoms are more like a sore throat (fever, sickness, pain when swallowing), but in our case, inflammation is present in only one tonsil.

From birth side by side with danger

Syphilis can be transferred from mother to child during pregnancy, which negatively affects the fetus even during the prenatal period.

Modern medicine has identified the main indicators that by which it can be judged that syphilis has affected intrauterine growth:

• Interstitial keratitis - inflammation of the outer ball of the mucous membrane of the eye and the eyeball. This can be observed as significant redness and suppuration of the eyes. After completing the course of treatment, traces of surgical intervention will remain on the eyeball, and a leukoma (white mesh) will appear in front of the eyes. Usually, such changes still attract a significant decrease in vision, pain and tearing of the eyes.
• Chronic lack of hearing - the fetus during intrauterine growth is subjected to an active attack of treponema pale, as a result of which hearing loss is one of the main symptoms of a woman carrying syphilis during pregnancy;
• Hutchinson's teeth are the unfinished development of dental tissue during pregnancy in the fetus. In this case, the teeth have an unpleasant appearance, can rarely grow, are not completely covered with enamel. And all this leads to their early destruction.

If a woman has undergone a course of treatment and got rid of treponema pale, then the child will still have a chronic weakened immune system.

But with incorrect and untimely treatment, the child after birth will definitely have external deviations.

Breastfeeding in the presence of syphilis is strictly prohibited for mothers, milk with treponema pale bacteria automatically enters the child, causing only harm.

A woman after treatment for syphilis can have children, but for a more accurate conclusion, you need to get a referral from your therapist for the two main tests described above.

Treatment methods for the disease

Since the middle of the 20th century, this STD has been treated with antibiotics, mainly using penicillin or analogues based on it. Since pale treponema is simply not adapted to this type of antibiotics.

With this method, syphilis is treated in the initial stages, before the transition to the stage of neurosyphilis.

After that, antibiotic treatment is continued, introducing them with the help of injections, and the method of forced increase in the patient's body temperature is used.

At the onset of the third stage, patients with syphilis are placed in a special hospital, and subsequent treatment is carried out using highly toxic doses of drugs based on the substance - bismuth.

If a person is diagnosed with the initial phase of syphilis, it is necessary to force the treatment of all his sexual partners over the past three months.

All personal belongings of the patient and things that he used in everyday life are subject to compulsory disinfection.

During the primary stage, the immediate elimination of a person in the hospital is not required, it is quite possible to get by with outpatient treatment.

If the patient has already applied with the second stage of the disease, then he will be immediately admitted to the hospital.

Otherwise, self-medication can do more harm and only give treponema a pale vessel for ideal development.

The disease has been successfully treated, but can there be any consequences? What is the life of a person who has had such a dangerous illness in the past? Can there be any difficulties in having children or finding a job?

How to live with treated syphilis? The question worries all those who have been ill. However, not everyone turns to a venereologist with such a question. Below we will consider everything that you may have to face in real life.

Forever forgetting that you were once sick is quite real. To date, the disease is successfully treatable, and patients can lead a full life. But in order to avoid any consequences, it is important to follow a few simple rules: before treatment, during treatment and after treatment.

Before treatment

The key to successful treatment is a timely start: the earlier the patient went to the hospital and began treatment, the more favorable the prognosis for him. That is why, if suspicious symptoms appear, you should consult a venereologist for a consultation. If the fears have been confirmed, you need to start diagnosing as soon as possible.

During treatment

During the treatment period, you should follow all the recommendations indicated by the attending physician. Omission of medication can affect the result, as well as a delay in time: there is an increased risk that the disease will be suppressed, but not completely destroyed. If this happens, then syphilis will definitely return again after a while.

If the patient does not follow other recommendations and does not adhere to these prohibitions (abuses bad habits, uses drugs), re-infection may occur. Against the background of a new developing infection, the current treatment may not be effective.

After treatment

After therapy is completed, patients have to be registered in a medical institution for a long time and periodically take tests. This is necessary, first of all, in order to be sure that the treatment was successful and recovery has come.

If control tests show positive result additional treatment is given.

The main task of the patient at this stage is not to miss visits to the hospital, to undergo examinations and take tests in a timely manner. The patient does not have the right to refuse registration at his own request.

If all three rules have been followed, then the disease will be successfully cured and will no longer bother. But we must not forget that there will still be no immunity to the disease, that is, re-infection cannot be ruled out.

The video in this article goes into more detail about how the disease develops.

Accounting after treatment

Each patient who has undergone treatment is registered in the dispensary. How much time is needed, the doctor decides, individually for each patient. The observation period depends on the stage of the disease at which treatment was started, as well as on the characteristics of the person.

Three months after the treatment, patients come to the hospital and take the first tests. This period is the minimum of all possible when you have to be registered.

Three months later, only those who have undergone preventive treatment will be removed from the register, that is, they did not develop syphilis, but had contact with a sick person. In all other cases, the accounting period is much longer. Below we will consider how it is built on the basis of treatment at different stages.

Patients with early syphilis

The duration of early syphilis is about two and a half years. There are certain signs on the basis of which it is possible to establish the stage of development of the disease.

After the completed course of treatment, patients come for examination every three months during the first year, and once every six months during subsequent years. This will continue until the tests show a consistently negative result.

After the tests are negative, the patient will be observed for another six months or a little more. During this period, you must go to the hospital 2 times and pass control tests. If both results are negative, and no symptoms of the disease are present, the patient is removed from the register.

For the examination, non-treponemal tests are used. In the normal state, tests should show a negative result for the next few years after the treatment.

The photo below is an example of the development of syphilis.

Interesting! Patients diagnosed with early syphilis are registered for at least two years after treatment.

late syphilis

The duration of late syphilis is several years. Only a doctor can determine the exact stage of the development of the disease after taking special tests. After the treatment, this category of patients is registered for at least three years, exactly according to the same principle as the previous category.

It is especially difficult to destroy the causative agent of the disease at this stage: treponemas are able to hibernate, thus escaping antibiotics. Bacteria can move to hard-to-reach places in the body, where they later cause serious complications. It is necessary to select therapy especially carefully.

Even during treatment, analyzes of non-troponemal tests may show a negative result. However, a few more years after the therapy can be positive. Treponemal tests, as a rule, remain positive until the end of life.

Each patient with late syphilis is deregistered individually. It is necessary to take into account the condition of the mucous membranes, skin, the degree of damage to the nervous system, and so on.

Patients with neurosyphilis

Neurosyphilis is a condition in which treponemas affect the nervous system, namely the brain and spinal cord. It can develop both with early and late syphilis.

After the treatment, patients are registered for three or more years. However, in addition to the fact that they are checked by a dermatovenereologist and tested, a spinal puncture is performed every six months or a year. This is necessary in order to be able to understand whether the treponemas have been destroyed or they are still in the spinal canal. If the results are positive, additional treatment is prescribed.

Important! After the treatment has been completed, patients are issued a certificate stating that the therapy has been completed and they are healthy.

Should doctors tell about syphilis in the past?

If a person has been ill with syphilis, even if it was 20 years ago, blood tests will definitely show this.

Such analyzes may be required in the following case:

• to pass a medical book when applying for a job;
• at the time of hospitalization;
• before surgical interventions, as well as invasive studies - gastroscopy, colonoscopy;
• pregnant women and donors.

In most patients with treated disease at an advanced stage, as well as in patients with early syphilis, tests may be positive. Most patients are sent to the ATC for examination to confirm the diagnosis, but only if there is no certificate of successful treatment.

Why do antibodies not go away after treatment?

How long does syphilis live and why is the blood not cleared after treatment? In order to understand this, you need to understand what antibodies are.

Antibodies are human defense proteins. They are produced by the body in response to an infection in order to successfully fight it off. They can be of a general profile, that is, non-specific - they oppose various diseases.

There may also be specialists, that is, specific ones - the body produces them to fight the infection. So, for example, with syphilis, it is precisely those antibodies that are capable of being destroyed by trepone that begin to be produced.

General profile antibodies begin to appear during the development of primary syphilis, after a complete cure, they quickly leave the body. As for antibodies - specialists, their features are slightly different: they appear at a late stage of the disease, and after treatment they are produced for some more time.

Important! How long the antibodies will circulate depends on how long the person has been sick.

After the complete cure of early syphilis, the blood will be completely cleared in one to two years. It is this time that is enough for all non-specific antibodies to go away. Most of the tests performed will show a negative result.

Thus, we can say that after therapy for another 1.5 years or a little more, the tests will indicate that there is a disease. After treatment of the late stage of syphilis, antibodies completely disappear in only 30% of patients, in others they will continue to remain for life.

Several factors influence this:

• some fragments of dead bacteria will be present in the body for some time: all this time antibodies will be produced;
• the state of the patient's immunity is important: some antibodies stop producing earlier, while others a little later.

Many patients often wonder if it is possible to somehow get rid of antibodies, but in fact this is not possible, and it is not necessary. There is no specific treatment aimed at eliminating antibodies. Due to the fact that these are the body's own particles, there is no danger.

IVF and syphilis testing

Thanks to IVF, it is possible to conceive a child artificially: a sperm and an egg are taken, doctors help them to unite, after which the embryo is placed in the woman's uterus. Thus, it is possible to have a child regardless of the form of infertility.

The IVF technique is complicated, before proceeding with its implementation, you should undergo an examination and pass some tests, including for syphilis.

If the tests show a positive result, then this is a contraindication to carrying out the procedure. But what to do if such a result gives a treated disease? Is IVF allowed in this case?

You can answer this question with absolute accuracy - yes, with fully treated syphilis, there are no contraindications for IVF. To do this, it is enough to provide a certificate from the KVD, which is a confirmation of the state of health.

Is it possible to relapse the disease?

People who have had syphilis once can become infected with it again. Most often this infection with "new" syphilis. However, in some cases, past pathology may return if it was not completely cured at some time.

But what does it have to do with it?

Syphilis is a disease that can be cured, but it takes a large number of time. If the treatment was chosen incorrectly, the dosage of the drugs was not observed, or the therapy schedule was violated, then treponemas can become resistant to drugs.

As a result, the bacteria will begin to move into a stable form and continue to remain in this position. Under favorable conditions, they will come out of hibernation and begin to attack again.

Consequences of the disease

Life after syphilis depends on how the disease managed to harm the patient. Below we will consider possible consequences for each period.

Primary syphilis

The period of hard chancre or primary syphilis is the most favorable time for treatment. Treponema during this time do not have time to cause much harm to health. The disease at this stage is easily treatable, and the consequences remain extremely rare.

Secondary syphilis

With the initial secondary syphilis, a rash appears on the body, but the time is also considered favorable for undergoing treatment.

In addition to rashes during this period, the following is possible:

• eyelashes, hair or eyebrows fall out;
• white spots appear on the neck, in medicine they are called the necklace of Venus;
• diseases related to internal organs: hepatitis, nephritis, gastritis, etc.;
• CNS damage.

After proper treatment, most of the manifestations of the disease quickly disappear. After a few months, hair is restored in the place where baldness formed.

As for the necklace of Venus, it can be preserved for several more years. Most often this is associated with the development of neurosyphilis. Treatment in this case will take a long time, but with the right approach, there will be no consequences.

Tertiary syphilis

With the development of tertiary syphilis, gummas and tubercles appear. The disease is difficult to treat, the consequences remain more.

So, what can pathology lead to:

1. Scars remain on the skin- visible defects after suffering syphilis. Outwardly, they are very conspicuous. Tubercles with gums do not pass without a trace, scars remain after them.
2. As a result of damage to cartilage and bones, they become fragile. In the future, this may cause the development of osteochondrosis or fractures. In addition, a hole is formed in the hard palate, a saddle nose appears.
3. development of neurosyphilis. Symptoms may persist throughout life even after treatment.
4. The development of diseases of the cardiovascular system.

It is important to remember that prescribed antibiotics kill treponemas, but do not eliminate the consequences that they have time to leave behind.

Syphilis and future offspring

Women and men who have been ill are worried about whether they can have offspring in the future. The situation may be different for each gender.

A man has been ill with syphilis

Provided that the pathology has been cured completely, this will not affect future offspring in any way. Even if the antibodies remain in the blood, there will be no danger. The only thing is that you should not plan conception until the patient is deregistered.

A woman has been ill with syphilis

Pregnancy and syphilis - these two combinations are extremely rare. Many pregnant women are forced to take tests for the same infection several times.

At the planning stage of pregnancy, women are required to inform their gynecologist that they once suffered such a dangerous disease. In general, the patients calmly bear the baby, no features appear for 9 months.

If a woman became pregnant before she was taken off the register, then the likelihood that the unborn baby will become infected is high. In this case, some preventive measures should be observed.

How to understand when prevention is needed and when not:

1. If the disease has been cured completely, and the tests show negative results, the management of the pregnancy will be normal. There will be no negative effect on the fetus.
2. Previously, syphilis was treated, but at the time of pregnancy, the results show a positive result - this means that there is a high risk of infection. In this case, women are prescribed prophylactic treatment, but not earlier than from the 20th week.
3. If the infection occurred before conception, but according to some indications, a woman should be treated during pregnancy - this should be done in without fail. If syphilis was treated in the first trimester, the baby will not become infected.

With treated syphilis, a woman gives birth in an ordinary delivery room, under the same conditions as other women in labor.

Treatment was completed during pregnancy

A baby born to a woman who has recently undergone treatment will have to be observed by many specialists in the future.

Such children are required to be registered:

1. A healthy child is registered for one year. Analyzes are taken every three months, if they show a negative result, then a year later the baby is removed from the register.
2. If after three months the tests show a positive result, then the child should be monitored more closely: subsequent tests are carried out with an interval of two months.
3. A baby born sick must undergo full treatment, after which he is registered for three years.

Women can only breastfeed if both they and the baby are healthy. In other cases, therapy is possible only if patients are treated.

Work and past syphilis

Can syphilis in the past somehow affect future employment? Patients can work anywhere: at school, catering, police, but only on condition that the disease has been fully treated.

How to live with syphilis and after its treatment depends on many factors. If the disease has been completely destroyed, no restrictions arise and you can safely do your favorite thing.

Frequently asked questions to the doctor

Self-treatment

Good afternoon, tell me, I was diagnosed with syphilis, can I recover from it myself?

The answer in this case is a clear no. Immunity to a disease is not developed, and the absence of symptoms does not mean that recovery has occurred. In the absence of traditional treatments, numerous irreversible consequences can occur.

Analyzes

I had sex with a sick person, after what time will the tests show a positive result?

If you are worried that you could become infected, then you should take tests no earlier than a month later. But if you are sure that the partner was sick, you need to undergo preventive treatment.

oral sex and syphilis

Some time ago, a girl gave me a blowjob, a week later I passed the necessary tests, the results were all negative. Three weeks have passed and the girl reported that she had syphilis, tell me, what is the probability that she could get infected?

It is necessary to contact a medical institution again and donate blood for tests. In addition, it is necessary to do a preventive injection. As a rule, it is this action that helps protect against possible infection.

Historically reliable are the descriptions of syphilis by the Spanish doctors from Barcelona Skilatus and Diaz de Isla, which date back to 1493. Their first patients were the sailors of Christopher Columbus, who returned from world travel. It was established that they received their illness from the natives of the island of Haiti, where it had long been known to the local population. Soon, the disease spread among the inhabitants of Barcelona, ​​​​and then the epidemic swept neighboring cities and states. The campaign of the French king Charles VIII of Valois in Italy in 1494 and the subsequent siege of Naples greatly contributed to the spread of syphilis. In the army of Charles VIII there was a detachment of 300 Spanish mercenaries, among whom were patients with syphilis. After the war, the multi-tribal mercenaries of Charles VIII spread the disease all over Europe at once, causing a significant pandemic in Europe, and then in Asia. At first, syphilis proceeded among the inhabitants of Europe in extremely severe, malignant forms, which was facilitated by the complete absence of methods for its treatment.

There is, however, another point of view, according to which syphilis was found in Europe in ancient times. When studying the skeletons recovered by archaeologists from ancient burials, bone and dental changes characteristic of congenital syphilis were sometimes found. G. Forberg (1924) believed, for example, that the busts of Socrates in the Vatican and Louvre museums depict typical external signs of congenital syphilis (such as a saddle nose). This statement, of course, cannot be considered indisputable.

12. What does the word "syphilis" mean?

A detailed description of syphilis was given in the work of the famous Renaissance scientist, physician and poet Girolamo Fracastoro. The work was called "On the French disease". The same author in a poetic poem outlined the love story of a shepherd named Syphilis, punished by the gods for disobedience to them with a disease that was unknown before. Fracastoro described the manifestations and course of the "French disease" in Syphilis, making it so obvious that the name of Syphilis was already used by subsequent authors as a common noun.

At first, syphilis had many names in different countries. In total, up to 300 names of this disease are known. So, in France this disease was called Spanish, in Italy and Poland - French, in Russia it was called Polish and French, in Japan - Chinese disease.

13. What are the first signs of syphilis?

Immediately after infection, syphilis does not detect itself in any way. The disease, as it were, builds up strength before manifesting itself openly. In the body, there is a rapid reproduction of pathogens - pale treponema, but there is usually neither temperature nor any complaints. Only three weeks after infection (the so-called incubation period), a small painless sore appears at the site of the introduction of pale treponema, dense to the touch - a hard chancre. Usually it is located on the genitals (during the sexual route of infection), but if the infection occurred through household or other contacts (for example, when kissing, biting, getting infected saliva or mucus on the skin abrasions of a healthy person), a hard chancre can be located on the lip, in mouth, hands and other parts of the body. The lymph nodes closest to the chancre are significantly enlarged, which helps the doctor to distinguish an ulcer of a different origin from a syphilitic one.

Sometimes from the moment of infection to the appearance of a hard chancre, it takes not three weeks, but more or less. The incubation period of syphilis is reduced if a person weakened by other diseases (tuberculosis, chronic pneumonia, alcoholic cirrhosis of the liver, rheumatism, etc.), malnourished, with poor resistance to infections, falls ill with it. The lengthening of the incubation period can be observed in cases where the patient for another reason begins to take antibiotics during this period. Usually their dose is insufficient to stop the onset of syphilis, but delays its manifestations, makes the symptoms "erased", fuzzy, and makes diagnosis difficult.

Three weeks after the appearance of a hard chancre, the correctness of the diagnosis can be confirmed by specific blood tests of the patient. It should be remembered that in some forms of infection with syphilis, for example, transfusion, that is, when blood is transfused from a donor with syphilis, no hard chancre occurs and there are no described signs of infection. The disease immediately manifests itself from its next stage - secondary syphilis.

14. How does syphilis progress?

Syphilis is a common chronic infectious disease that affects all organs and tissues of the human body. In the absence of treatment, the duration of the course of syphilis is not limited, it can last for decades. Syphilis is extremely diverse in its clinical manifestations, depending on the predominant lesion of certain organs. However, several regular periods can be distinguished in its course. First of all, this is the already mentioned incubation period without any external manifestations of the disease, lasting 3 weeks. Then - primary syphilis, its duration is 6 - 7 weeks. It is characterized by the presence of a hard chancre at the site of introduction of the pathogen, an increase in lymph nodes and the appearance of positive serological reactions in the blood. Only two and a half months after infection, a pronounced clinical picture of a common general disease occurs - secondary fresh syphilis. The most demonstrative skin lesions in the form of a rash, and in some patients - pigmentation and baldness. Internal organs also suffer: syphilitic tonsillitis, hepatitis, meningitis, neuritis, etc. can occur. After some time, however, there is a relapse of secondary syphilis. Such relapses can occur repeatedly, over 2-4 years or more, after which syphilis passes into the third stage (tertiary syphilis). This stage is characterized by foci of specific inflammation of the skin and internal organs in the form of gums and tubercles, while the affected tissues of the body disintegrate with the formation of extensive ulcers, and then rough scars. Some patients develop malignant forms of damage to the spinal cord and brain - dorsal tabes and progressive paralysis. These forms of the disease are fatal if left untreated.

15. Is a syphilis patient always contagious?

A patient with syphilis is contagious in all periods of the disease. It is especially dangerous for others in stages I and II of syphilis, which is why the latter are called acutely infectious forms. On the surface of the hard chancre contains a large number of pale treponema. Numerous rashes on the skin and mucous membranes in the secondary fresh and recurrent periods of syphilis can, when moistened and rubbed (on the genitals, in the mouth, in the folds of the skin), grow, become wet and ulcerate, secreting great amount pale treponemas, and pose a great epidemiological danger to everyone who comes into contact with the patient or objects that he used (dishes, cigarettes, toilet seats, clothes, etc.). Pale treponemas are contained in saliva, in the milk of a nursing mother, semen and other physiological fluids of patients.

Here are two examples of indirect transmission of syphilis.

1st case. An 81-year-old woman came to one of the dispensaries with an ulcer on her back. Much to the doctor's surprise, the ulcer bore all the typical features of a hard chancre. In the right armpit (on the side of the chancre), enlarged, dense, painless lymph nodes were palpable. In a laboratory study, the causative agent of syphilis was found - pale treponema. An epidemiological survey revealed an unusual way domestic infection syphilis. The patient lived alone, in a separate apartment with all amenities. She didn’t go anywhere, but 1.5 months ago, her son stopped by her for one day, spent the night in her bed. She did not change her underwear after her son. A request was sent to the dermatovenerological dispensary at the son's place of residence with an order to conduct a medical examination of him. My son had secondary fresh syphilis. Consequently, when he was visiting his mother, he had a hard chancre, the secretions from which he stained the linen, and through the linen from his son, the mother became infected.

2nd case. A young engineer, a good family man, went to the dispensary because of a rash on his skin. On examination, a chancre was found on the gum, abundant syphilitic rash and swollen lymph nodes. My wife has primary syphilis, she contracted it from her husband. All residents of the communal apartment in which the patient lived were examined. A neighbor, a single man, had secondary recurrent syphilis. As it turned out, the sick engineer had mistakenly used a neighbor's toothbrush, very similar to his own, which was enough to transmit syphilis.

16. Is the patient contagious with latent (latent) syphilis?

Contagious. However, the degree of its epidemiological danger to others is somewhat less than with acute infectious forms of syphilis. Although such a patient does not have any external manifestations of syphilis, he can transmit his disease to others through sexual contact, since pale treponemas may be contained in the semen of a patient with latent syphilis and in the vaginal discharge of women. Such a patient can always have manifestations of syphilis that are invisible to him on the mucous membrane in the mouth and transmit syphilis through saliva when kissing or using common dishes. In addition, a patient with latent syphilis at any time may experience a relapse of the disease with active manifestations.

17. Do I need to tell relatives about syphilis infection?

This is decided individually in each case, taking into account the interests of the patient and the health of the people around him. All those who have been in contact with the sick person are examined to determine possible infection. The examination is carried out correctly, and where there is no need, neither the name of the patient nor the real reason for the examination is called. Of course, the wife or husband, as well as persons who had sexual contact with the patient, should be informed about the disease. If the patient fulfills all the prescriptions of the doctor, his secret is preserved.

18. Can syphilis be cured without going to a doctor?

Treatment of syphilis requires high professional training of the doctor, knowledge of the general pathology of syphilis, features of the course of syphilis in different periods illness. Schemes and methods of treatment are diverse. A combination of a number of drugs is used in a certain sequence and arrangement in time. The biggest mistake of the patient is self-treatment. It is dangerous in all respects: incorrectly chosen drugs and their doses, irregular administration, insufficient concentration of drugs in the body, etc. - all this will result in the transfer of the pathogen into the so-called "survival forms" - L-forms and cysts , which lose any external resemblance to pale treponema, are surrounded by a multilayered membrane, are persistently stored in the tissues of the patient and are no longer amenable to the further action of commonly used medicines. The external symptoms of the disease disappear, but years will pass, and syphilis will manifest itself with more severe consequences or be found in the offspring of the patient.

19. Do animals get syphilis?

Syphilis is a human disease. Although some animals have described some sexually transmitted infections, they do not get sick with syphilis under natural conditions. Only in the experiment is it possible to infect monkeys, rabbits, white mice and rats with syphilis. However, clinical manifestations of syphilis in white mice and rats, despite significant infection, are virtually absent. In the laboratory, they are used as biological reservoirs for the preservation of certain strains of treponema pallidum. Only in higher great apes does the disease of syphilis proceed as in humans. But the most accessible in laboratories is the simulation of syphilis in rabbits. Subject to a number of conditions, they manage to get a hard chancre and manifestations of secondary syphilis. Inoculation of syphilis in animals, especially rabbits, is effectively used in scientific laboratories to develop new treatments and study the general pathology of syphilis.

20. Syphilophobia - what is it?

Fear of contracting syphilis can also become a disease. Sometimes people who have had casual sexual intercourse and experienced the fear of being infected at the same time make their own diagnosis, based on random, insignificant signs. Deciding that they are ill, such persons repeatedly visit doctors, insisting on repeated examinations and courses of treatment, do not believe assurances that they do not have a disease, believe that doctors “hide the bitter truth from them,” or treat them inattentively. Sometimes patients with syphilophobia insist on examining family members, most often their children, and also convince them that they have "syphilis". In all these cases, we are talking essentially about mental disorders from mild, reversible "overvalued ideas" to delusional experiences that indicate the presence of psychosis. Patients with syphilophobia need the advice and help of a psychiatrist.

21. How does parental syphilis affect offspring?

A pregnant woman with syphilis can become infected with the developing fetus and develop congenital syphilis in the baby. Infection usually occurs as a result of a syphilitic lesion of the placenta (children's place), more often at 4-5 months of pregnancy. The causative agent of syphilis - pale treponema - finds favorable conditions in the tissues of the fetus for its rapid reproduction. Significant damage to the tissues of the fetus is noted: lungs, liver, nervous system, spleen, bones, etc. In many cases, these lesions of the internal organs are so severe that they become incompatible with life, and the fetus dies in utero, followed by miscarriage or stillbirth. Many children with congenital syphilis die shortly after birth. A newborn suffering from congenital syphilis often has a characteristic appearance: wrinkled, grayish skin, low weight, large belly, where a significantly enlarged liver and spleen are determined. It is characteristic that the more "fresh" the mother's disease is, the more often cases of intrauterine death of the fetus are noted, the more severe are the violations in newborns.

22. Is congenital syphilis curable?

We will definitely heal. Modern methods treatments give this a full guarantee. It is important to recognize the disease in time and carry out a full treatment.

23. If a child becomes infected during childbirth, passing through the birth canal of the mother, can this syphilis be considered congenital?

There are cases when a woman becomes infected with syphilis in the last trimester of pregnancy, and pale treponema does not have time to seed the fetus before the onset of generalization of the infection. In these cases, the child enters into childbirth healthy, but during the passage of the birth canal it becomes infected from contact with the affected mucous membranes of the mother. Following this, he develops primary syphiloma after the usual incubation period, and syphilis proceeds in the same way as in persons with acquired infection. The approach to treatment and the prognosis of such cases is different, more favorable than with congenital syphilis.

24. How often does congenital syphilis occur in our country at present, what measures are taken to prevent it?

Exceptionally rare. In the USSR, a well-thought-out system for the prevention of congenital syphilis was organized as one of the sections complex measures in the fight against venereal diseases. According to the Instructions of the Ministry of Health of the USSR for 1976, a double examination for syphilis is carried out: at the first visit of a pregnant woman to an obstetrician-gynecologist (usually in the first half of pregnancy) and at 5, 6, 7 months before maternity leave.

Be sure to examine the blood according to the generally accepted complex of classical serological reactions to syphilis. If necessary, to clarify the diagnosis, more time-consuming and more informative specific reactions to syphilis are put - the immobilization reaction of pale treponema (RIT) and the immunofluorescence reaction (RIF).

Pregnant women who had syphilis in the past, who completed treatment, but were not deregistered by the observation period, receive additional specific treatment during pregnancy. An additional course of antisyphilitic treatment is also carried out during the first pregnancy of those women who previously had syphilis, but have already been deregistered.

Congenital syphilis is registered mainly in the children of those women who did not know about their illness, turned to the doctor late, and mainly in the children of women with antisocial behavior, suffering from alcoholism, indifferent to their health, to the health and fate of their unborn child, who did not apply during pregnancy to a medical institution.

25. Can a father pass on syphilis to offspring, while the mother remains healthy?

No. There can be no hereditary syphilis, that is, syphilis transmitted through germ cells, in particular through spermatozoa. The latter die when pale treponema is introduced into them. A sick father is guilty of infecting a future mother, and a sick mother is guilty of infecting a child, in utero. Therefore, it is necessary to say "congenital" syphilis, and not "hereditary."

26. Is it possible, being ill with syphilis, not to know about it?

Such cases are quite possible. Syphilis can be hidden if the initial symptoms went unnoticed by the patient, and subsequently syphilis did not manifest itself for some time. More often, women do not know about their disease, less often - men, since in women primary syphiloma (hard chancre) can be located in the cervical region. In addition, the chancre may remain unrecognized both by the patient himself and by doctors of other specialties who are not sufficiently familiar with the syphilis clinic. A chancre on the tonsils is mistaken for a sore throat, in the area nail phalanx- for panaritium, in the region anus- for a crack, etc.

Often, syphilis becomes latent when the dose of antibiotics taken during the incubation period (usually for another reason) is insufficient to prevent it, but makes the classic symptoms of the initial stages of syphilis "erased", hardly noticeable.

Unknown syphilis is usually detected during an active examination of contacts of other patients, during a blood test for the Wasserman reaction as part of a general clinical examination, or during a relapse of syphilis by manifestations on the skin, bones, and internal organs.

Manifestations of secondary syphilis, as a rule, do not give subjective sensations, the rash is usually faded, without itching and soreness, and may temporarily disappear on its own, without any treatment. All this is the reason that the patient does not go to the doctor in a timely manner, is unaware of his illness and can infect others.

Let's take the following illustrative example.

An excited young woman came to the evening appointment with the doctor of the dermatovenerological dispensary with a request to examine her. The patient, going to the theater, took a shower and put on a sleeveless dress. A friend who was present at the same time drew attention to some kind of rash on the skin of the patient, which the latter had not noticed before. During a medical examination, in addition to a skin rash, a hard chancre was found in the cervix. Laboratory data confirmed the diagnosis of syphilis. As it turned out, 2.5 months before the events described, the patient was in a rest home and had a casual relationship with an unfamiliar man. Thus, before the onset of symptoms of secondary fresh syphilis, the patient did not suspect anything about her disease. After taking a shower, the rash became brighter and more noticeable.

27. Is it possible to get syphilis and gonorrhea at the same time?

Simultaneous infection with these two venereal diseases is not so rare. Due to the fact that each of them has its own characteristics of the clinical course, they appear at different times after infection. Gonorrhea reveals itself after 3-5 days, and the incubation period for syphilis is 21-28 days. Each patient with gonorrhea, in cases where the source of infection is not established, should be under the supervision of a doctor for six months. This is done because the antibiotics used in the treatment of gonorrhea also act on pale treponema, the causative agent of syphilis, with the only difference being that their total dose in the treatment of gonorrhea is insufficient to prevent syphilis, just as the method of their administration is unsatisfactory for this purpose. (with syphilis, the concentration of the drug in the blood must be constantly high, and therefore injections are made every three hours, and with gonorrhea - 1-2 times a day). Nevertheless, even in insufficient doses, antibiotics can delay the manifestations of syphilis, lengthen the incubation period to 4 or more months, which determines the need for a doctor to monitor this category of patients. During this period, repeated examinations of patients and a serological blood test for syphilis are carried out.

28. To what does the "subscription" that is taken from venereal patients oblige?

The subscription is a legal document that sets out existing legislation criminalizing contracting a sexually transmitted disease under Art. 115 of the Criminal Code of the RSFSR with amendments and additions made to the article by the Decree of the Presidium of the Supreme Soviet of the USSR of October 1, 1971 "On strengthening the responsibility for the spread of sexually transmitted diseases." The subscription states that the patient has been informed of the presence of a contagious venereal disease, the need for treatment and observation by a doctor until removal from the dispensary, the implementation of the prescribed regimen and the need to refrain from sexual activity until a complete cure. The patient gives his signature, and in the future the subscription is stored in the medical history.

29. How is syphilis treated?

Currently, doctors have at their disposal for the treatment of syphilis a whole arsenal of highly effective drugs that provide a complete cure for syphilis. Given the full responsibility of treating such a serious disease, the consequences of poorly treated syphilis, the ability of pale treponema (according to the latest scientific data) with insufficient doses of drugs to turn into "survival forms" - L-forms and cysts, "reserved" from adverse effects multilayer shells with a special structure, the treatment of syphilis in our country is carried out only in strict accordance with the "Instructions for the treatment and prevention of syphilis." In this regard, syphilis is the only infection where the choice of drugs, their doses, the sequence of administration and the timing of treatment must be carried out without any deviation from the instructions. That is why in the USSR the treatment of syphilis by private practitioners is categorically prohibited and prosecuted by law.

The "Instruction" is periodically updated taking into account the latest scientific data and the results of clinical testing of treatment regimens and new drugs, generalization of accumulated experience and analysis of the results of the work of all scientific and practical institutions of the country. The last "Instruction" of 1976 was compiled by a team of authors of the Central Research Institute of Dermatovenerology of the Ministry of Health of the USSR. 7 research institutes, departments of skin and venereal diseases of the largest medical universities of the country and some large dermatovenerological dispensaries participated in its development.

For the treatment of syphilis, penicillin and bismuth preparations are mainly used. As auxiliary means, iodine preparations, vitamins, drugs that have a stimulating effect (pyrogenal, prodigiosan, aloe), autohemotherapy, sulfur preparations and others are used.

All patients with a newly diagnosed syphilis, suffering from its contagious forms, are subject to mandatory inpatient treatment. This is done in the interests of society (isolation of a contagious patient) and in the interests of the patient himself, since it is important to administer drugs at a certain time arrangement (for example, penicillin is administered every 3 hours around the clock).

Treatment of syphilis begins and is carried out only under the condition of an accurately established diagnosis, confirmed by clinical and laboratory data (detection of pale treponema, positive serological reactions).

30. What is the duration of treatment for syphilis?

The duration of treatment for syphilis depends on a number of circumstances: the clinical form of syphilis, the age of the patient, his general condition, the presence of concomitant diseases, the tolerance of drugs, the dynamics of the disease and the rate of negative serological reactions during treatment. On average, treatment with penicillin antibiotics for primary syphilis with a negative Wassermann reaction lasts from 40 to 68 days, with a positive reaction - from 76 to 125 days, with secondary fresh syphilis - from 100 to 157 days. In all other cases - with secondary recurrent syphilis, with tertiary and congenital - only course treatment with various drugs is carried out. The duration of the course with combined treatment is on average from 40 to 60 days, a break is 1 month. The number of courses depends on the form of syphilis, ranging from 2 to 8 courses.

31. What is preventive treatment and for whom is it prescribed?

This is a preventive treatment. It is prescribed to persons who had contact (sexual or domestic) with a patient with syphilis, when there was a possibility of infection. Preparations, terms and doses of treatment are prescribed depending on the duration of contact. If no more than two weeks have passed since the possible infection, one course of treatment with penicillin or ecmonocillin is prescribed. For a longer period (from 2 to 4 months), treatment is carried out as for primary syphilis with a negative Wasserman reaction (primary seronegative syphilis).

Of particular importance is the so-called prophylactic treatment of pregnant women who had previously suffered from syphilis and completed treatment before pregnancy. Treatment is prescribed by them in order to guarantee the birth of a healthy child as much as possible. Preventive treatment is also carried out for children born to mothers who previously had syphilis, even if these children are practically healthy, with negative serological reactions to syphilis.

32. Is syphilis completely cured?

Modern methods of treatment make it possible to guarantee a complete cure for syphilis, which is proved by the vast experience of clinical observations, experimental studies, the birth of healthy children from mothers who previously had syphilis and completed treatment by the beginning of pregnancy. Convincing evidence of the curability of syphilis is re-infection with it, accompanied by manifestations of primary syphilis. The decisive and determining outcome and prognosis of syphilis is the timely treatment started and its implementation in full accordance with the current instructions and taking into account the individual characteristics of the patient.

33. Is it possible to re-infect with syphilis?

Syphilis after treatment does not leave immunity, that is, immunity to re-infection. A person who has had syphilis and is successfully treated can get syphilis again. Cases of not only double, but also triple and even quadruple transferred syphilis are known. Re-infection is called reinfection. Each time during reinfection, the disease begins and proceeds in the same way as during the first infection: with a chancre, if left untreated, with subsequent generalization of the infection, swollen lymph nodes, baldness and other common manifestations of syphilis. Immunological shifts are also consistently increasing, which are revealed by a change in the periods of syphilis, the appearance of a positive Wasserman reaction and other serological reactions. Reinfection indicates a complete cure for syphilis with a previous infection.

34. Are there any features of the course of syphilis in case of repeated infection?

With a thorough study and analysis of cases of re-infection with syphilis, it was found that people with antisocial behavior, alcohol abuse, and disorderly behavior are most often re-ill. sexual life. In such people, even with primary infection, a more unfavorable course of the disease is observed. However, when comparing equivalent contingents of individuals with primary and re-infection, it was found that when re-infected, syphilis is more severe: ulcerative and multiple chancres, purulent (pustular, with tissue decay) rashes are more often observed, a positive Wasserman reaction is more stable, often a longer period is required. treatment, additional courses of therapy, restorative and stimulating agents. Of great importance is the simultaneous anti-alcohol treatment in persons suffering from chronic alcoholism.

35. If a person has latent syphilis and has been in contact with someone who has infectious syphilis, will they get it again?

In such a situation, there will be not a re-infection, but a layering of the infection or the so-called superinfection. At the same time, as experimental and clinical studies show, no reaction develops at the site of penetration of treponema or an element of a rash occurs that corresponds to the clinic of the stage of syphilis that the patient has: for example, with secondary syphilis, a papule (nodule), with tertiary syphilis, a tubercle with outcome in the scar. A hard chancre that develops as a response to pale treponema in a previously healthy person usually does not occur with superinfection.

36. Is it possible to get syphilis through a blood transfusion?

This possibility is not excluded if the donor had syphilis during the incubation period during blood donation, but he did not know about it. When examining such a donor, there were no clinical manifestations of syphilis, serological reactions for syphilis were negative, and there was no reason to suspect infection. In order to prevent such cases, appropriate sanitary and educational work is being carried out with donors. Before donating blood, all donors are examined by a doctor, the blood taken from them is examined by a complex of classical serological reactions to syphilis. In turn, each patient must be asked if he has donated blood, and an appropriate entry is made in the medical history.

37. Can a person who has had syphilis be a donor?

38. What measures are taken if a person receives a blood transfusion from a patient with syphilis?

First of all, if the fact of blood donation by a donor who later turned out to be sick with syphilis is established, the blood taken is destroyed. If the patient's blood has already been used, it is immediately established when and to whom it was transfused. All persons who have been injected with infected blood are given preventive treatment.

39. Is disinfection carried out in the home of a patient with syphilis?

The causative agent of syphilis - pale treponema (spirochete) - outside human body dies quickly, especially when dried, exposed to disinfectants and even hot water and soap. Therefore, special disinfection in the patient's home is not required. It is recommended to boil underwear and bed linen, washcloths, towels with the addition of washing powders. Of course, you need to treat the bath, toilet, sink that the patient used with a disinfectant solution (for example, chloramine), and then wash them with hot water.

40. How does syphilis proceed in patients who abuse alcohol?

Systematic alcohol abuse significantly reduces the body's resistance to many infections, including syphilis. In chronic alcoholics, syphilis tends to be more severe, often malignant. The so-called galloping course of syphilis is often noted. The incubation period may be shortened, the generalization of a syphilitic infection occurs unusually early (after 4 weeks), often there are no specific signs of the disease, such as swollen lymph nodes and a positive Wasserman reaction, which makes diagnosis difficult. Manifestations of secondary syphilis are more polymorphic, pustular (purulent) rashes are often found, resembling pustular skin diseases - acne, boils, purulent ulcers.

In chronic alcoholics suffering from syphilis, syphilitic alopecia and pigmentary syphilis in the neck are more common, tertiary gummous manifestations and severe lesions of the nervous system occur early - meningitis, dorsal tabes, progressive paralysis, liver damage develops with an outcome in cirrhosis.

The famous French syphilidologist Fournier pointed out that syphilis favorably affects organs that have a pathological past behind them. Such an organ in patients suffering from chronic alcoholism is the liver. Double harm - alcoholic and syphilitic poisons - have a detrimental effect on the vascular wall and nervous tissue, determining an unfavorable prognosis of the disease. To illustrate, one clinical observation can be cited.

A young man who fell ill with syphilis in the North received one course of treatment and told the doctor that he decided to return to his parents, giving the city and address where he was going. The patient was given a referral for further treatment in his arms and a notice was sent to the dermatovenerological dispensary of the city indicated by the patient. But the patient, having received a large amount of money in the calculation, decided, before going to his parents, first to "walk". For six months he did not work, he drank a lot, which he was prone to before. After beatings received in a drunken fight, a tight knot appeared on his neck, which turned into an ulcer. Over time, the ulcer not only did not heal, but continued to spread, capturing almost half of the neck, although the pain was of little concern. 2 months after the appearance of the ulcer, the patient was hospitalized and during the examination he was diagnosed with gummous syphilis. By this time, only 10 months had passed since the infection. Under the influence of a specific treatment, the ulcer quickly healed, but an extensive scar remained, which caused torticollis, which is why plastic surgery was performed at the end of the treatment of syphilis.

Asked by: Olga, Korea

Female gender

Age: Zhulev Oleg Evgenievich

Chronic diseases: not specified

Hello, dear Oleg Evgenievich! Earlier, I had syphilis (I got it from my husband, we were treated together). I am now 43 years old, I was ill 20 years ago. As far as I remember, the treatment was completed (after that, all family members were tested themselves). I don't remember how many were registered. The following years sometimes donated blood to both RW and from a vein (for syphilis), everything was negative. She divorced her husband, after 7 years she got married again (and before that there were constant sexual partners and nothing bothered me or them). In the second marriage with my husband we lived for 13 years and it so happened, gray hair in a beard, as they say, and my husband went on a business trip to the Philippines and it looked like he had a good walk there. And as it turned out, he infected me with trichomonas vaginalis (he infected me in May) and was treated with pills. And since another country did not even ask the doctor about the infection. And literally a month and a half later, he again went on a business trip and returned in mid-July (she was close to him). And a week later he leaves me. And there was a lot of suspicion. And I went to the doctor and began to ask what they were treating for in May. Was in shock, from her husband's gift. And then I started to panic (I had enough experience in my youth). I passed all all the tests for AIDS, syphilis, hepatitis C and a bunch of vaginal tests (everything came out negative negative) It was September 1, 2016. And in November the head began to itch and there are many small pimples that burst and itch terribly. I thought a private clinic, you never know what they missed and went to the state. Hospital. This is och. Big honey. Center. I again passed all this bunch of tests and everything came out negative, but syphilis was confirmed. Interrogations began with the predilections of doctors. I told them how it was when I was young. And I asked them if I had an analysis of immune memory because of this and pluses. They can’t really explain what analysis scared them (they said only one thing there, the pluses go off scale). So I couldn’t get from them where the pluses on what analysis go off scale) The language barrier is still. They asked where my husband is (I say he ran away) They say let him take tests for comparison. Oleg Evgenievich (I'm afraid to call him). Yes, he first infected me with Trichomonas. And what if it’s an immune memory that I was sick of them so scared (or was it a new syphilis he brought me in addition. Please tell me, Oleg Evgenievich, could there be a relapse of the treated syphilis 20 years ago. Or is it a new syphilis. Although a month has passed after his parties when I took the test and came out negative.To be sure, I passed it again two months later and it came out.In different clinics, there is an interval of two months and such different tests. Thank you very much in advance. I look forward to your reply. And then another country and there is no one to ask. Doctors have them at all as in army. Briefly and clearly, there is syphilis injections of oplpt and that's it. And to calm the patient something for the soul to say no.

One of the most dangerous diseases from the group of STDs is syphilis. There are tens of thousands of patients in the world, most of whom are young people under the age of 40. Due to the easy transmission of the pathogen in various ways and the development of dangerous complications (paralysis, dorsal tabes) this problem very relevant.

Definition and types of disease

Syphilis is an infectious, slowly progressive sexually transmitted disease caused by pale treponema.

Infection of sexual partners entails criminal liability. This disease affects mainly the sexually active part of the population. This is due to unprotected sex.

The following types of syphilis are known:

• primary;
• tertiary;
• early, latent and late neurosyphilis;
• congenital.

The peculiarity of the disease is that it can last for decades, slowly destroying tissues. With this pathology, the skin, mucous membranes, lymphatic, nervous systems, as well as many organs are involved in the process.

Risk factors for developing the disease

Syphilis in women and men occurs after pale treponema enters the body. All people are highly susceptible to this infection. The main mechanisms of disease transmission are:

• contact;
• blood contact;
• artificial;
• vertical.

The transmission of treponemas is carried out by sexual, transfusion, injection and indirect household routes. In 95-98% of cases, infection occurs during unprotected sex. The causative agent can be present in various biological secrets. Treponema transmission factors are seminal fluid, blood, sputum, saliva, hands, syringes, razors, medical instruments and wet household items.

Risk factors for developing the disease are:

The causative agent of the disease is Treponema pallidum. These are small spiral-shaped microorganisms. Treponema can persist for several days on wet objects and at low temperatures. environment. These microorganisms are sensitive to high temperature, acids, alkalis and disinfectants. Many modern antibiotics do not work on treponema.

The first stage of the disease

At an early stage of syphilis, the signs are poorly expressed. Asymptomatic (varies from 8 to 100 days. Most often, the first complaints appear 3-4 weeks after infection. The main ones are chancre and swollen lymph nodes.

A typical hard chancre is localized most often in the genital area. In women, the labia, cervix and vagina are involved in the process, and in men, the glans penis and foreskin. Chancre often occurs on the oral mucosa, in the abdomen and anus. Primary syphiloma is represented by a round red erosion. The classic chancre is painless and is about 1 cm in diameter.

This formation has raised edges and a saucer-shaped shape. In most patients, the chancre is solitary. In weakened people, there may be several erosions. A feature of the chancre is the presence of a seal at the base. After 3-4 weeks, it disappears without leaving scars.

Atypical forms of syphilomas can occur in men and women. Sometimes there is an indurative edema. It is localized in the region of the lower lip, foreskin or . This seal is pink. In some cases, chancre-amygdalite appears with syphilis. The amygdala is involved in the process. The defeat is one-sided. At given state fever, sore throat and general malaise appear.

To atypical forms primary syphilis includes chancroid panaritium. It inflames the nail bed. The person's finger swells, turns blue, and becomes painful. Healing is slow. This venereal disease at an early stage leads to an increase in regional lymph nodes. They become dense, but pain and inflammation are absent.

The second period of the disease

Following the primary syphilis, a secondary one develops. It drags on for 3-5 years and manifests itself 3 months after infection. At the very beginning of primary syphilis, malaise, muscle and joint pain, headache and fever are possible. The main symptom of this period is a polymorphic rash.

For some time, a hard chancre may persist, which gradually disappears. After him, secondary syphilides appear. They are roseolous, papular, miliary, seborrheic, pigmented and pustular. Most often, roseola occurs on the body. These are spots of pale pink color, which are localized mainly on the lateral surfaces of the body.

The elements of the rash do not exceed 1 cm in diameter. The limbs and trunk are involved in the process. Rashes appear within a week in small groups of 10-12 pieces. When pressed on the skin, the stain disappears. Some patients have specific roseola (raised and scaly).

The disease may present with papular exanthema. Papules are nodules that rise above the skin. They rarely exceed 5 mm in diameter. A typical sign of rashes in secondary syphilis is peeling of papules along the periphery. These rashes disappear, leaving behind areas of hyperpigmentation. In some cases, coin-like, weeping, psoriasiform and seborrheic papular syphilides are detected.

Regardless of the route of transmission of the pathogen, round-shaped white spots may appear on the human body. Most often they are localized on the neck. Much less often with secondary syphilis, pustules (pustules) are formed. These are inflammatory elements of the rash containing pus. They leave behind sores and scars.

Along with the skin, secondary syphilis affects the mucous membranes and internal organs. Develop, pharyngitis, lymphadenitis, alopecia (baldness), meningitis, gastritis and dyskinesia. Patients become irritable. Already during this period, the central nervous system can be affected. This indicates the development of neurosyphilis.

The third stage of the disease

You need to know not only the causes of the disease, but also how it manifests itself. Today, it is becoming less common due to early diagnosis and mass screening of the population. Often this pathology develops in people who have undergone an incomplete course of therapy. Often patients die from complications at this stage.

The main symptoms of syphilis are gummas and tubercles. They occur on the skin and mucous membranes 4–10 years after infection. Tubercular syphilides are infiltrative nodules up to 7 mm in size. They rise above the skin. The tubercles are arranged randomly and do not merge with each other. Tertiary syphilides disappear over time.

In their place, even ulcers with a clean bottom are formed. Healing takes place over several months. Ulcers, areas of hyperpigmentation and atrophy remain on the skin. Instead of tubercles in tertiary syphilis, gummas may appear. These are painless nodules located deep under the skin. On the early stages tertiary syphilis, these formations are mobile, but soon they grow together with the tissues. A hole is formed through which liquid is released to the outside.

Tertiary syphilides are formed not only on the skin, but also on the mucous membranes. When the nose is affected, rhinitis and difficulty breathing are observed. Deformation of the back is possible due to damage to the cartilage tissue. If the tongue is affected, glossitis develops. This makes it difficult for the patient to chew and speak. Along with these changes, the function of organs and systems is disrupted.

Manifestations of neurosyphilis

Syphilis is dangerous because at any stage it can cause damage to the nervous system. This happens when treponema penetrates into the brain and spinal cord. There are early, latent and late neurosyphilis. In the first case, the symptoms of CNS damage appear at the 1st or 2nd stage of the disease.

Vessels and membranes of the brain are involved in the process. Meningitis or meningomyelitis develops (combined damage to the spinal cord and). Signs of meningitis:

• nausea;
• headache;
• vomit;
• dizziness;
• noise in ears;
• positive symptoms of Kernig and Brudzinsky;
• stiff neck muscles.

Change personal qualities of a person in combination with sleep disturbance, dizziness and headache indicates damage to the cerebral vessels. If the patient is not treated in a timely manner, then it develops. This is a type of late neurosyphilis, in which the posterior cords and roots of the spinal cord are affected.

With spinal dryness, the following symptoms are observed:

With a disease duration of 10–20 years, progressive paralysis may develop. It is characterized by personality changes, memory impairment, intellectual decline, delirium, hallucinations, dysarthria, limb tremors, and epileptic seizures. Often dementia develops.

congenital form of the disease

You need to know not only what syphilis is, but also whether it is dangerous for the unborn child. Often, women become infected before conceiving a baby, unaware of the disease. Syphilis can cause early miscarriage or fetal death in the 3rd trimester. This is due to the possibility of penetration of the pathogen through the placenta.

There are early and late fetal syphilis. The early form occurs in a child in the first 2 years after birth. These children often develop syphilitic pemphigus. The main signs of early congenital syphilis are:

• tearfulness;
• deformation of the bones of the skull;
• gray skin;
• exhaustion;
• runny nose with mucous discharge;
• nose deformity;
• difficulty in nasal breathing;
• the presence of a dense infiltrate on the chin, lips, palms, feet or buttocks;
• bleeding and swelling of the lips;
• decrease in skin elasticity.

It develops in children over the age of 2 years. Specific signs of this pathology are tuberculous or gummous syphilides, eye damage by the type of keratitis, deformity lower extremities, changes in the upper incisors and damage to the labyrinth in the ear cavity.

Negative consequences of the disease

Complications in this pathology are very common. In the absence of proper treatment, the following consequences of syphilis are possible:

Some patients become disabled. The greatest danger to humans is tertiary and late neurosyphilis. The use of antibiotics in this case does not always achieve a complete cure. With tertiary syphilis, death in the absence of treatment is observed in 25% of cases.

No less dangerous is the congenital form of infection. The negative consequences of early syphilis in children are myocarditis, glomerulonephritis, hepatitis, inflammation of the inner layer of the heart with valves, orchitis, dropsy of the testicle, hydrocephalus, meningoencephalitis, interstitial pneumonia and damage to tubular bones.

Patient examination plan

To clarify the diagnosis, the following studies will be needed:

Blood and syphilide discharge are used as biological material for analysis. Very informative serodiagnosis. During the reactions, specific antibodies to the infectious agent are detected in the blood. They appear at the end of the incubation period. On the early dates primary syphilis results may be negative.

If syphilis is suspected, an anamnesis is necessarily collected, a physical and visual examination is performed. The doctor must determine the possible mechanism and ways of transmission of the infection. In the event of complications from the internal organs, tomography, ultrasound, electrocardiography, angiography and radiography are performed. You may need to consult an ophthalmologist, neurologist, cardiologist, pulmonologist and gastroenterologist.

Treatment Methods

The treatment of syphilis is predominantly medical. When pale treponemas are detected in the body, systemic antibiotics from the penicillin group are prescribed (Bicillin-3, Bicillin-5, Benzylpenicillin sodium salt, Penicillin G). The dosage and duration of therapy are determined by the attending physician. only those drugs that do not have a teratogenic (embryotoxic) effect are used.

In case of intolerance to penicillins, macrolides or tetracyclines. The latter cannot be used while carrying a baby. With secondary syphilis, symptomatic therapy is additionally carried out. If the temperature is very high, then antipyretics are prescribed. In case of trophic disorders, means are shown that improve the condition of the skin and its appendages.

With late (tertiary) syphilis, immunomodulators, bismuth and iodine preparations are included in the treatment regimen. Etiotropic (antibacterial) therapy is carried out in two courses.

With liver damage, hepatoprotectors are prescribed. During treatment, sexual intercourse and the use of antibiotics are excluded.

Forecast and preventive measures

You need to know not only which doctor treats syphilis, but also what is the prognosis for this disease. At 1 and 2 stages it is favorable. With late syphilis, the prognosis is aggravated due to damage to vital organs. Not everyone knows how many years you can live with this diagnosis. This disease develops slowly. In the absence of treatment, it can be delayed for 10 years or more.

There is no specific prophylaxis for syphilis. To reduce the risk of infection, you need to:

• refrain from unprotected and casual sex;
• drink vitamins;
• exercise;
• do not contact with patients;
• be examined periodically;
• do not use other people's towels, washcloths and razors;
• give up tattoos.

Important aspects of prevention are blood quarantine, examination of donors and people from risk groups. Thus, infection with pale treponema is not a sentence. These microbes are sensitive to penicillins.