Syphilis - Causes, Symptoms and Treatment .MF .
Syphilis - an infectious disease caused by the Treponema pallidum (Treponema pallidum), manifested by diverse clinical symptoms depending on the current stage.The path of infection mostly sexual, but also there is a risk of infection through hygiene items and articles in contact with the genitals.
causative agent of syphilis spirochete
- strict anaerobic (good grows and multiplies in the anoxic conditions), but even so it can be stored for 3 days in the related subjects.By the action of sub-zero temperatures they are stable and can be stored in lifetime condition throughout the year.Much more destructive effect of high temperature (about 60 ° C) - are killed within 20 minutes at the boil killed instantly.The action of antiseptics and disinfectants also comes quick death.
causative agent of syphilis spirochete pale (model)
Treponema (Treponema) under a microscope
Causes of infection - promiscuity, and, with a few exceptions - the neglect of personal hygiene.
Symptoms of syphilis
Clinical manifestations depend on the stage of infection, compensatory reactions of the organism and the immune system both at the time of infection and the time flow.Syphilis has 3 during the period.
The incubation period - the absence of symptoms from the moment of infection until the first symptoms.This period can last from 15 days to 2 months (the duration will depend on immune acceptance of the background and antibiotics).
Primary period (primary syphilis) - penetration of the pathogen into the internal environment with reproduction at the site of deployment and migration to regional lymph nodes.As breeding treponem in place of introduction, formed solid chancre - plotnoelasticheskoy infiltration (ulcer or erosion) appearing 4 weeks after infection, pain or insignificant or non-existent.Therefore, if the chancre appears on the cervix or the tonsils, the patient may not notice that he was sick.
chancre on the neck of the uterus
chancre on the lip
Solid chancre on the amygdala
Ulcerative chancre on
penis Once the pathogen spreads through the lymphatic vessels andreaches the lymph nodes, there is lymphangitis (reaching nearby lymph vessels of solid chancre start to be painful on palpation and because of violations of the outflow of lymph, can still join infiltrative tissue edema - it is inherent to the scrotum, prepuce, the labia, the tonsils) and lymphadenitis (sklerodenit) - an increase from the nearby hard chancre lifouzlov.Lymph nodes are increased by 7-10 days from the appearance of the chancre, painless, plotnoelastichny, not soldered to each other and surrounding tissues, the size of a bean.
All these 4 symptoms consecutively joined to each other over 1.5-2 months on average.After that there is the next period -
secondary syphilis .There is a generalization of infection for 3 months from the moment of infection and lasts 3-5 years, this period is characterized by multiple different in appearance rash in different organs and tissues, and therefore absolutely any symptoms, depending on whether the system / organ struck more and how heIt was previously compromised, ie whether he was healthy at the time of the defeat - if so, then the manifestations of syphilis will be minimal.In this period there are prodromal symptoms (as for colds - malaise, muscle pain, joint pain, temperature, appearance), they last 7-10 days before the sifilom (rozeolёzno-papular rash) - it is often the little red spots, with clear boundariesnot merging with each other.When pressed disappear and then appear, or may turn yellow due to the destruction of red blood cells.These fabrics rashes do not destroy and where antisyphyllitic treatment disappear instantly.These rashes are recurrent in nature, ie there again, but not as pronounced and much smaller amounts.
roseolous rash in secondary fresh syphilis
Pustular syphilitic papules
flaky syphilitic papules on the palms
subjective sensation of the rash does not appear except on the scalp - itching sensationand the occurrence of alopecia (hair loss areas).The rash may be different - from harmless spots to pustules - making it difficult to diagnose, because it joins a secondary infection.Also remains lymphadenitis.If untreated or immunopathology occurs
tertiary syphilis - for 3-10 years after infection.This period is characterized by the appearance gummas (infiltrative limited tubercle plonoelastichny and prone to decay and scarring) in the internal organs and bones.Visceral syphilis - is synonymous with the Tertiary.Gunma formed in the internal organs and bones, and entail severe degenerative changes of the internal organs and bones.Depending on the affected organ, symptoms are relevant:
- CNS - degeneration of the individual;
- defeat bones / joints - periostitis, arthritis;
- defeat intra-lymph node - mesadenitis, with severe pain.
And yet so many possible symptoms, depending on the location of the lesion.Untreated syphilis leads to death of the patient.
Congenital syphilis occurs in children with transplacental infection of the fetus, after a sufficient development of placental circulation (with 3 months of pregnancy), because the placenta does not penetrate the spirochetes.In the case of a viable child birth, congenital syphilis is subdivided into early and late.
- Early congenital syphilis manifested papular rash on the buttocks, the defeat of the nasal mucosa, the destruction of the nasal septum, hepatosplenomegaly, hydrocephalus, as well as in the subsequent lag in mental and physical development.
- Late congenital syphilis is characterized by a triad Hutchinson: pathology of the teeth (barrel-shaped central upper incisors) + parenchymal keratitis (corneal lesion) + labyrinthine deafness.There are other manifestations, appropriate tertiary syphilis in adults.
Late congenital syphilis
During pregnancy, the mother suffering from syphilis or aching, but not removed from the register - going consultation and addressed the issue of abortion or continuation, but with the antibiotic.
self-diagnosis and self-treatment are unacceptable, because of the diversity of the clinical picture (variability rashes, frequent latent periods) the possibility of misdiagnosis is high, followed by infection of others and the risk of disabling complications.
This is especially true of rashes, they are so diverse that they have to distinguish them from those of cutaneous manifestations like:
- herpes, pyoderma shankrioformnaya, miliary tuberculosis (such diseases are differentiated in the first period);
- measles, rubella, typhus, pink and scaly skin disease, genital warts (secondary syphilis).
Pay attention to phasing rashes associated manifestations, morphology of lesions, etc.- All these descriptions require clinical experience.
tests for syphilis:
The main diagnostic methods include:
1. smear method (it is aimed at the detection of the pathogen in smears chancre or lymph node biopsy) - this method is carried out in the first 4 weeks after infection.
2. Serological method (method of determination of IgM - suggests an acute phase reaction, and is determined only by FTA-ABS and IFA - only they determine the immunoglobulins M, the use of other serological methods will give erroneous results seronegative, they unnecessarily targetedfor the detection of IgG - he talks about the process of synchronization).
first 2 methods used in primary syphilis;In secondary and tertiary - using serological methods to detect IgG (RW, Phragmites, RIF).In the diagnosis of congenital syphilis using ELISA and FTA-ABS (in the first 3 months), and after - RW, Phragmites, RIF.
That is in the early stages of syphilis appearing immunoglobulin M (IgM) treponemal origin - in the laboratory and writing.And in the later stages of the presence of IgG write treponemal origin.And depending on what Ig (immunoglobulins) are determined, they talk about acute or have long flowing process.But what kind of serological test to send the patient decides dermatologist while defining the clinical stage.
3. Other laboratory diagnostic methods to be less informative, and besides the overall picture of inflammation or immunopathology any results will not give.
Treatment is not specific and is carried out with large doses of antibiotics, sensitive to syphilis, these groups include: tetracyclines (doksitseklin), erythromycin, azithromycin (sumamed), ceftriaxone.
Treatment is carried out under the control of biochemical parameters and the KLA, OAM - to monitor the compensatory reactions of the organs and systems.
treatment lasts an average of 2 months, and treatment during pregnancy has no fundamental differences from conventional landline.Partner treatment necessary, it is called preventive therapy (treatment for people who are in close contact with an infected).For personal hygiene use a separate bowl, towel and other personal household items.Also, after sexual intercourse or other contact need to use 0.05% hlorgiksedina digluconate, Albucidum solution (it can and should have in the personal first-aid kit) - the use of any part of the body, to which there was contact.
Specific methods of rehabilitation, prevention and diet have not been developed to date.You can certainly try to treat with antiseptic solutions infested place immediately after contact, but the risk of the disease remains quite large, although a little lower.
Doctor's consultation on syphilis:
Question: Does immunity develops after suffering the disease?
Answer: a clear opinion on the matter is not, because in the blood of some people without a history of syphilis, found treponemostaticheskie, treponemotsidnye antibodies that prevent infection.Also, it formed non-sterile immunity, but at the time of the latent current at the time of his illness, he is weakened, and possibly re-infection over and above what is already there - ie the formation of superinfection.But clearly we can say that the proof of immunity after suffering no disease.
Question: Why there comes an imaginary being and no symptoms of the disease may not be?
answer is there in the primary and secondary periods, this is due to the structure of Treponema pallidum, namely the presence of her capsule shell, protecting it from phagocytosis, resulting in partial destruction of treponemes and their stay in the L-form ( "sleeping"state) - from the antibodies and antibiotics protection, but also on the development of disease protection.The same effect answers the question of "re-infection in the absence of contact with the patient" - ie, there is an awakening "sleeping" treponem.
Q: Is it dangerous to other routes of transmission?
Answer: unlikely, but possible through household items.
Q: Do scars remain after the skin manifestations?
answer may be, only if it was not started early treatment and there was ulceration (ulcers formed) or the same mechanism but in places of frequent trauma (anal region, the area of the tonsils).
Question: Legal aspects of the concealment of the disease?
Answer: the willful concealment of venereal diseases, which led to a contamination of others is seen as an administrative offense FZRF №116 st.6.1-6.3 and persecuted Russian Criminal Code Article 121.
doctor Shabanova I.E