Treatment of syphilis is quite a difficult task. The question of whether syphilis can be cured is very relevant in our time and worries many people, especially young people. Syphilis must be understood as an infectious disease that leads to the formation of a large number of pathological processes on the skin and internal organs. If syphilis is not treated, it can lead to the development of generalization of the infectious process, damage to the nervous system and even death.

The main route of transmission is considered to be sexual. We will talk about how syphilis is treated and what are the features of its course in this article.

Key Aspects

The causative agent of syphilis is Treponema pallidum (Treponema pallidum), which is capable of rapid penetration through damaged skin and spread throughout all systems of the body. Cured patients do not have immunity, so the risk of becoming infected again remains quite high.

The first cases of the disease were recorded back in 1495, among soldiers of the French army. After this, the pathological condition quickly spread throughout Europe. Despite the fact that the disease did not have a high mortality rate, it was considered terrible, because it was accompanied by the formation of genital ulcers (chancres), which led to pain and had a rather repulsive appearance. Over time, they were transformed into abscesses, and ulcerative processes spread over the surface of the entire body.

Transmission of the pathogen occurs during vaginal, anal or oral intercourse.

Syphilis, as a disease, is considered dangerous also because its clinical manifestations do not appear immediately, but only after a few weeks. Over a given period of time, a sick person can infect a large number of people. If the disease is not diagnosed in time and syphilis is not treated, it can cause male and female infertility, the formation of pathological processes in internal organs, and even death.

In medical practice, it is customary to divide syphilis:

• Depending on the stage at which the pathological condition is located: primary, secondary and tertiary.
• Depending on the route of infection - or acquired over time.
• Depending on the period of diagnosis of the pathological process, late and early.

Taking into account the above aspects, the choice of scheme and effective method of treatment is made.

Clinical picture

The causative agent of syphilis, having penetrated the cavity of the human body, spreads by hematogenous or lymphogenous route. The incubation period can reach four months, but the first stage of syphilis and its characteristic symptoms can appear as early as 2 weeks after infection.

The manifestations of the disease will depend on what stage of the disease it is at.

• Primary syphilis is characterized by the formation of a chancre at the site of introduction of Treponema pallidum. In the vast majority of cases, chancre forms on the external genitalia, anus or rectum, but its appearance on the mucous membranes of the mouth and lips is no exception. Chancroid is accompanied by hyperemic ulcerative processes that have clear boundaries, absence of pain, and tissue swelling at the site of pathogen penetration. After a week, an increase in lymph nodes and an increase in temperature may be observed. Due to the fact that the symptoms of this period are not expressed too clearly, patients are in no hurry to seek medical help.
• . The appearance of rash elements on the skin indicates secondary syphilis, this is a kind of evidence that the infection has begun to spread throughout the body. In the absence of adequate therapy, the disease enters the second late stage, this occurs after about 2-3 months. This pathological condition is characterized by the appearance of rash elements of an erythematous, papular or pustular nature, hair loss, and disruption of the functioning of internal organs.
• . This type of disease develops 3-5 years after infection. It manifests itself by the appearance of tubercles and nodes (gummas) in the thickness of the skin and organs, the development of a very serious complication -.

Quite often, people do not realize that they are sick and do not pay much attention to the appearance of a rash. Over time, it disappears, and therefore any worries seem unfounded, but it must be remembered that the disease is gaining momentum at this time and will manifest itself again with renewed vigor.

Diagnostics

First of all, it is necessary to focus on the fact that in no case should you make a diagnosis yourself (by analyzing the information presented on the Internet), much less self-medicate. This is explained by the fact that syphilis has a large number of symptoms similar to other diseases, and this causes an incorrect diagnosis even by doctors. To make a diagnosis it is necessary:

• Get examined by a dermatovenerologist. The doctor conducts a general examination of the patient, collecting anamnesis and complaints.
• Take tests for direct immunofluorescence reaction, PCR.
• Undergo serological examinations that can detect the presence of antibodies to treponema in the human body. This could be the Wasserman reaction, VDRL, fast plasma reagent test.
• In some cases, the doctor refers the patient to instrumental examinations, such as ultrasound, MRI, CT, and x-rays. They allow you to identify changes in internal organs.

Treatment of syphilis - choice of tactics

Due to the fact that the disease belongs to the group of serious diseases, the doctor who treats syphilis must be very careful. The treatment regimen and its duration will depend on the stage of the pathological condition, its severity and the general condition of the patient.

Therefore, different ones have been developed depending on each specific case:

• Specific treatment. It is the option of choice for those patients who have an accurate diagnosis.
• Peremptory or in other words preventive. Intended for persons who have been in contact with people sick with syphilis. In this case, not only sexual intercourse, but also everyday communication will be considered contact. This method of treatment is also used for those individuals whose lifestyle is considered antisocial. A positive effect from such treatment will be observed if there was contact with an infected person less than a month from the start of therapy. Otherwise, there is no hope for a positive result from the therapy.
• Preventive. It is carried out while a woman is carrying a child. Its implementation is necessary not only to alleviate the woman’s condition, but also to slow down the progression of the pathological condition in the fetus. This type of therapy is prescribed to all pregnant women without exception who have a history of syphilis and have completed the full course of treatment (regardless of how old the case is). In a situation where a pregnant woman does not have time to undergo complete treatment before giving birth, therapy is prescribed afterward for both the woman and the baby.
• Trial course. Used to treat those individuals whose syphilis is at an advanced stage of development. Treatment using this method is carried out even in cases where the presence of the disease is not laboratory confirmed. This is explained by the fact that syphilis at the third stage is quite difficult to diagnose, and there is no way to waste time. This drug therapy received this name due to the fact that the causative agent of the pathological condition is unknown according to the results of the analysis, but all the characteristic symptoms of syphilis are present. During treatment, the patient's condition and changes in his body are monitored. If there is a positive effect, then the trial treatment switches to a specific one.

Syphilis is a sexually transmitted sexually transmitted disease. There are several stages, each of which can progress. Syphilis in its advanced form can lead to damage to internal organs and the nervous system. Therefore, it is necessary to treat the disease at the first symptoms.

Where and who treats syphilis?

Where is syphilis treated? This disease can only be identified through tests that are performed at a dermatovenerological dispensary (DVT). The doctor who treats this disease is called a dermatovenerologist.

How is syphilis treated?

Syphilis is caused by Treponema pallidum. This is a harmful bacterium that is sensitive to antibiotics. Therefore, they are prescribed to all patients with syphilis. What antibiotics treat syphilis? Mostly penicillin drugs are prescribed. If such antibiotics cause allergic reactions in a patient, or the body is intolerant to penicillin, then tetracyclines, fluoroquinolones and macrolides are used. These same drugs are also prescribed when initial treatment with penicillins is ineffective.

In addition to the medications listed above, vitamins and natural remedies are prescribed to stimulate the body's protective properties. Intramuscular injections of immunostimulants are given.

The doctor must check the patient for tolerance to medications, especially antibiotics. Therefore, antihistamines are prescribed before the first two injections.

How was syphilis treated before?

How was syphilis treated in the past? In earlier times, therapy was not effective. The first effective treatment for syphilis was proposed by Paracelsus, who began to use mercury salts and ointments made on its basis to eliminate rashes and sores on the body.

A special method for treating syphilis with mercury vapor was developed. But patients died in most cases, so this method was included in the list of unacceptable ones.

In earlier times, surgery (removal of chancre) was used to treat syphilis. But since treponema was by this time firmly established in the blood, such operations were useless.

Over time, iodine solutions and chemical compounds based on arsenic, benzene and bismuth began to be used for therapy. As a result, the treatment effect doubled. Fire treatment was used. Treponema pallidum dies at high temperatures. Therefore, the patients were injected with bacteria that cause fever and raise body temperature to 40 degrees. Fever not only inhibited the development of syphilis, but also completely destroyed treponema, which contributed to complete recovery.

What types of treatment for syphilis exist today?

There are several types of treatment for syphilis:

• Specific. Once the diagnosis is made, treatment is carried out with antibiotics. But since they kill not only harmful, but also beneficial microbes, vitamins and drugs that increase the body’s immune defense are prescribed.
• Preventative. It is prescribed to persons who have been in contact with a patient with syphilis during the infectious stage of the disease.
• Preventive. Applies to pregnant women who have previously had syphilis or currently have this disease. And also to children whose mothers were infected during pregnancy.
• Trial. Prescribed for suspected specific damage to internal organs in the absence of the ability to confirm the diagnosis with convincing laboratory data.
• Epidemiological or syndromic. It is carried out on the basis of anamnesis and clinical picture in the complete absence of laboratory diagnostics.

TO How to treat syphilis using traditional methods?

Syphilis cannot be cured using traditional methods. In addition, self-medication is completely unacceptable, since it not only complicates the diagnosis of the disease, but also causes unwanted and dangerous complications.

Treatment of syphilis in pregnant women

How to treat syphilis in a woman if she is pregnant? Therapy can only be used up to 32 weeks. Follow-up therapy, if necessary, is prescribed after the birth of the child. After successful and timely treatment, healthy babies are most often born in the first half of pregnancy. And later therapy complicates the recovery of a pregnant woman.

Can syphilis be treated at home?

Only a doctor can prescribe the most effective treatment. It should be remembered that the stage of the disease, as well as complete recovery, can only be determined by test results. And they are obtained only in laboratories. Therefore, to the question of how to treat syphilis at home, you can answer that you cannot engage in therapy yourself without a doctor’s permission. In some cases, if the disease progresses or there is a danger of infection for others, the person is placed in a closed special hospital.

How long does it take to cure syphilis?

How long does it take to treat syphilis at different stages? In any case, therapy takes a long time. Even at the first stage, the treatment process takes from two to three months. Moreover, therapy should be continuous. If the second stage has occurred, then the treatment will be longer - up to two years or more. During this time, sexual intercourse is prohibited.

If the disease is detected in a partner, he is also required to undergo a full course of therapy. Treatment time will depend on the stage of the disease. All family members should undergo preventive treatment at the same time as the sick person. The treatment time for neurosyphilis depends on the severity of the disease and the characteristics of the patient’s body.

Preventive treatment of syphilis

How long does it take to treat syphilis? Preventive treatment is prescribed to people who had household or sexual contact with a patient during the infectious stage of the disease. But if no more than 3 months have passed from this moment. Treatment begins with injections of medications containing penicillin. The course of therapy is carried out for 14 days. Injections are given from two to eight times a day. When a patient is intolerant to the penicillin group of drugs, they are replaced with clarithromycin, sumamed and doxycycline.

How to treat syphilis if a person consults a doctor after a few months? If the period of treatment is from 3 to 6 months after contact with a patient with syphilis, then the examination is carried out twice, with an interval of 2 months. And treatment will be prescribed only when the disease is detected. If more than six months have passed since contact with a person with syphilis, then only one examination is sufficient.

How is syphilis treated in the early stages?

What medications are used to treat syphilis in the early stages? Treatment of primary and secondary syphilis is carried out using the same methods. Therapy involves a course of antibiotics for 2 weeks. Afterwards a large dose of long-acting penicillin is administered. 30 minutes before the injection, a suprastin or tavegil tablet is given.

There are some other treatment regimens. But they are all selected individually. The most popular treatment regimen is the prescription of long-acting penicillin. Injections are given once a week. In the early stages, syphilis responds well to treatment, so 1 to 3 injections are sufficient.

Skin rashes that begin in the second stage of the disease are treated with chlorhexidine with penicillin dissolved in saline solution. Repeat the lotions until the rash disappears completely. For faster resorption of hard chancre, they are lubricated with heparin ointment or a special mixture of podophyllin, dimethyl sulfoxide and glycerin.

For faster healing of ulcers on the body, they are irradiated with a helium-neon laser. They cauterize each rash for 10 minutes daily. The course of treatment is 14 days.

How is secondary recurrent and latent early syphilis treated?

The stages of latent early and secondary recurrent syphilis take a long time to treat. What drugs are used to treat syphilis? Antibiotics of the penicillin group are administered in large doses for a month. Starting from the third day of therapy, antibiotics are combined with bismuth preparations.

If treatment is inpatient, penicillin is administered 8 times a day for 2 weeks. Then the patient is transferred to outpatient therapy, and penicillin is replaced with bicillin (3 or 5), administered twice a week - a total of at least 10 times. But the first injection is done in the hospital, three hours after the penicillin injection.

In addition, as with conventional treatment, vitamin complexes and drugs that support and restore the liver are prescribed.

Treatment of neurosyphilis

Neurosyphilis is one of the advanced stages of syphilis that affects the nervous system. It has two types - early and late. Treatment of the early stage is identical to the treatment of secondary relapse. The only difference is that at the secondary stage the concentration of antibiotics in the cerebrospinal fluid increases. For this purpose, drugs are used that slow down their removal from the body.

Treatment of late neurosyphilis is selected taking into account the degree of brain damage. Courses of antibiotic therapy are combined with immunomodulators, vitamin complexes and symptomatic treatment. During treatment, the patient’s condition is additionally monitored by a neurologist and an ophthalmologist.

Treatment of syphilis with Ceftriaxone

"Ceftriaxone" is a reserve drug. Doctors use it if a patient is intolerant to penicillin. Ceftriaxone treats syphilis much more effectively, as it quickly penetrates into the cerebrospinal fluid. This antibiotic has high treponemocidal activity. The fastest effect is achieved with injections into the muscles.

The drug is effective at any stage of syphilis disease. It can be taken by pregnant women. When treated with Ceftriaxone, there is no harmful effect on the body, which distinguishes it from other antibiotics. The medicine acts on bacterial cell membranes, inhibiting their synthesis. How to treat syphilis with Ceftriaxone? This drug can cause side effects, so it can only be used as prescribed by a doctor who can determine the exact dose of the drug.

Prevention of syphilis

Syphilis is a highly contagious infection, and if you have sexual contact with a carrier of this virus, the risk of infection is extremely high. And if the disease manifests itself on the skin in the form of a rash, eczema, etc., then the likelihood of becoming infected increases several times.

Therefore, if there is a person with syphilis in the house, then to prevent infection of healthy family members through household means, the following measures must be taken:

• provide the patient with separate dishes and personal hygiene products (bed linen, towel, soap, etc.);
• Avoid any contact (even simple touching) during the infectious stage.

There are general rules for preventing syphilis:

• have only one trusted sexual partner;
• avoid short-term relationships, especially with people at risk;
• use condoms during sexual intercourse.

If emergency prophylaxis is required, it should be carried out immediately, no later than two hours after contact with the patient. In this case, it is necessary to thoroughly wash the genitals with soap and then use antiseptics. Men should insert them into the urethra, and women into the vagina.

But this does not guarantee complete safety. Therefore, after 2-3 weeks it is necessary to be examined by a venereologist and take tests at the VD. Before the specified period, checking for the presence of syphilis is useless, since during the incubation period the tests will show negative results.

Poor awareness of a syphilis patient about his disease and self-medication lead to a worsening of the epidemic situation. Decisive in the fight against the spread of infection is the high quality of treatment for syphilis, which is strictly regulated in the Russian Federation. Treatment tactics are determined by a dermatovenerologist.

The treatment regimen depends on the form of the disease and the socio-psychological status of the patient and includes specific (antibiotic therapy), nonspecific and local treatment.

The most effective treatment for syphilis is considered to be in a hospital setting under the supervision of medical personnel. Inpatient-outpatient and outpatient treatment of syphilis is indicated for socially adapted individuals who want to be treated and follow all medical recommendations.

Rice. 1. The photo shows chancroid with syphilis in a woman and a man.

Antibiotics for syphilis

The basis of specific treatment for syphilis is penicillin preparations.

• For treatment in a hospital setting, water-soluble penicillin is used. The drug provides a high concentration of the active substance in the patient’s body and penetrates the blood-brain barrier. Due to rapid elimination from the body, repeated administration is required throughout the day.
• For outpatient treatment, long-acting penicillin preparations (durant drugs) are used: foreign drugs Retarpen And Extensillin And Bicillin-1 — their domestic analogue.
• Combined antibacterial drugs: Bililin-3 And 5 .
• Antibacterial drugs recommended for use in case of intolerance to penicillin drugs.

Rice. 2. Penicillin mold is the main enemy of Treponema pallidum.

Treatment of syphilis with penicillin

Penicillin group drugs are used in the treatment of syphilis in a hospital setting. Water-soluble penicillin is administered intramuscularly every 3 hours, novocaine salt of benzylpenicillin is administered 2 times a day.

Treatment of syphilis with durant drugs

Durant drugs are prescribed for the treatment of syphilis on an outpatient basis. Retarpen, Exencillin and Bicillin-1 are administered in a single dose of 2.4 million units. This dose ensures the presence of the drug in the blood serum for a long time - up to 2 - 3 weeks. Exencillin And Retarpen administered once a week, administered once every five days Bicillin-1.

Treatment of syphilis with combination drugs

Combination drugs include penicillin preparations, which consist of 2 - 3 salts - Bicillin-3 And Bicillin-5. The frequency of administration is 2 times a week.

In some patients, a few hours after the start of treatment with antibacterial drugs (usually penicillin), the Herxheimer-Jarisch reaction develops, which is characterized by a sudden increase in body temperature, headache and muscle pain, vomiting, and tachycardia. This phenomenon is due to the massive death of pathogens. Symptoms are quickly relieved with aspirin.

Endolymphatic penicillin therapy

Professor E. A. Batkaev (Department of Dermatovenerology of the Russian Medical Academy of Postgraduate Education) developed a method of introducing penicillin directly into the lymphatic vessels - endolymphatic penicillin therapy. The method is recommended for use when it is necessary to create a higher concentration of an antibiotic in the affected tissue, as well as in the treatment of neurosyphilis.

Rice. 3. Retarpen and Exensillin are long-acting drugs for the treatment of syphilis.

Penicillin drugs are the mainstay in the treatment of syphilis.

Treatment of syphilis with intolerance to basic antibacterial drugs

Some patients have increased sensitivity to penicillin drugs; in some patients, the drugs in the doses used do not penetrate the blood-brain barrier; in others, there is no negativity of control serological reactions after treatment with long-acting penicillin drugs. In such cases it is recommended to use Tetracycline, Erythromycin, Doxycycline or Sumamed, Ceftriaxone and others. It is advisable to prescribe these drugs for 14 to 30 days in increased daily doses.

In case of intolerance to benzylpenicillin drugs by patients, it is recommended to treat syphilis with semisynthetic penicillins Ampicillin or Oxacillin.

In case of combined intolerance to penicillin, tetracycline and erythromycin, it is recommended to prescribe Cefazolin. Fresh forms of syphilis can be treated Sumamed (Azithromycin). When treating late latent syphilis, antibiotics are prescribed together with bismuth preparations.

The tactics and treatment regimen for syphilis is determined by a dermatovenerologist and depends on the form of the disease and the socio-psychological status of the patient.

Rice. 4. Hard chancre on the tongue and lip.

Pathogenetic treatment

Complex treatment including immuno- and enzyme therapy, adequate local therapy and treatment of concomitant chronic diseases of the genital organs is a significant reserve for improving the quality of anti-syphilitic therapy and contributes to the negation of serological reactions after the end of specific therapy.

In addition to antibiotics, immunotherapy is used in the treatment of syphilis. The immune system suppresses the development of new lesions, removes toxins and destroyed bacteria from the body, and protects the body from re-infection. Immunotherapy increases the effectiveness of treatment of syphilis, improves the prognosis of the disease and the patient’s quality of life.

1. Pyrogens

A biogenic drug is used to stimulate the immune system for syphilis Pyrogenal. The drug is similar in action to Pyrogenal Prodigiosan.

2. Interferon preparations

In early forms of syphilis, patients experience disturbances in the production of interferons. Their production decreases by 2-5 times. Correction of the immune system can be carried out with a domestic drug Amiksin, which is an oral inducer of endogenous interferon. When using Amiksina regression of syphilides and negativity of the CSR (complex of serological reactions) occurs faster.

3. Immunocorrection of the T-cell immunity

Drugs in this group stimulate the work of lymphocytes and phagocytes. These include Timalin, Taktivin, Timogen, Immunomax and Imunofan.

4. Phagocytosis stimulators

Phagocytosis and antibody formation are stimulated by drugs such as Polyoxidonium, Lykopid, Galavit, Methyluracil, Levamisole and etc.

5. Enzyme therapy

Under the influence of systemic enzymes, microcirculation and tissue trophism improve, toxins are eliminated, the concentration of antibiotics in areas of inflammation increases, and the immune system is stimulated. Application shown Wobenzina, Flogenzima, Vobe-Mugos E.

6. Vitamin therapy

Patients with syphilis are advised to take ascorbic acid and B vitamins.

7. Adaptogens

In order to increase the body's nonspecific resistance, it is recommended to take adaptogens: Pantocrine, Rhodiola rosea and Eleutherococcus extract, Ginseng and Schisandra tincture.

8. Biogenic stimulants

Biogenic stimulants stimulate the body’s protective functions, metabolism and activate regeneration processes: PHYBS, Placenta extract, Plazmol, Splenin, Polybiolin.

Rice. 5. Chancre (hard ulcer) of the lower lip before treatment (photo on the left) and 14 days after treatment (photo on the right).

Physiotherapeutic treatment

To achieve the best effect in the treatment of syphilis, physiotherapy is prescribed.

1. Inductothermy

Inductothermy is a type of electrotherapy. The technique is based on the use of a high-frequency magnetic field. In patients with syphilis, it is recommended to use inductothermy

Preventive (warning) treatment is carried out for persons who have been in the lumbar region and combined with taking a centrally acting drug Etimizole. A drug Etimizole affects the pituitary gland, which leads to an increase in glucocorticosteroids in the blood plasma.

Magnetotherapy in patients with syphilis is used to obtain a general strengthening effect. It is recommended to place inductors along the spine.

3. Microwave therapy

This type of physiotherapy is used to improve the functional state of the nervous system, enhance local blood circulation, increase the level of metabolism and the body's defenses. The procedures are performed sequentially on the epigastric and thyroid gland area on the first day and on the epigastric and adrenal gland area on the second day.

4. Laser therapy

Laser therapy for syphilis is used to correct cellular and humoral immunity.

Rice. 6. Magnetic therapy.

Local treatment of syphilis

Giant ulcerative chancre, condylomas lata and pustular-ulcerative syphilides in syphilis are subject to local treatment. It is indicated to use a 0.05% solution of chlorhexidine bigluconate or a 50 - 70% solution of dimexide in physiological solution containing 100 thousand units in 1 milliliter. penicillin.

Lotions are applied until complete epithelization or scarring of syphilides occurs.

Dense lymphoid infiltrates at the base of syphilides are lubricated with heparin ointment or a mixture containing podophyllin, dimethyl sulfoxide solution and glycerin in a ratio of 1: 5: 5.

The use of a helium-neon laser has a beneficial effect on the resorption of lymphoid infiltrates, scarring of hard ulcers (chancres) and condylomas lata, and the time required for the rehabilitation of syphilitic ulcers is shortened.

Rice. 7. Ulcerative chancre and condylomas lata are subject to local treatment.

Rice. 8. Pustular-ulcerative syphilides of the secondary period of syphilis.

Preventive treatment

Preventive (warning) treatment is carried out to persons who have had sexual or close household contact with patients with contagious forms of the disease, who have not shown signs of syphilis and no more than 3 months have passed since the contact. Preventive treatment is provided to persons who have received infected blood transfusions.

Treatment regimens

Preventive treatment is carried out for 14 days with water-soluble penicillin or novocaine salt of penicillin. Most often, preventive treatment is carried out on an outpatient basis using durable drugs:

• Extensillin or Retarpen in a single dose of 2.4 million units. once a week. The course of treatment is 3 injections.
• Bicillin-1, 3, 5. 4 injections are enough for the course - 2 injections per week. Bicillin-1 and 5 in a single dose of 1.5 million. units, Bicillin-3— in a single dose of 1.8 million units.

Surveillance and control

• If 3 to 6 months have passed since the moment of contact, then the patient is monitored and monitored using a set of serological reactions, RIT or RIF. The examination is carried out twice with an interval of two months. Together with serological control, a general clinical examination is always carried out.
• If more than 6 months have passed since contact, then serological testing is performed only once.
• Patients who have received contaminated blood transfusions are examined quarterly for one year.
• Persons who have had gonorrhea or other infections, but the source of infection has not been identified, are subject to control examination once every quarter for 6 months.
• Persons who have been subjected to sexual violence are examined according to the same scheme.
• If persons who were in close household or sexual contact with patients with early forms of syphilis have undergone preventive treatment, then they are not subject to further observation, or are examined once after three months.

Rice. 9. Congenital syphilis.

Update: December 2018

Syphilis (Lewis) is one of the few diseases that entails criminal liability when infecting a sexual partner or surrounding people. As a rule, the first signs of syphilis in men and women do not appear immediately, but several weeks after the actual infection, which makes this disease even more dangerous.

Syphilis stands out among all socially significant diseases (threatening not only the health of the population, but also life) in that today in Russia the syphilis epidemic has a progressive trend. The incidence rate has increased fivefold over the past decades. If untreated, this sexually transmitted disease can lead to infertility in both women and men; during the pregnancy of a sick woman, infection of the fetus occurs in 70% of cases, which ends with the death of the fetus or congenital syphilis in the baby.

Syphilis happens:

• by origin - congenital and acquired
• according to the stage of the disease - primary, secondary, tertiary
• by timing of occurrence - early and late

Diagnostics

The diagnosis of such a serious disease cannot be made to oneself “on the Internet” by reading about syphilis and its symptoms. The fact is that the rash and other changes can visually copy those of completely different diseases, so that even doctors are periodically misled. For this reason, doctors diagnose syphilis through examination, characteristic signs and laboratory tests:

• Examination by a dermatovenerologist. He asks the patient in detail about the course of the disease, examines the skin, genitals, and lymph nodes.
• Detection of treponema or its DNA in the contents of gummas, chancre, syphilides using dark-field microscopy, direct immunofluorescence reaction, and PCR.
• Carrying out various serological tests: Non-treponemal - search for antibodies against treponema membrane lipids and phospholipids of tissues destroyed by the pathogen (Wassermann reaction, VDRL, rapid plasma reagin test). The result obtained may be false positive, i.e. show syphilis where there is none. Treponema - search for antibodies to Treponema pallidum (RIF, RPGA, ELISA, immunoblotting, RIBT).
• Instrumental studies: search for gummas using ultrasound, MRI, CT, X-rays, etc.

Properties of the pathogen

The spirochete Treponema pallidum (treponema pallidum) is recognized as the “culprit” of syphilis. In the human body, treponema multiply rapidly, which leads to damage to internal organs. Among other things, there are many of them on the mucous membranes, so they are easily transmitted through sexual or close household contact, for example, through shared utensils, some personal hygiene items (household syphilis). Treponema pallidum does not cause lasting immunity, so a recovered partner can become infected again from his partner who continues to have Lewis.

Treponema does not tolerate drying out and high temperatures (it dies almost instantly when boiled, and raising the temperature to 55 0 C destroys treponema in 15 minutes). However, low temperatures and a humid environment contribute to the “survivability” of this spirochete:

• maintaining viability for a year when frozen to minus 78 0 C,
• survival on dishes with residual moisture for up to several hours,
• even the corpse of a syphilitic patient can infect surrounding people for 4 days.

How is syphilis transmitted?

Syphilis is transmitted through:

• sexual contact (eg, vaginal, oral, anal sex)
• through blood (sharing syringes among drug addicts, during blood transfusion, sharing toothbrushes or shaving utensils in everyday life)
• through mother's milk (acquired syphilis in children)
• in utero (congenital syphilis of a child)
• through common household items, if the patient has open ulcers, disintegrating gums (for example, a shared towel, dishes)
• through saliva (this route of infection occurs rarely and mainly among dentists, if they do not work in protective gloves)
• Read more about methods of transmission of infection in our article.

In case of accidental unprotected sexual intercourse of any kind, the following procedure can be performed as an emergency prevention of syphilis (the sooner the better, no later than 2 hours after the act): first, thoroughly wash the genitals and inner thighs with soap, then treat the genitals with antiseptic solutions Chlorhexidine (men should inject the solution into the urethra, women - into the vagina).

However, this method reduces the risk of infection by only 70% and cannot be used constantly; condoms are the best method of protection and even after using them with an unreliable partner, the genitals should be treated with an antiseptic. After casual sexual contact, you should be examined by a venereologist for other infections, and to rule out syphilis, you should undergo an examination a few weeks later; there is no point in doing so earlier

All external papules, erosions, ulcers with scanty discharge are extremely contagious. If there are microtraumas on the mucous membrane or skin of a healthy person, contact with the patient leads to infection. From the first to the last day of illness, the blood of a patient with syphilis is contagious, and transmission is possible both through blood transfusion and when the skin or mucous membranes are injured by medical, cosmetology, instruments in pedicure and manicure salons, which came into contact with the blood of a patient with syphilis.

Incubation period

After entering the body, Treponema pallidum is sent to the circulatory and lymphatic system, spreading throughout the body. However, an externally infected person still feels healthy. From the time of infection to the period when the initial symptoms of syphilis appear, it can take from 8 to 107 days, and on average 20–40 days.

That is, for 3 weeks and up to 1.5 months after infection, syphilis does not manifest itself in any way, neither symptoms nor external signs, even blood tests give a negative result.

The duration of the incubation period is extended:

• old age
• conditions accompanied by high fever
• treatment taken with antibiotics, corticosteroids, other drugs

The incubation period is shortened during massive infection, when a huge amount of treponemas enters the body at once.

Already at the stage of the incubation period, a person becomes infectious, but during this period, infection of other people is possible only through blood.

Syphilis statistics

In the early stages, syphilis responds well to treatment, but despite this, it ranks confidently in third place, behind trichomoniasis and chlamydia, among sexually transmitted diseases.

According to official statistics, 12 million new patients are registered in the world every year, but these figures are underestimated, since some people are treated themselves, for which there is no statistical data.

People aged 15-40 years are most often infected with syphilis, with the peak incidence occurring at 20-30 years of age. Women have a higher risk of infection (microtears of the vagina due to sexual intercourse) than men, however, the increase in the number of homosexuals in large cities in the US and EU leads to higher rates of infection in these countries in men than women.

The Russian Ministry of Health reports that there is no unified registration of patients with syphilis in our country. In 2008, 60 cases of the disease per 100 thousand people were registered. Among those infected, there are often people without a permanent place of residence, without a regular income or with low-paid jobs, as well as many representatives of small businesses and service sector workers.

Most cases are registered in the Siberian, Far Eastern and Volga districts. In some regions, cases of neurosyphilis that cannot be treated are increasing, the number of which has increased from 0.12% to 1.1%.

The first signs of syphilis - primary syphilis

What are the first signs of syphilis? In the case of the classic version of the Lewis disease, this is chancre and enlarged lymph nodes. By the end of the primary period, patients are concerned about the following symptoms:

• headache
• general malaise
• pain in muscles, bones, arthralgia
• heat
• decreased hemoglobin (anemia)
• increase in white blood cells

Hard chancre- A typical chancre is a smooth ulcer or erosion with rounded and slightly raised edges up to 1 cm in diameter, bluish-red in color, which may or may not be painful. On palpation, there is a dense infiltrate at the base of the chancre, which is why the chancre is called “hard.” Hard chancre in men is found in the glans area or on the foreskin, in women on the cervix or labia. It can also be on the mucous membrane of the rectum or near the anus, sometimes on the pubis, abdomen, and thighs. In medical workers, it can be localized on the tongue, lips, and fingers.

A chancre can be either a single or multiple defect on the mucous membrane or skin, and mainly appears at the site of infection. As a rule, a week after its occurrence, the lymph nodes become enlarged, but sometimes patients notice the lymph nodes earlier than the chancre. After oral sex, chancre and enlarged lymph nodes may resemble or, which can lead to the prescription of inadequate treatment. Anal chancre can also be misleading, since it resembles a fissure of the anal fold with elongated outlines, without infiltration.

Even without therapy, hard chancre disappears after 4–6 weeks, and the dense infiltrate resolves. Often, chancre does not leave any changes on the skin, although giant forms can produce pigment spots of a dark brown or black color, and ulcerative chancre leaves rounded scars surrounded by a pigment ring.

Usually, the appearance of such an unusual ulcer causes anxiety in a person, so syphilis is detected in time and promptly treated. But when the chancre remains unnoticed (on the cervix) or is ignored by the patient (smeared with potassium permanganate, brilliant green), after a month when it disappears, the person calms down and forgets about it - this is the danger of the disease, it turns into secondary syphilis without being noticed.

Stages of syphilis - click to enlarge

Atypical chancres - In addition to the classic chancre, there are other varieties of it, which makes the recognition of syphilis difficult:

• Indurative edema. A large thickening of a pale pink or bluish-red hue appears on the lower lip, foreskin or labia majora, spreading beyond the boundaries of the erosion or ulcer. Without adequate treatment, such chancre persists for several months.
• Felon. Chancre, in the form of ordinary inflammation of the nail bed, is almost no different in appearance from ordinary panaritium: the finger is swollen, purple-red, painful. Nail rejection often occurs. Unlike classic felon, it does not heal for several weeks.
• Amygdalite. This is not just a hard chancre on the tonsil, but a swollen, red, dense tonsil that makes swallowing painful and difficult. Usually, like a typical sore throat, amygdalitis is accompanied by fever, general weakness, and malaise. Headaches (mainly in the back of the head) may also occur. Syphilis may be indicated by unilateral damage to the tonsil and low effectiveness of the treatment received.
• Mixed chancre. This is a mixture of hard and soft chancre with parallel infection with these pathogens. In this case, the chancroid ulcer appears first, since it has a shorter incubation period, and then compaction occurs, and the picture of a typical hard chancroid develops. Mixed chancroid is characterized by a 3-4 month delay in laboratory test data (for example, the Wassermann reaction) and the appearance of signs of secondary syphilis.

Lymph nodes - With primary syphilis, enlarged lymph nodes are observed (see). When the chancre is localized on the cervix or in the rectum, the enlarged lymph nodes remain unnoticed, since they enlarge in the pelvis, and if syphiloma has formed in the mouth, then the chin and submandibular nodes, cervical or occipital, enlarge; when the chancre is found on the fingers, the lymph nodes enlarge in the area of ​​the elbow. One of the distinctive signs of syphilis in men is a painless cord with thickenings that forms at the root of the penis - this is syphilitic lymphadenitis.

• Bubo (regional lymphadenitis). It is a dense, painless, mobile lymph node, which is close to the chancroid, for example:
  • in the groin - chancre on the genitals
  • on the neck - chancre on the tonsils
  • under the arm - a chancre on the nipple of the mammary gland

• Regional lymphangitis. This is a dense, painless and mobile cord under the skin between the chancre and the enlarged lymph node. The average thickness of this formation is 1–5 mm.
• Polyadenitis. By the end of the primary Lewis period, all lymph nodes enlarge and thicken. In fact, from this moment we can talk about the beginning of secondary syphilis.

Complications of primary syphilis - Most often, complications arise when an infection occurs in the area of ​​chancre or a decrease in the body’s defenses. Developing:

• balanoposthitis
• inflammation of the vagina and vulva
• narrowing of the foreskin
• paraphimosis
• phagedenization (gangrene, which spreads deeper and wider than chancre - it can even lead to rejection of the entire organ or part of it).

Symptoms of secondary syphilis

Secondary syphilis begins to develop 3 months after infection, on average the duration of the secondary period of syphilis is from 2 to 5 years. Ngo is characterized by wave-like rashes that go away on their own after a month or two, leaving no marks on the skin. The patient is not bothered by either fever or fever. At the beginning, the symptoms of secondary syphilis are as follows:

Cutaneous syphilides - Secondary syphilides have a variety of rash elements, but they are all similar:

• benign course and rapid disappearance with appropriate treatment of syphilis
• the rash lasts several weeks and does not lead to fever
• different elements of the rash appear at different times
• the rash does not itch or hurt

Syphilide options:

• syphilitic roseola - a round or irregularly shaped pale pink spot, which is most often seen on the sides of the body;
• papular - many wet and dry papules, often combined with syphilitic roseola;
• miliary - pale pink, dense, cone-shaped, disappearing much later than other elements of the rash and subsequently leaving spotty pigmentation:
• seborrheic - formations covered with scales or greasy crusts in those areas where the activity of the sebaceous glands is increased (skin of the forehead, nasolabial folds, etc.), if such papules are located along the edge of hair growth, then they are called the “crown of Venus”;
• pustular - multiple ulcers, which then ulcerate and scar;
• pigmented - leucoderma on the neck (white spots), called the “necklace of Venus”.

Syphilides of the mucous membranes - First of all, these are sore throats and pharyngitis. Syphilides can spread to the vocal cords, pharynx, tonsils, tongues and oral mucosa. The most common are:

• Erythematous tonsillitis. Syphilides are located on the soft palate and tonsils in the form of bluish-red erythema.
• Papular tonsillitis. In the area of ​​the pharynx there are many papules that merge with each other, ulcerate and become covered with erosions.
• Pustular tonsillitis. Pustular lesion of the mucous membrane of the pharynx area.
• Pharyngitis. With the development of syphilide in the area of ​​the vocal folds, there may be hoarseness or complete loss of voice.

Baldness - it can be focal, observed in the form of small rounded areas on the head, beard, mustache and even eyebrows. Or diffuse, in which case the hair falls out profusely all over the head. After starting treatment, hair grows back after 2-3 months.

Complications of secondary syphilis- The most severe complication of secondary syphilis is the transition of the disease to the tertiary period, when neurosyphilis and associated complications develop.

Tertiary syphilis

Years or decades after the secondary Lewis period, treponemes transform into L-forms and cysts and gradually begin to destroy internal organs and systems.

Skin syphilides of the third period - Tubercle is a painless and dense burgundy-colored tubercle located in the skin. Sometimes such tubercles are grouped together and form garlands resembling scattered shot. After they disappear, scars remain. Gummous is a sedentary nodule the size of a nut or a pigeon's egg, located deep under the skin. As the gumma grows, it ulcerates and gradually heals, leaving a scar. Without adequate treatment, such gummas can exist for several years.

Syphilides of the mucous membranes of the third period - First of all, these are various gummas, which, ulcerating, destroy bones, cartilage, soft tissues and lead to permanent deformations and deformities.

• Gumma of the nose. It destroys the bridge of the nose, causing deformation of the nose (it simply collapses) or the hard palate, followed by reflux of food into the nasal cavity.
• Gumma of the soft palate. Gumma forms in the thickness of the palate, which makes it motionless, dark red and dense. Then the gumma breaks out in several places at once, forming long-term non-healing ulcers.
• Gumma of the tongue. There are 2 main forms of tongue damage in tertiary syphilis: gummous glossitis - small ulcerations on the tongue , sclerosing glossitis - the tongue becomes dense and loses its mobility, then wrinkles and atrophies (speech, the ability to chew and swallow food suffers).
• Gumma pharynx. Difficulty swallowing, accompanied by painful sensations and disorders.

Complication of the third period Lewis are:

• The appearance of gummas in the internal organs (liver, aorta, stomach, etc.) with the development of their severe failure and even sudden death.
• Neurosyphilis, which is accompanied by paralysis, dementia and paresis.

Features of syphilis symptoms in women and men

In the second and third periods there are practically no differences. The difference in the symptoms of syphilis can only be observed with primary syphilis, when chancre is located on the genitals:

• Chancre in the urethra - the first signs of syphilis in men are bloody discharge from the urethra, an inguinal bubo and a thick penis.
• Gangrenous chancre on the penis- self-amputation of the distal part of the penis is likely.
• Chancre on the cervix. When infected with syphilis, signs in women with hard chancre on the uterus are practically absent (discovered by a gynecologist during an examination).

Atypical syphilis

Hidden syphilis. It occurs unnoticed by the patient and is diagnosed only on the basis of tests, although a person can infect others.

Today, venereologists are faced with an increase in the number of cases of latent syphilis, this is due to the widespread use of antibiotics, when a person’s initial signs of syphilis remain undiagnosed, and the patient begins self-treatment or antibiotics prescribed by a doctor for other diseases - sore throat, ARVI, stomatitis, as well as trichomoniasis, gonorrhea, chlamydia. As a result, syphilis is not cured, but acquires a latent course.

• Transfusion. It is characterized by the absence of hard chancre and the primary period of syphilis, immediately starting with the secondary 2–2.5 months after the transfusion of infected blood.
• Erased. Symptoms of the secondary period “fall out”, which in this case are almost invisible, and then asymptomatic meningitis and neurosyphilis.
• Malignant. A rapid course, accompanied by gangrene of the chancre, a decrease in hemoglobin and severe exhaustion.

Congenital syphilis

A woman infected with syphilis can pass it on even to her grandchildren and great-grandchildren.

• Early syphilis - deformation of the skull, continuous crying, severe exhaustion, sallow skin color of the baby.
• Late syphilis - Hutchinson's triad: semilunar edges of teeth, symptoms of labyrinthitis (deafness, dizziness, etc.), keratitis.

How to treat syphilis?

Which doctor treats syphilis?

A dermatovenereologist treats patients with syphilis; you should contact a dermatovenerological clinic.

How long to treat syphilis?

Syphilis is treated for quite a long time; if it is detected at the primary stage, continuous treatment is prescribed for 2-3 months; if secondary syphilis develops, therapy can last over 2 years. During the treatment period, any sexual contact is prohibited while the infectious period lasts, and preventive treatment is indicated for all family members and sexual partners.

Are there folk remedies for treating syphilis?

Neither folk remedies nor self-medication for syphilis is acceptable; it is ineffective and dangerous because it complicates future diagnosis and blurs the patient’s clinical picture. Moreover, the cure and effectiveness of therapy is determined not by the disappearance of symptoms and signs of syphilis, but by the results of laboratory data, and in many cases treatment is indicated in a hospital rather than at home.

What drugs are used to treat syphilis?

The best and most effective method of treatment is the administration of water-soluble penicillins in a hospital setting, this is done every 3 hours for 24 days. The causative agent of syphilis is quite sensitive to penicillin antibiotics, however, if therapy with these drugs is ineffective or if the patient is allergic to them, drugs such as fluoroquinolones, macrolides or teracyclines may be prescribed. In addition to antibiotics, immunostimulants, vitamins, and natural immune stimulants are indicated for syphilis.

What should family members of a patient do to prevent syphilis?

Syphilis is a highly contagious infection; during sexual contact, the risk of infection is very high, and if a man or woman has signs of syphilis on the skin, this risk increases significantly. Therefore, if there is a person with syphilis in the house, the risk of household infection should be minimized - the patient should have personal utensils, hygiene products (towels, bed linen, soap, etc.), it is necessary to avoid any bodily contact with family members at the stage when the person is still contagious.

How to plan pregnancy for a woman who has had syphilis?

To avoid congenital syphilis, pregnant women are examined several times during pregnancy. If a woman has had syphilis, has been treated and has already been removed from the register, only in this case can she plan a pregnancy, but even then she should be examined and undergo preventive therapy.

Treatment of syphilis at home is currently allowed, but only if the disease is at an early stage and the patient does not lead an antisocial lifestyle. Therapy is not particularly difficult; the main thing is to make the correct diagnosis and accurately determine the stage of the syphilitic infection. Equally important is repeated examination, which allows assessing the effectiveness of treatment.

Is it possible to get rid of syphilis at home?

Therapeutic measures should be carried out as prescribed by a doctor.

Despite the wide range of antibacterial drugs to which treponema pallidum is sensitive, self-treatment can contribute to the transition of the disease to a latent form with further damage to vital organs and the nervous system. A thorough examination of the patient helps to prevent this, determining the severity of syphilis and the presence of pathologies of the brain and bone marrow. In accordance with the results of diagnostic procedures and the general condition of the body, the doctor selects an antibacterial drug and its dosage.

At home, you can treat primary and fresh, as well as take a preventive course. In all other cases, hospitalization is indicated. The treatment regimen for late forms of the disease includes drip medications that ensure a constant concentration of the active substance in the blood.

Drug treatment

The main drug used in the treatment of syphilis is penicillin. Treponema pallidum has not developed resistance to it. The most effective is the water-soluble form of the antibiotic, which is injected every 3 hours. With this drug you can eliminate the causative agent of infection in all tissues of the body.

With primary syphilis, there is no damage to the nervous system, so therapy can be carried out using long-acting antibiotics, which can be administered once a week. These include:

• Retarpen;
• Bicillin;
• Extensillin.

To get rid of “fresh” syphilis, 3–5 injections are enough. The active substance of Retarpen and Extensillin is benzylpenicillin. The drugs have a high degree of purification, which is associated with a low risk of side effects.

The most common consequences of the administration of penicillin antibiotics:

• a decrease in the number of leukocytes, contributing to the development of bleeding;
• weakening of the body's defenses;
• allergic reactions, manifested in the form of skin rashes, irritation of mucous membranes, Quincke's edema and anaphylactic shock.

With long-term use of antibacterial agents, superinfection caused by drug-resistant pathogens may occur.

Long-acting penicillins for home treatment of syphilis are administered in maximum doses, which is why it is necessary to assess the risk of allergic reactions in advance. If it is impossible to use drugs of this pharmacological group, broad-spectrum antibiotics are prescribed. Active against Treponema pallidum:

• tetracyclines and macrolides (Josamycin, );
• cephalosporins ().

Syphilitic rash is an indication for the use of external antiseptics. Antibiotic ointments prevent bacterial infections. For washing wounds the following are prescribed:

Syphilitic chancre on the mucous membranes of the mouth or throat is treated:

• furatsilin;
• 2% gramicidin;
• boric acid.

After completion of the therapeutic course, a control examination is carried out. Patients with primary seronegative syphilis are monitored at the dispensary for six months, tests are performed every 3 months. With a fresh secondary form, when tests give a negative result 3 months after completion of therapy, a visit to the doctor within a year is indicated. If treponema pallidum ceases to be detected one year after treatment, clinical observation is carried out for 2 years. How to cure syphilis with folk remedies?

Alternative Therapeutics

It is impossible to cure venereal disease with herbal decoctions, but natural preparations are used to strengthen the immune system and improve the general condition of the body.

1. Wine and garlic can be used to treat syphilis. To prepare the medicine you will need 200 g of strawberry jam, 100 ml of water, 400 ml of red wine and a head of garlic. The jam is mixed with water and brought to a boil, wine and apple juice are added. The liquid is thoroughly mixed and cooled, then add chopped garlic and leave for 3 hours. The product is filtered and taken once a day, 0.5 cups.
2. When treating syphilis at home, cranberries are often used. The juice is squeezed out of the berries, mixed with red wine and heated. After cooling, add a few crushed cloves of garlic and leave overnight. The finished drink is taken 200 ml before bedtime.
3. Sandy sedge root is crushed and poured with hot water. Cook over low heat until the volume is reduced by half. The decoction is infused for 2 hours, filtered and taken 50 ml 4 times a day.
4. 2 tbsp. l. dried field Yakut grass, pour 0.5 liters of boiling water, leave for 5 hours, cool, filter and take 1 tsp 5 times a day. Hop cones (2 tablespoons) are brewed in 2 glasses of hot water and left for 2 hours. The finished drug is drunk throughout the day. In 200 ml. boiling water add 1 tbsp. l. burdock root, boil for 20 minutes, cool. The medicine is taken before each meal.

Treatment of syphilis with folk remedies should begin after consultation with your doctor. It does not imply giving up traditional medicine.