A disease such as syphilis has been known to society since the 15th century and, until the invention of antibiotics, was a severe and practically incurable pathology.

But even today it affects a large number of patients - most often diagnosed in the age group of 18-40 years. It is more common in women than in men - according to statistics, syphilis ranks third among sexually transmitted diseases.

What is syphilis?

Syphilis is a systemic, chronic disease, part of the group of venereal diseases, which has an infectious nature of its origin.

In this case, the virus will infect the mucous membrane, as well as all internal organs and healthy systems, the central nervous system and bone tissue.

Syphilis is caused by a bacterium known as treponema pallidum, most often transmitted sexually, less often through blood.

Depending on the course of the pathological process, it can provoke serious negative consequences.

The causative agent of syphilis

As doctors note, the causative agent in the body of syphilis is the bacterium Treponema pallidum, and it was the discovery of this root cause in 1905 that allowed doctors and microbiologists to find an effective key to treatment.

In addition, effective diagnostic methods were invented, and accordingly the effectiveness of treatment, patient recovery and quality of life increased.

If we talk more specifically about the properties of the bacterium, it is called pale due to the fact that for quite a long time doctors and biologists could not examine it under a microscope.

It is its transparent color that is difficult to stain in reagents for its subsequent identification and research.

Most often, in this case, the technique of staining and impregnation in the laboratory with silver is used. For subsequent laboratory research, doctors use a dark-field microscope, which allows them to identify the bacterium, determine its number and carry out all the necessary research.

As the researchers note, in the human or animal body the bacterium divides at intervals of 30 hours, its disadvantage is that it will live and multiply at a temperature of 37 degrees. All this justifies the effectiveness of using archaic methods of treating this viral disease - the essence is to increase body temperature to 41 degrees.

Incubation period of the disease

Penetrating into the body through microcracks and damage to the skin, the pathogenic bacterium begins its incubation period, hidden without obvious signs of its course.

It gradually accumulates at the site of penetration, dividing at intervals of every 30 hours, and at this stage the process itself does not manifest itself in any way by any symptoms.

But in accordance with the genesis of the pathological process of infection, a month later a formation of a dense and hard ball occurs at the site of infection.

Next to it there is an increase in the size of the lymph nodes - these are the symptoms that indicate the transition of the pathology to the stage of the so-called primary form of syphilis.

Depending on the level of immunity and the body’s defenses, doctors identify a fairly wide range during the incubation period, ranging from several weeks to six months.

Routes of infection

Syphilis, or more precisely the bacterium known in medical circles as Treponema pallidum, enters directly into the body in several ways.

Transmission of infection through sexual intercourse

In practice, sexual transmission is the most common and common route of infection, especially if the couple does not practice contraception.

In this case, syphilis is classified as an STD - sex can be oral, anal, vaginal, and just one sexual act is enough for infection to occur.

Each of these forms of sexual intercourse is dangerous, but doctors call anal penetration the most dangerous due to the high percentage of infection when the rectal mucosa is injured.

When considering contact with vaginal penetration, it is the woman who is more likely to become infected than the man.

This is easily explained - the vaginal mucosa is more susceptible to injury during sexual intercourse.

The insidiousness of this disease, syphilis, is that a healthy person can become infected with it at any stage of its course. Therefore, a sick or infected man or woman can transmit a pathogenic infection to a healthy partner even at the incubation stage. This is how a vicious circle of sexual transmission is formed, when ignorance involves new sexual partners in it.

Transmission via saliva

The infection can also be transmitted through the saliva of a sick patient - the important condition in this case is that rashes should appear around the lips or in the oral cavity.

Only in this case will bacteria be present in the saliva.

The infected patient himself poses a potential and immediate danger when trying to kiss or perform oral sex.

But as doctors themselves note, based on medical statistics, transmission of the syphilis virus through even the deepest kiss is very rare.

The thing is that such rashes are very rare. In addition, a prerequisite for infection must be injuries and abrasions, microtraumas of the oral cavity in a healthy person.

Infection through breast milk

Infection with pathogenic microflora itself can also occur through breast milk during breastfeeding, natural feeding after childbirth.

It is in its composition that treponemes are present and they can easily be transmitted to a newborn.

Due to the fact that a newborn’s immunity is still weak and not yet strong, babies are at high risk of infection.

Infection through blood

Thus, direct transfusion of donor blood and surgical transplantation of internal organs of an infected person provoke the introduction of infection into the body of a healthy patient.

In practice, according to doctors, this is unlikely. The thing is that before transplantation and transfusion, biological material is tested for all pathogenic viruses, including the presence of the syphilis bacteria.

It is more likely that you can become infected with syphilis through blood through a syringe in the corresponding circles of drug addicts. You are also more likely to become infected during a fight accompanied by bloodshed or when visiting a nail salon, when the infection can be acquired through an unsterile instrument.

Accordingly, when you detect the first manifestations of syphilis infection - papules and ulcerative neoplasms, erosion on the surface of the skin, it is important to immediately visit a doctor.

This also applies to suspicions of possible infection - the patient becomes a carrier of the virus and a potential danger to his own environment.

Infection during professional activities

Even such a route of infection as professional activity is also included in the list of possible ones.

In the professional circle of people, this applies more to doctors, cosmetologists are no exception, and other employees whose direct work involves close contact with people and invasive procedures and biological materials.

Most often, in relation to medical personnel, infection can occur through an accidental injury with a sharp instrument, which was previously used by a patient infected with syphilis and which did not have time to be disinfected or disposed of.

Cosmetologists and beauty salon workers can also become infected through personal use of a tool that was previously used by an infected client.

The main condition for introducing bacteria into the blood is the presence of unhealed, open wounds and abrasions on the skin through which pathogenic microflora will enter the blood.

Domestic infection

Most patients often ask infectious disease doctors about the possibility of syphilis transmission and household infection.

After all, someone lives next to an infected person, rides in public transport and goes to work, uses cutlery, and so on.

And even before the first manifestations, signs that indicate the development of syphilis, the patient himself may not know about his situation and may not take measures for treatment.

In this case, transmission of pathogenic microflora is possible through the common use of household items - dishes and bed linen, cigarettes and other household items.

But with prolonged and fairly close communication, at the terminal stages, during which there is an active release of bacteria into the environment from decaying ulcers and gummas.

But remember - when the treponema bacterium dries out, it will lose its pathogenicity and the only means of transmission in everyday life can be saliva or another type of liquid left on a household item.

Transplacental infection

The presented route of infection with syphilis involves the direct transmission of pathogenic microflora from a sick patient during gestation - here the bacterium is transmitted from mother to child.

If the pathogen enters the placenta at 5-6 months of pregnancy, the fetus dies.

If the mother became infected later than this period, then the child’s signs of the disease will appear 1-2 months after birth, and a positive reaction to syphilis will begin to appear from the 3rd month of life.

As a result, in the absence of timely treatment by a woman for syphilis, the pathogenic microflora will be transmitted to the child at the stage of intrauterine development.

At the very beginning of its course, the treponema bacterium will infect the protective layer of the placenta and then easily penetrate the organs and internal tissues of the fetus through the umbilical vein or through the lymphatic system.

Syphilis in infants manifests itself as anxiety, breast refusal, retarded growth and development, and skin lesions. Syphilitic runny nose is characterized by mucous, purulent or sanguineous discharge from the nose, forming crusts. The skeletal system, liver, spleen, lungs and other organs are affected.

Infection of a child during childbirth

Since the bacterium itself is present in the vagina, and childbirth itself involves direct contact between the blood of the fetus and the mother, the presented route of infection can easily be implemented.

If the child was not infected at the stage of intrauterine development, it is simply unrealistic to avoid this fact during natural childbirth.

In this case, the best option is to perform a caesarean section procedure, when possible risks of infection are minimized.

Blood test for syphilis

Laboratory test of blood composition for syphilis is a study aimed at identifying in biological material antibodies produced by the body to a pathogenic pathogen. Also, during the study, the indicators of decay of the damaged Treponema pallidum cell and the identification of the pathogen itself in the blood are taken into account.

Types of results

Each and every analysis done for syphilis can be conditionally divided into specific ones - these are the RNGA tests themselves, RIF, ELISA and nonspecific ones, which include blood tests for RW.

Thus, nonspecific results will give positive results in the presence of infection, and negative results after recovery. Specific - from the very first result they will show the presence of pathogenic microflora in the blood.

For the most part, the results are marked according to the following system:

Types of tests for syphilis

In the practice of laboratory research, the following testing methods are distinguished:

1. Direct– Doctors look for the pathogenic microflora itself in the blood, either entirely or individual parts of it, DNA remnants.
2. Indirect, serological studies I - in this option, antibodies to the causative agent of syphilis are detected in the biomaterial.

Direct methods

So direct diagnostic methods– in the practice of doctors they will be considered the most accurate and reliable, since the bacterium itself is visible in the original biological material. However, it can be difficult to identify this bacterium in the results, and even if there are negative results, this is not an indicator of the absence of pathogenic microflora in the body.

It makes sense to carry out this test when rashes are detected on the body, and therefore in practice doctors use this test very rarely - rather in combination with other tests and to confirm them.

Doctors include the following in this group of tests:

Indirect techniques

If we talk about indirect laboratory methods, the diagnostic method is the basis for identifying pathogenic microflora in biomaterial.

Indirect methods for diagnosing the causative agent of syphilis can be divided into the following subgroups - non-treponemal and treponemal testing:

Symptoms of syphilis

When the bacterium that causes syphilis enters the body, treponema pallidum in its stage of development goes through, first of all, an incubation period. The duration of this period of latent, incubation period is from 1 week to one and a half months.

At this stage of the pathological process in the body, the patient does not know about his infection, since the disease, syphilis, does not manifest itself with characteristic and inherent symptoms.

As doctors note, even many tests are not able to detect pathogenic bacteria in biological material taken for laboratory testing. The very first and characteristic symptoms of syphilis will manifest themselves only after this latent period.

The characteristic symptoms of syphilis show themselves in the form of a hard, spherical chancre, multiple in number and the presence of a specific rash on the skin.

Rashes on the mucous membranes and baldness also show themselves - so-called cutaneous syphilides in the patient.

Signs of syphilis in women

After the incubation period has passed, most often it lasts 3-4 weeks after infection - a hard and characteristic spherical compaction, a chancre, forms at the site of infection.

It is its appearance on the skin that gives the very first indication of the primary course of the disease - in this way the immune system reacts to the penetration of treponema pallidum into the body, its development and reproduction.

Most often, doctors diagnose a solid tumor in the oral cavity and in the area of ​​the external genitalia, internal genital organs and anus.

A chancre is a hard compaction, an inflammatory growth of origin, which has a round shape and a flat base.

Signs of syphilis in men

The very first and characteristic of syphilis in men is the formation of a dense, round chancre at the site of penetration of the pathogenic microorganism.

Most often it forms on the penis - its head and in the base area, somewhat less often it shows itself in the area of ​​the scrotum and anus.

But many symptoms and their manifestation depend on the stage of the pathological process.

Stages of syphilis

Let us take a more detailed look at the symptoms of the disease without dividing patients by gender, taking into account the stages of syphilis.

Primary stage

During the initial stage of syphilis infection:

• Painless and characteristic lumps and ulcerative growths may appear on the body. They appear after 3-4 weeks, however, depending on the level of the body’s defenses and immunity, this period can vary from a week to 3 months. As noted earlier, in men there are similar ball-shaped seals in the scrotum area, on the head of the penis, in women - in the genital area and the internal mucous membrane of the uterus and vagina. At the very beginning, such chancres are painless when pressed, but depending on the degree of development and spread of the infection, they are painful.
• The next symptom indicating the course of syphilis will be compaction and an increase in the size of the lymph nodes. Most often, those lymph nodes that are located closest to the formed chancre become inflamed, at the point of penetration of pathogenic microflora into the body.
• Gradually, the chancre increases in size and acquires a reddish or bluish color.- as during the course of the inflammatory process. After a certain time, they can go away, disappearing, leaving a scar. But you should not get your hopes up - this does not indicate that the disease has passed.

Secondary stage

Signs of secondary syphilis appear 1-3 months after the first chancre appears on the body. In addition, other symptoms of syphilis also show themselves - most often doctors call syphilitic rashes such a characteristic symptom.

The characteristic rash appears as reddish-brown and small pimples, flat in shape, at least 2 cm in circumference. Along with the rash, ulcerative neoplasms also appear on the body - filled with pus and most often localized on the mucous membrane, plus wet ulcers that look like warts.

It is enough to note that in a patient with dark skin, ulcers and wart-like rashes may not be reddish, but lighter in color, lighter even than their own skin.

As the pathology progresses, such rashes can go away on their own in 1-3 weeks and not leave scars, the only thing is to provoke excessive pigmentation at the site of their formation. However, the fact that the rash has gone away will not indicate that the patient has been cured.

As the infection spreads throughout the body, the patient will experience the following symptoms:

1. Body temperature will vary between 37.5-38 degrees and not exceed this barrier, but also not fall below.
2. Shows himself and sore throat like a cold, general weakness and feeling of discomfort.
3. The patient will suddenly lose weight for no apparent reason. and uneven hair loss, especially on the eyebrows and eyelashes, and scalp.
4. Enlargement and swelling of the lymph nodes.
5. Nervous system disorders also show themselves as a result of the action of pathogenic microflora - headache and problems with vision, hearing, excessive irritability and manifestation of paralysis, behavior inappropriate to external and internal stimuli.

Latent (hidden) stage

Doctors conditionally divide the latent form of syphilis into early and late - this division into groups is quite arbitrary, since in practice there may be cases and clinical manifestations of the disease that cannot be classified into one group or another.

Groups:

In the absence of appropriate and timely treatment, the disease will necessarily progress and pass into a latent stage in its symptoms.

As doctors note, this latent stage occurs a year after the alleged infection, after acne, rashes, and chancre have disappeared from the body.

The stage itself can last quite a long period of time - it all depends on the state of immunity and can vary from a year to 20 years.

It is possible to diagnose the course of syphilis at this stage only on the basis of an analysis, a laboratory blood test and a history of symptoms, or after a woman has given birth to a child with a congenital rather than acquired form of infection.

At this stage, a patient infected with syphilis also poses a potential threat to his environment, since he can transmit a dangerous infection.

Regarding the relapse of the pathological process - during the latent, latent stage of syphilis in 25-30% of patients, it can manifest itself with negative symptoms or without them. As doctors note, relapses can occur several times.

Late stage

It is the late stage of syphilis that is the most dangerous and destructive, and in the absence of timely and prompt, and most importantly correct treatment at the very beginning, the third stage of the pathology occurs after a year from the moment of infection or at another point throughout his life.

At this stage, under the influence of pathogenic microflora, serious and irreversible destructive processes develop in the body, affecting the cardiovascular system, vision and hearing, as well as the nervous system, failure of internal organs, even death.

With regard to the characteristic symptoms inherent in the 3rd stage of syphilis, doctors call the following:

1. The appearance of gummas and large-diameter ulcers, both on the surface of the skin and inside the body, forming subcutaneous neoplasms and compactions.
2. Cardiovascular syphilis develops, affecting the heart muscle and blood vessels.
3. Development of neuro-syphilis– in this case, the infection affects the gray matter of the brain, its membrane.

This is not a complete list of symptoms characteristic of the third stage of syphilis.

Treatment of syphilis

1. First you need to get tested for syphilis. Until the preliminary diagnosis of syphilis is confirmed or refuted by the results of laboratory tests, the patient should not take any pills or antibiotics. This can distort the course of symptoms characteristic of syphilis, the clinical picture and test results will be negative - the pathology will not be detected, time will be lost and, as a result, irreversible processes and death.
2. Currently, syphilis can be successfully treated with a course of antibiotics.– both inpatient and outpatient treatment is allowed. Treatment is carried out under the supervision of a physician, and the effectiveness of the chosen course of therapy is monitored by the results of regularly taken tests. The patient undergoes tests both during the course of treatment and after - the testing interval is 3, 6 and 12 months.
3. Duration of treatment– taking into account the stage of the pathology, it ranges from 1 to 3 months for the primary form of the pathology and about 2 years to treat for the secondary form of the pathological process.
4. While treatment is ongoing, any sexual relations should be excluded., full prevention is carried out with relatives and sexual partners, in order to avoid and prevent the spread of syphilis.
5. During treatment– the patient must have his own dishes and linen, hygiene products, and minimize contact with healthy people.

Antibiotics

The most effective course of treatment for syphilis is the prescription of certain antibiotics from a number of drug groups:

1. Penicillins and fluoroquinolones.
2. Macrolides and teracyclines.

The main drugs are penicillin antibiotics, and if they are ineffective or there is an allergy to these medications, others are selected, taking into account the individual characteristics of the body.

Additional drugs

The course of treatment includes the use of, in addition to the course of antibiotics, the following drugs:

During treatment, any sexual contact and alcohol intake are excluded, and treatment of the disease in a pregnant woman is carried out until the 32nd week of pregnancy and continues after the birth of the child.

As necessary, local treatment of skin rashes and ulcerative neoplasms is carried out, and if necessary, dead tissue is removed. They also treat all complications that are caused by syphilis, restoring the functioning of the central nervous system and cardiovascular system, gastrointestinal tract and bone tissue, joints.

Prevention of syphilis

Compliance by each person with basic personal safety standards will allow, if not eliminate, then minimize the risk of contracting syphilis:

1. Using a condom as a means of protection during any sexual contact, as well as the use of local antiseptic solutions to treat not only the oral cavity, but also the genitals, rectum after oral, anal or vaginal intercourse.
2. If sex was unprotected - Within a few hours, contact a gynecologist and undergo a course of preventive treatment.
3. If a mother who is infected gives birth to a healthy baby– practice artificial feeding.
4. Use exclusively your own items and personal hygiene products.
5. For any injection, use disposable syringes.
6. Compliance with all personal safety rules by persons at risk and timely examination by a gynecologist, testing for STDs.

As you can see, the rules are simple, but they are the ones that will help maintain your health and the health of those close to you.

Syphilis is the most common infectious disease, which is transmitted primarily through sexual contact and is prone to a chronic and progressive (increasing number of symptoms) course. The cause of syphilis and its causative agent is Treponema pallidum. The disease is characterized by damage to individual organs and systems (nervous, lymphoid systems). You can learn about how syphilis is transmitted and how it manifests itself in our article.

In contact with

Features of the pathogen

Treponema pallidum is a thin spiral-shaped microorganism. Due to its ability to absorb dyes, it received the prefix “pale”. It is difficult to detect with a simple light microscope due to its negligible diameter. Therefore, to identify treponema, a dark-field microscope examination of a specimen that has not been subjected to fixatives is used. The drug is made from the serous secretions of primary syphiloma.

Sexual transmission

The route of transmission of Treponema pallidum is only anthroponotic (that is, one person to another), the source of infection is a patient with syphilis of the primary and secondary period.

Patients with syphilis are the most dangerous in the first 1.5-2 years disease, after - the likelihood of infection decreases.

Sexual tract infection The most common, refers to the direct contact method of infection (in 98% of cases).

Infection occurs during sexual intercourse (vaginal, oral, anal) without the use of contraceptives. Biological fluids (such as semen, menstrual blood) are sources of Treponema pallidum.

Is syphilis transmitted through saliva, touch, kiss or blood?

There is also a known type of disease called household syphilis. In everyday life, small children can be exposed to this method of infection if their parents have an active form of syphilis.

There is an indirect route of infection with syphilis through objects that have been in contact with biological material and contain pathogenic microorganisms.

Such items can be toothbrushes, household items (spoons, forks, dishes), hygiene items (razors) that came into contact with the oral mucosa, and towels. In this case, family members and people from closed groups are at risk of infection.

When carelessly processing instruments on which biological material is preserved (rectal and uterine mirrors, burs and endo-instruments in dentistry), in medical and cosmetology institutions there is also a risk of infection with Treponema pallidum.

How can you become infected with syphilis:

Healthcare workers can become infected while working with infected patients if they ignore protective rules.

The risk group includes the following specialists:

• Venereologists;
• Surgeons (if the patient’s blood comes into contact with the unprotected damaged skin of the doctor during a surgical operation);
• Dentists (possible infection through dental instruments that were in contact with an infected patient, as well as when working without gloves with contaminated oral mucosa and blood);
• Obstetricians-gynecologists (infection during the delivery of an infected woman through blood, birth secretions, and also from the blood of the child).

Although venereologists encounter patients with syphilis during the most active periods of the disease, they are extremely rarely exposed to infection. This is due to several reasons:

1. Doctors know what diseases they are dealing with and what consequences they face;
2. They always work with rubber gloves, or carry out their manipulations through cotton wool; take care of the skin of your hands, preventing it from being injured;
3. Disinfectants (70° alcohol or carbolic acid) are always available, which can be used to disinfect the affected area if infection is suspected.

Prevention of syphilis is simple and does not require much effort:

• Compliance with generally accepted hygiene standards (use only your personal hygiene items and separate utensils);
• During sexual intercourse, refuse casual sexual contacts;
• If there was a fact of intimate intimacy with a stranger, it is necessary after some time (during the incubation period there are no manifestations of syphilis) to consult a venereologist for consultation, examination and subsequent treatment;
• Regularly visit a venereologist for preventive examinations, both yourself and with your sexual partner, in order to exclude infections with sexual diseases, including syphilis;
• Do not treat syphilis on your own or with folk remedies. Such actions will make it difficult to diagnose syphilis and will lead to questionable tests in the future;
• Before a planned pregnancy, it is advisable to undergo an examination for the presence of sexual diseases, and during pregnancy to conduct a serological test in order to protect the child from congenital syphilis;
• Provide additional treatment for syphilis during pregnancy in women who have had this disease and have been removed from medical registration;
• Limit close communication and contact with people with syphilis.

Avoiding casual sex and early contact with a specialist will help you protect yourself and your family from Treponema pallidum.

Content

The dangerous disease household syphilis is characterized by a long incubation period and specific symptoms. Infection with it occurs due to poor personal hygiene, when people use other people's toothbrushes, drink from mugs other than their own, and smoke the same cigarette with friends. It is worth learning the characteristic signs of the disease and possible diagnostic and treatment options.

What is household syphilis

Sexual syphilis and domestic syphilis are the same disease, differing in the method of transmission. In medical terminology, this disease is understood as a chronic infectious venereal disease that affects all human organs and tissues and progresses very quickly. Through close household contact, you can become infected with syphilis, which has similar symptoms to sexual syphilis.

Is syphilis transmitted through household contact?

People mistakenly believe that it is difficult to become infected with syphilis, but this is not true. Through blood transfusion taken from a patient, ordinary contact such as a handshake or a kiss, you can easily get this disease without even knowing the risk. Doctors, having discovered symptoms in a patient, check not only his sexual partners, but also family members. Often the disease is detected in close relatives at the same time.

How is it transmitted?

The modes of transmission of syphilis are domestic and sexual. Rapid infection is possible through objects contaminated with syphilitic elements of the skin and mucous membranes, because the causative agent of the disease remains active for a long time in a humid environment. You can become infected through bites, kisses, dishes, cigarettes, towels, and underwear. The most dangerous are the first two stages of the disease, when the patient has ulcers and erosions in the oral cavity, which will be a source of infection.

The contagiousness of the urine and sweat of a patient with syphilis has not yet been proven, but there is a possibility of infecting a child through the milk of a nursing mother. Doctors, if they do not use gloves, risk when carrying out medical procedures and coming into contact with the patient’s internal organs during surgery. There is also a transfusion method of transmission - through blood transfusion.

What is the causative agent of the disease?

Syphilis is caused by Treponema pallidum, a gram-negative spirochete that looks like a spiral. It is not very resistant to external influences - it disappears after household items dry out, but it persists for a long time in a humid environment. Treponema pallidum activates at a temperature of 40-42 degrees, then dies; at 55 degrees it dies in 15 minutes. Low temperature does not have a detrimental effect on the microorganism - during 9 years of experimental storage at minus 70 degrees, its activity did not disappear. Treponema is sensitive to chemicals.

How to recognize

Infection with domestic syphilis is similar to genital syphilis - the patient feels tired, aching joints, and his temperature rises. The disease weakens the immune system, so other diseases occur in parallel. You shouldn’t see a doctor if these are the only signs you notice, but you should regularly undergo examinations, medical examinations and donate blood.

Symptoms

In accordance with the stages of development, the symptoms of household syphilis also differ. The incubation period lasts 3-4 weeks, during which the disease is asymptomatic. Only at the primary and secondary stages do destructive signs begin, which by the third stage become very noticeable and cannot be ignored. In the first two stages, the disease can actually be cured, but advanced cases cannot.

The primary stage of household syphilis

Signs of household syphilis at the primary stage begin with the appearance of a small spot of reddish color at the site of introduction of treponema pallidum into the body. After a few days, a hard round chancre appears in this place - an ulcer with hard edges several millimeters in diameter that does not hurt. All lymph nodes gradually enlarge. Chancre appears on the lips, tongue, tonsils, and gums, while with sexual syphilis, its location is the genitals.

Rarely, chancre can appear on the chin, mucous membrane of the eyelid, eyeball, nipples of the mammary glands, and fingers. Asymptomatic initial cases occur. The duration of the period is 6-7 weeks. Additional signs of the disease are general malaise, headaches, bone pain, insomnia, and anemia. The transition to the second stage is characterized by weakness, fatigue, rare pain in muscles and joints, insomnia, and appetite disturbances.

Secondary period

As the infection and virus spread throughout the body, secondary syphilis begins, which without treatment can last up to four years, accompanied by several relapses. At this stage, rashes of various shapes, sizes, and colors appear on the skin or mucous membranes. They can often be found in areas subject to friction.

Without treatment, the rashes grow powerfully, forming lesions and abrasions with oozing tissue fluid. During the secondary period, whitish spots appear on the neck - evidence of damage to the nervous system. In addition, blood vessels, heart, eyes, ears, joints, bones, internal organs, bones become infected, and hair falls out. Spots and papules are prone to spontaneous disappearance or reappearance.

Tertiary syphilis

After the secondary period, the tertiary period begins, characterized by a rash on the skin and mucous membranes. Tubercles appear, and gummas containing the causative agent of the disease appear in the subcutaneous tissue, bones and internal organs. They are dense formations in the shape of a ball, in appearance resembling nodes the size of a hazelnut kernel. The formations develop into scars and ulcers, tissue damage is irreversible. The period lasts for decades. If gummas affect the face, the skeleton is destroyed - the patient’s nose collapses, as in the photo, and disfiguring deformities appear.

Household syphilis in children

Young children - between the ages of six months and one and a half years - are susceptible to infection with household syphilis. A hard chancre appears on the child’s body, which is localized in areas on the head, forehead, lips, mouth and tonsils. A nursing mother or another relative can infect a baby through kisses, dishes, or bedding.

How can household syphilis affect pregnancy?

A woman infected with syphilis experiences hormonal imbalance during pregnancy. This leads to the risk of miscarriage or premature birth, and anemia occurs. In most cases, a child is born infected - infection occurs through the blood and placenta. Secondary syphilis of the expectant mother is dangerous for children. At this stage, there is the greatest chance of miscarriage or stillbirth. The tertiary period allows you to carry and give birth to a healthy child even in the absence of therapy.

If treatment was carried out before the 16th week of pregnancy, the chances of having a healthy baby are greatly increased. Congenital syphilis is also considered domestic - infection occurs in the womb during 28-32 weeks of pregnancy. If the child survives and is born, he suffers from signs of the disease. In children, extensive rashes and wounds on the skin, damage to the heart, eyes, liver, and dropsy are found. Children suffer from diseases of the bones, joints, brain, deformation of the teeth, skull, nose, and later lag behind in development, mental characteristics, and gain weight poorly.

During pregnancy, syphilis can be diagnosed by taking a blood test - the Wasserman reaction. Later, treponemal methods are used to double-check the positive result. A CT scan is performed, smears are taken, and antibiotic treatment is prescribed. The fetus can be protected from congenital disease if you start taking medications at 20 weeks of pregnancy.

Diagnostics

To identify syphilis, you need to contact a venereologist or dermatovenerologist. After the examination, a blood test for RW is performed. If a positive reaction is detected, additional studies are carried out. The immunofluorescence reaction (RIF), Treponema pallidum immobilization reaction (TPI) and treponemal antigen (TPNA) are used. In special cases, computed tomography is performed to identify damage to the central nervous system. Swabs are taken from the skin rash to check for the presence of Treponema pallidum. At the first two stages, PCR diagnostics are carried out.

Treatment

For domestic syphilis, outpatient treatment and home quarantine are prescribed. Individual treatment is prescribed for each patient, combining specific and nonspecific therapy. This will help only in the first two stages of the disease; in the tertiary stage, damage to tissues and organs is irreversible. Here are some popular drugs to get rid of the disease:

1. Antibiotics - penicillin groups (Oxacillin, Ampicillin, Benzylpenicillin, Carbenicillin) quickly penetrate into the blood and are excreted. Prescribed use every three hours in the form of tablets or injections. Bicillin, Erythromycin, Oletetrin or Tetracycline may be prescribed in combination with antihistamines. The course lasts two weeks for the primary period and a month for the secondary period.
2. Preparations with bismuth - contain a heavy metal that fights the spiral microorganism and has an anti-inflammatory effect. Biyoquinol - a suspension of bismuth salts in peach oil destroys bacteria, but has many contraindications. It should not be used by infants, people with heart and vascular diseases, tuberculosis, or stomatitis. Injections are prescribed once every three days, one ampoule, and can be used for late and recurrent syphilis. For individual intolerance to quinine, liver and kidney diseases, Bismoverol is used.
3. Immunostimulants – strengthen the body’s protective functions, relieve inflammation. These include Pyrogenal, Peat, preparations with aloe.
4. Vitamins – to support the immune system, it is recommended to drink vitamins B, C, A, E.

Prevention

To prevent the occurrence of household syphilis, it is worth remembering the following points, which will be good prevention:

• compliance with personal hygiene rules;
• use of individual underwear, towel, toothbrush, razor;
• washing dishes with hot water.

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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Syphilis infection begins when Treponema pallidum enters the human body. Neither the skin, at first glance, is healthy, nor the mucous membranes are a serious obstacle to the pale spirochete, which can enter the body through the smallest irregularities in the skin, invisible to humans. The main routes of infection with syphilis: sexual, household, blood transfusion, occupational and transplacental.

Sexual tract

Syphilis infection occurs through any unprotected sexual contact with a sick person. The risk of infection is very high.

The causative agents of syphilis multiply in all liquid substances of the body, including in semen in men and in vaginal secretions in women. Therefore, venereologists never tire of warning that even with one single sexual contact with a person with syphilis, the risk of infecting his partner is at least 45%. Moreover, this does not depend either on the stage of development of syphilis in the patient, or on the characteristics of its course, since syphilis is extremely contagious at any stage, including latent.

Often, syphilis is transmitted not only through “traditional” sexual intercourse, but also through oral or anal contact, and the risk of infection in this case is no less, and sometimes even greater. This is due to the fact that during oral contact, partners are less likely than during genital contact to think about the need for protection.

Venereologists, on the contrary, believe that during oral contact, the use of barrier contraception, for example, a condom, is absolutely necessary, especially if the partner is new.

As for anal contacts, their danger is also obvious. Cracks in the rectum occur more often than in the vaginal mucosa. It is no coincidence that the proportion of homosexual men among patients with syphilis reaches almost 60% of the total number of infected.

Household way

It is less common, but it is not at all excluded in families where one partner has syphilis, and the second does not know about it or does not attach due importance to it. Syphilis is transmitted from one partner to another through saliva during a kiss, through any shared object (spoon, cup, toothbrush, lipstick, cigarette, etc.) on which there is dry discharge containing pale treponema.

Syphilis that arises in this way is called household syphilis. It is quite rare, since pale spirochetes outside the body do not live long. In order to avoid infection with household syphilis, you just need to follow basic hygiene standards, for example, not use one toothbrush and thoroughly wash dishes with hot water after use.

Hematotransfusion route (through blood)

The blood transfusion route of infection with syphilis is relevant when transfusing the blood of a sick person to another person (unfortunately, such cases do occur, although this is most likely an exception to the rule - the donor must certainly be tested for sexually transmitted diseases).

Infection through blood is more likely when using a single injection syringe. That is why drug addicts, like homosexuals, are at particular risk of contracting syphilis.

Professional path

This is, unfortunately, the lot of doctors and medical staff.

It is possible to become infected with syphilis through anything that a sick person’s body secretes, including saliva, semen, vaginal secretions, blood, and so on. Doctors have to deal with all these contaminated substances.

Among the possible ways of transmitting syphilis, infection during surgery is quite common - when the surgeon’s hands are wounded and the patient’s blood gets into the wound.

Cases of pathologists becoming infected when their hands were injured while working with a patient's corpse have been described.

It is possible for a dentist who has microtraumas on his hands to become infected with syphilis through contact with infectious manifestations of syphilis on the oral mucosa and with the patient’s blood. In addition, a dentist can become infected not only through direct contact with a person with syphilis, but also through instruments that come into contact with his mucous membranes.

Midwives and gynecologists can become infected with syphilis when delivering a baby to a woman with syphilis; in this case, not only the blood and secretions of the woman in labor are dangerous, but also the blood of the child.

However, the professional route of infection with syphilis is quite rare, since doctors in specialties associated with the risk of contracting syphilis take certain precautions (sterilization of instruments, rubber gloves, etc.), and, as a rule, this is enough.

If the possibility of infection does occur, it is necessary to contact a venereologist, who may recommend preventive treatment with penicillin drugs.

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Transplacental route

This is the transmission of syphilis from mother to child during pregnancy through the placenta.

The disease that arises in this way is called congenital syphilis by venereologists.

A fetus affected by congenital syphilis often dies in the womb or is born dead. If the child remains alive, then congenital syphilis can manifest itself as disturbances in the functioning of all body systems.

In addition to the transplacental method of infection with syphilis, the disease can be transmitted when a child passes through the birth canal during childbirth or during breastfeeding.

In order to prevent the child from contracting syphilis, a sick woman usually undergoes a caesarean section, and after birth the baby is immediately prescribed artificial nutrition.

From all that has been said, we can draw the following conclusion: the risk of contracting syphilis is the sexual partners of people with syphilis during unprotected sexual intercourse, children of mothers with syphilis, and representatives of non-traditional sexual orientation.

The maximum risk group includes drug addicts, prostitutes, and people who change sexual partners frequently and randomly.

You can always get tested for any mode of transmission of syphilis and be tested for other sexually transmitted infections at our Euromedprestige medical center. Our venereologists are always ready to help you and prevent sexually transmitted diseases.

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The disease syphilis has been known to mankind since the 15th century, and until a certain time, namely the era of the discovery of antibiotics, this disease was a severe and disabling pathology that significantly shortened human life.

However, today the active use of antibiotics in the treatment of other diseases in some cases contributes to blurring the clinical picture and the development of latent syphilis in the population.

Modern syphilis is widespread. The main age group is young people 15-40 years old with a peak incidence at 20-29 years of age. The risk of infection is higher in women (microtraumas of the vagina contribute to infection), but today the increase in the number of homosexuals leads to more frequently reported cases of syphilis in men.

Syphilis is the third most common sexually transmitted infection, killing about 12 million people every year. However, these statistics do not reflect the real picture, since some of the sick are treated independently, hidden, or do not contact doctors at all. And many people think about how infection with this sexually transmitted disease can occur other than through sexual intercourse, is syphilis transmitted through everyday contact, through saliva, through kissing, is it transmitted to a child? This is what our article is about.

How long after infection do symptoms appear?

The incubation period, calculated from the moment Treponema pallidum enters the body until the formation of chancre, averages 3-4 weeks (see details about). The following latent phase options are possible:

• shortening to 8-15 days with simultaneous infection from several sources
• extension to 100-190 days while taking antibiotics for the treatment of another pathology

That is, after infection, a person does not feel any symptoms for at least 2-6 weeks, which, with a large number of sexual partners, makes it difficult to determine the source of infection.

How is syphilis transmitted?

Knowing how syphilis is transmitted, you can easily protect yourself and your loved ones from this unpleasant disease.

• Infection with syphilis through sexual contact

Sexual intercourse, which occurs during unprotected sexual intercourse without the use of barrier contraception, is the main one in the epidemiology of the disease, as a result of which syphilis belongs to the group of STIs. Sperm and vaginal discharge are an excellent environment for the life of Treponema pallidum, and even a single sexual intercourse (with vaginal, anal or oral penetration) with a sick person is characterized by a 50% risk of infecting the second partner.

Any type of sexual intercourse is equally dangerous, but anal penetration is characterized by the greatest risk of infection, since trauma to the rectal mucosa is likely. If we consider sexual intercourse with vaginal penetration, a woman has an increased risk of contracting syphilis than a man, and this is explained by the ease of trauma to the vaginal mucosa during sexual relations.

An insidious feature of syphilis is the contagiousness of a sick person at any stage of the disease. Not knowing about his illness, during the incubation period, a sick person can involve more and more new partners in the vicious circle of the disease by engaging in sexual relations.

• Infection with syphilis through saliva

Syphilis is transmitted through the saliva of a sick person if the rash is located in the mouth or on the lips - only in this case is treponema pallidum detected in the saliva. Such patients pose a risk of infection during deep kissing, when the oral cavities are in direct contact with each other.

According to statistics, syphilis is transmitted through a kiss, through saliva very rarely, since syphilitic rashes on the mucous membranes of the mouth and lips are quite rare. In addition, a healthy person must have microtraumas of the oral mucosa so that the causative agent of syphilis can penetrate the bloodstream.

• Infection through breast milk

Treponema is found in the breast milk of a sick woman, so she can infect her baby through breastfeeding. Because infants, especially newborns, have an impaired immune system, they are at increased risk of contracting syphilis.

• Infection with syphilis through blood

Since the causative agent of syphilis is present in the blood, transfusion of infected blood or organ transplantation of a sick person will lead to infection with this pathology. However, this route of transmission of syphilis can be realized with a very low probability, since both blood and transplanted organs are carefully checked for the presence of various infections, including syphilis.

A more likely route of infection with syphilis through the blood is the use of one syringe among a group of drug addicts or one container for preparing a solution of a narcotic drug. If the mucous membranes and skin are damaged, for example, during a fight, you can also become infected with syphilis from a sick person.

From the very first day of infection to the last day of illness, the blood of a patient with syphilis is contagious. This means that not only through a blood transfusion is infection possible, but also when the mucous membrane or skin is injured by medical instruments, instruments in manicure and pedicure salons (without treatment), which have been exposed to the blood of a patient with syphilis, it can lead to infection of a healthy person. Any external manifestations of syphilis (papules, ulcers, erosions) with scanty discharge from the patient are very contagious; the presence of microcracks in the skin of a healthy person in contact with the skin of such a patient leads to infection with syphilis through everyday contact (contact).

• Infection during professional activities

This route of transmission of syphilis occurs among persons in certain professions: medical personnel, cosmetologists and other persons whose activities involve invasive procedures and contact with saliva, vaginal secretions, and blood of infected people. Among physicians, infection most likely occurs through accidental injuries from instruments that were used on a patient suffering from syphilis. Cosmetologists can become infected through personal use of instruments that have not been disinfected, which were used during procedures on a person with syphilis.

A prerequisite for transmission is a violation of the integrity of the skin of a healthy person. Simply touching infected blood to intact skin does not lead to syphilis infection.

• Infection with syphilis through domestic means

Many people are interested in whether syphilis is transmitted through household means - after all, someone has to live next to a sick person. Transmission of syphilis through household items (towels, cutlery, dishes, linen, cigarettes, personal hygiene items) is likely through close and prolonged contact with a sick person, moreover, in the terminal stages of the disease, when the pathogen is actively released into the external environment (decaying gums, ulcers ). When treponema dries, it loses its pathogenicity, so transmission of syphilis is possible only with particles of saliva or other liquid on objects.

• Infection is transplacental

This path is realized during the pregnancy of a sick woman - syphilis is transmitted from mother to fetus. To the question of whether syphilis is transmitted to a child in utero from a mother who is not receiving treatment, the answer can be unequivocally yes. First, treponema infects the placenta, and, having destroyed the protective placental barrier, easily penetrates the tissues and organs of the fetus through the umbilical vein or lymphatic system. A woman is especially contagious in the first three years of the disease, but in the future the likelihood of infection of the fetus remains.

• Infection with syphilis during childbirth

Since the pathogen is present in the vaginal environment, and the birth process itself is accompanied by contact of the mother’s blood with the fetus, this route of transmission is easily realized. If a child managed to avoid intrauterine infection with syphilis, then during natural childbirth it is almost impossible to prevent this. In this case, a caesarean section is performed, during which the risk of infection of the child is significantly reduced.

How to avoid getting infected with syphilis?

Compliance with basic personal safety rules will help avoid this unpleasant and shameful disease. Knowing how syphilis is transmitted, it is easy to protect yourself from all possible situations in which the likelihood of infection is high.

• Use a condom for all types of sexual relations.
• The use of local antiseptics for treating the genitals, oral cavity, and rectum after sexual intercourse (Chlorhexidine). This measure is justified both during protected and unprotected sexual intercourse - in the second case, there is no complete guarantee that infection will not occur, but the likelihood of this is significantly reduced.
• Contact a venereologist within 2 hours after unprotected sexual intercourse to prescribe preventive treatment (antibacterial therapy from the choice group).
• Artificial feeding of children born to mothers with syphilis.
• Strictly individual use of personal hygiene and body care products.
• Use of disposable syringes for any type of injection (intravenous, intramuscular, subcutaneous, etc.).
• Strict adherence to professional safety rules for persons at risk.
• Mandatory treatment for a pregnant woman if she is diagnosed with syphilis.
• Timely, regular preventive screening for STIs.

How are blood tests for syphilis evaluated?

Diagnosing syphilis, especially latent syphilis, is a rather difficult task for doctors, since test results can be like:

• at the stage of the incubation period - negative
• and false positive - sometimes such results can be due to previous malaria or against the background of chronic tonsillitis, pyelonephritis, sinusitis, chronic hepatitis, pulmonary tuberculosis, cancer, pregnancy, antiphospholipid syndrome. Therefore, tests should be repeated after stopping chronic foci of infection and treating somatic diseases.
• when undergoing antibiotic therapy for other diseases, the results of reagin titers may not be high.

In world practice, to establish the diagnosis of syphilis (terponemal) and assess cure (non-terponemal), the following tests are used:

• non-treponemal test - RPR / VDRL, a decrease in these titers by 4 times within 1 year after treatment is considered a criterion for cure
• treponemal tests - passive hemoagglutination reaction (RPHA - TPHA)
• treponemal tests - immunofluorescence reaction (RIF-FTA)

Treponemal tests are used only to establish the diagnosis of syphilis, but not to monitor cure. To establish a diagnosis in Russia, the Waserman reaction (compliment binding reaction) is also used, as well as RIBT - the immobilization reaction of Treponema pallidum. The RPR test is usually supplemented by RIBT, PCR, and RIF analyses.

Result evaluation	RPR/VDRL	REEF	RPGA
or incubation period or early stage or no syphilis	-	-	-
or you have syphilis and it’s untreated or recently treated syphilis	+	+	+
or false positive result of RIF and RPR or primary syphilis	+	+	-
or false negative RIF or false positive RPR and RPGA	+	-	+
or late untreated syphilis or treated syphilis	-	+	+
biological false positive reaction	+	-	-
or false positive. RIF analysis or recently treated syphilis or early primary syphilis	-	+	-
or false positive RPGA or treated syphilis	-	-	+

After infection at the end of the incubation period the following may be positive:

• 1-2 weeks after the onset of chancre (that is, 4-5 weeks from infection), nonspecific antibodies may be positive
• IgG to treponemal antigens becomes + 4 weeks after the onset of syphilis
• specific anti-treponemal IgM antibodies may appear at 2 weeks of illness
• when symptoms appear, blood tests for syphilis may show positive total antibodies IgM + IgG

During the entire course of treatment, test results may change; with adequate therapy, IgM titers in blood tests quickly decrease, but IgG titers remain in the blood for a very long time, sometimes until the end of the patient’s life.

weeks	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15
incubation period				chancre							primary roseola
						enlarged lymph nodes					polyadenitis
						Reagins (IgM + IgG) positive. MR (RPR/VDRL)
			Antitreponemal IgM + Ig M - ELISA/IgM -immunoblotting
					Antitreponemal IgG + ELISA, RPGA, RIF
												+ RIBT

For mass screening of the population, inexpensive, simple and very fast test systems are used - non-treponemal tests. The following categories of citizens are subject to mandatory examination:

• Military personnel
• Pregnant women
• Those serving sentences in prison
• Before any surgical intervention and upon admission to hospital treatment
• Organ donors and blood donors
• Professional examinations of workers in the field of education, medicine, food workers