Syphilis can also occur in a latent form.
This variant of the course of the disease is called latent syphilis. Latent syphilis from the moment of infection takes a latent course, is asymptomatic, but blood tests for syphilis are positive.
In venereological practice, it is customary to distinguish between early and late latent syphilis: if the patient became infected with syphilis less than 2 years ago, they speak of early latent syphilis, and if more than 2 years ago, then late.
If it is impossible to determine the type of latent syphilis, the venereologist makes a preliminary diagnosis of latent, unspecified syphilis, and the diagnosis can be clarified during the examination and treatment.
Ordinary syphilis develops when pale treponemas, the causative agents of this disease, enter the human body. During their activity, the patient develops symptoms of syphilis: rash, bumps, gummas, and so on.
At the same time, the patient's immunity does not stand aside: as with any infection, it secretes antibodies (protective proteins), and also sends cells of the immune system to the breeding sites of bacteria.
Thanks to these measures, the majority of pale treponemas die. However, the most tenacious bacteria remain, which change their shape so that the immune system no longer recognizes them.
In the cystic form, pale treponema cannot be active, but it can multiply
This type of "masked" pale treponema is called cystic forms or L-forms. In this form, pale treponema cannot be active, but it can multiply.
As a result, when the immune system "loses its vigilance", secretly bred bacteria enter the bloodstream and harm the body again.
The same thing happens with improper treatment of syphilis. If the antibiotic is chosen incorrectly or in the wrong dose, not all pale treponemas die - the survivors are masked and remain invisible until better times.
False-negative (false-negative) results occur at high antibody concentrations, which inhibit agglutination (the prozone effect), which can be avoided with serial dilutions
serum.
The average rate of false-negative non-treponemal tests (VDRL) in secondary syphilis is about 1%. False-negative results of non-treponemal tests must be distinguished from negative non-treponemal tests at various periods of the course of syphilis, when the body has not yet developed antibodies or when the amount of antibodies is significantly reduced due to a decrease in the amount of lipid antigen.
The frequency of negative non-treponemal tests in different periods of syphilis
Bacteriology
Treponema pallidum subsp. pallidum is a spiral-shaped, Gram-negative, highly mobile bacterium. Three other human diseases that are caused by Treponema pallidum include yaws (subsp. pertenue), pinta (subsp. carateum), and bejel (subsp. endemicum).
Unlike the subspecies pallidum, they do not cause neurological disease. Man is the only known natural reservoir for the subspecies pallidum.
It cannot survive without a host for more than a few days. This is because its small genome (1.14 MDa) is unable to code for the metabolic pathways that are required to make most of its macronutrients.
It has a slow doubling time of over 30 hours.
This is the name of the presence of a positive reaction to syphilis according to a serological examination in the actual absence of the disease. Find out the reasons for the body's reaction to the test in this article. It is important to distinguish false positive syphilis from seroresistant and seropositive syphilis.
Is it possible to have a positive reaction in a blood test in the absence of syphilis?
Yes, you can get a false positive if you:
diabetes;
pregnancy;
oncological diseases;
tuberculosis;
alcoholism or drug addiction;
you have recently been vaccinated.
If you receive a positive blood test for syphilis, you should immediately undergo a detailed examination by a venereologist in order to start treatment as soon as possible.
False positive nontreponemal tests
The main reasons for biological false-positive reactions are related to the fact that when conducting non-treponemal tests, antibodies to cardiolipin are determined (the main component of mitochondrial lipids, especially the heart muscle - hence the name), which appears in the body when tissues are destroyed during
some diseases and conditions.
Thus, non-treponemal tests determine the so-called reagin antibodies, which the body has developed not against the causative agent of syphilis - pale treponema, but against the consequences of a syphilitic infection.
However, reaginic antibodies are produced not only to the lipids of destroyed tissues, but also to the membrane lipids of treponema pallidum, but more than 200 antigens have been identified that are similar in composition to the lipid antigen of treponema pallidum.
False positive treponemal
tests
The causes of false positive treponemal tests are unknown. Their percentage is very low.
It is noted that false positive treponemal tests are most common in systemic lupus erythematosus and in Lyme disease (borreliosis). Since antitreponemal antibodies are produced by immunological memory cells for quite a long time, there are hypotheses about a short-term contact of the body with pale treponema, which did not lead to infection with syphilis, but caused the production of antitreponemal
antibodies.
Undoubtedly, the appearance of positive non-treponemal and treponemal tests in non-venereal trepanematoses is not considered as a false positive biological reaction, but does not confirm the presence of syphilis.
Physicians who encounter various manifestations of disease point to biological false prerequisites. The proportion of people who received a false positive test for syphilis actually had lupus.
The same group includes bejel and relapsing fever, leptospirosis, leptospira. However, having received such a conclusion, the doctor cannot immediately ascertain the presence of the disease, if there are also no external signs.
A re-examination is required. The absence of symptoms a second time and a negative result only indicates that the person received an erroneous sentence.
It remains to find an alternative disease, which so far skillfully hides and does not allow itself to be detected visually.
The state of the body at the moment can also affect the receipt of a false positive result. LPR can result from a concussion, regular menstruation, significant trauma or gout.
Technical failures are also rare, but they cause a false positive analysis for syphilis. Lab technician errors or equipment failure will result in an incorrect result.
Non-recognition of serological false-positive reactions for syphilis can have negative prognostic and social consequences. Don't just trust your intuition. The diagnosis requires confirmation or competent refutation.
Decision makers may be due to technical errors and errors in the performance of research, as well as the quality of reagents. Despite the numerous advantages of diagnosticums for RPHA, ELISA and RIF and their modifications used for the diagnosis of syphilis, in some cases, unreliable test results are noted.
This may be due to both the insufficient level of qualification and professional responsibility of the personnel (the so-called non-biological or technical errors), and the characteristics of the tested samples (biological errors).
The causative agents of endemic treponematoses (yaws, pinta, bejel) are treponemas that have genus-specific antigens similar to those of T.pallidum. In this regard, the antibodies formed against them are able to cross-react with the antigen of the causative agent of syphilis.
Biological false positive Wasserman reaction
Nontreponemal:
Treponemal:
In the initial stage, you can use the bacterioscopic method, based on the determination of the pathogen - pale treponema - under a microscope. In the future, serological tests based on the determination of microbial antigens and antibodies produced by the body in biological material are widely used.
Bacteriological research is not carried out, since the causative agent of syphilis grows very poorly on nutrient media under artificial conditions.
All methods for detecting treponema, that is, types of tests for syphilis, are divided into two large groups:
1. Direct, which directly detect the microbe itself:
2. Indirect (serological), based on the detection of antibodies to the microbe, which are produced by the body in response to infection.
Serological tests are divided into two groups
Nontreponemal:
Treponemal:
The methods of these analyzes are quite complex, so we will focus mainly on when they are carried out and how accurate information they give.
Let's say right away that the basis for diagnosing syphilis is serological methods. What is the name of the analysis for syphilis: in each case, the examination may include different methods. Below we will describe them in more detail.
False-positive reactions of treponemal and non-treponemal tests can be observed in infectious diseases, the causative agents of which have antigenic similarity with pale treponema.
These are relapsing fever, leptospirosis, tick-borne borreliosis, tropical treponematosis (yaws, bejel, pint), as well as inflammatory processes caused by saprophytic treponemes of the oral cavity and genitals.
The causative agents of endemic treponematoses (yaws, pinta, bejel) are treponemas that have genus-specific antigens similar to those of T.pallidum. In this regard, the antibodies formed against them are able to cross-react with the antigen of the causative agent of syphilis.
Russia is not a territory endemic for this group of diseases. These infections occur mainly in Africa, Latin America and South Asia, and cases are rare in the practice of medical institutions.
A patient with a positive serological test for syphilis coming from a country with endemic treponematoses should be tested for syphilis and given anti-syphilitic treatment if not previously given.
Syphilis without symptoms is a fairly common occurrence that characterizes certain stages of the course of the infectious process. Screening tests are used to diagnose the asymptomatic course of the disease.
They make it possible to detect the activity of certain antibodies in the blood.
To date, atypical clinical forms of syphilis are quite often recorded. In this case, the primary chancre may not appear, which is associated with certain changes in the properties of pale treponema.
Another factor is the individual characteristics of the human body (insufficient functional activity of the immune system).
Also, the course of the infectious process may be atypical after the implementation of other routes of infection:
Such variants of the asymptomatic course of syphilis have recently become quite widespread.
We hope you got an answer to your question can there be syphilis without symptoms. It's possible. Therefore, it is better to check with a doctor from time to time, passing tests. They will allow you to diagnose the infection even without clinical signs.
To avoid serious consequences in the case of an asymptomatic course of the disease, contact experienced venereologists.
Latent syphilis is a condition when, in the absence of clinical manifestations of the disease, positive serological reactions are detected in the patient's blood. The treatment of such patients is aimed at serological negativity (obtaining negative serological reactions) and preventing the development of relapses of the disease.
Latent (latent) syphilis occurs in patients who have had active manifestations of the disease in the past, resolved on their own or under the influence of specific treatment.
In some cases, this condition is a special form of asymptomatic syphilis from the moment the patient is infected. Significant assistance in making a diagnosis is provided by a correctly collected anamnesis (history of the disease) and a number of other indirect signs.
Rice. 1. Manifestations of the disease in women in the primary period of the disease are multiple hard chancres (photo on the left) and hard chancre in the form of indurative edema (photo on the right).
According to some authors, the number of patients with latent forms of syphilis has increased 2-5 times in the last decade. Increasingly, it becomes difficult for a doctor to determine the timing of the disease, and the patient's sexual relations are often random. The only method for detecting syphilis in such cases is serological diagnosis.
In our country, the method of active detection of patients with syphilis is used during preventive examinations in clinics and hospitals, antenatal clinics and at blood transfusion points, for which a number of treponemal tests are also used. Thanks to this work, up to 90% of patients with latent forms of the disease are detected during preventive examinations.
Reasons for the increase in the number of patients:
The possibility of asymptomatic syphilis is now recognized.
Serological reactions in latent forms of the disease are the only criterion for confirming the diagnosis.
Rice. 2. Manifestations of the disease in men in the primary period - a single hard chancre (photo on the left) and multiple hard chancres (photo on the right).
If, from the moment of infection, syphilis takes a latent (latent) course (is asymptomatic), but with positive specific serological reactions, they speak of a latent form of the disease. The latent syphilis in most cases comes to light incidentally at statement of specific serological reactions. In some cases, the doctor manages to find out what period of the disease he belongs to:
Such a division of the latent periods of the disease is not always possible, therefore, in venereological practice, it has been established to distinguish between early, late and unspecified latent periods.
Rice. 3. Manifestations of the disease in the secondary period - papular syphilis on the face and palms.
Early latent syphilis includes the period from the moment of infection until the secondary recurrent period (on average up to two years). During this period, patients may experience manifestations of the disease of a high degree of contagiousness. A number of anti-epidemic measures are being taken against them. The main ones are:
Early latent syphilis is recorded mainly in people under the age of 40 years. Most of them have no control over sexual desire. They are prone to numerous casual sexual relationships, which in an epidemic leads to the inevitable development of the disease. The absolute proof of a case of latent syphilis is the establishment of an active form of the disease in a sexual partner.
Carefully collecting an anamnesis, it is necessary to pay attention to rashes of an erosive-ulcerative nature on the genitals, lips, oral cavity, skin, episodes of hair loss on the head, eyebrows and eyelashes, the appearance of age spots on the neck over the past 2 years. It is also necessary to find out whether or not the patient took antibiotics, was treated or not for gonorrhea.
Treatment of early latent syphilis is carried out in accordance with approved instructions and is aimed at the fastest destruction of pathogens in the patient's body. With specific treatment, negative seroreactions occur quite quickly. The extinction and complete negativity of specific serological reactions in latent syphilis are the only criterion for confirming the effectiveness of the treatment.
Timely detection of patients in the period of early latent syphilis and adequate adequate treatment have a positive effect on the prognosis of the disease.
Rice. 4. Manifestations of the disease in the secondary period - syphilitic roseola.
The diagnosis of late latent syphilis is established in patients whose infection duration exceeds 2 years, there are no clinical manifestations of the disease, and positive serological reactions are recorded. Basically, such patients are detected during preventive examinations (up to 99%), including examinations for the identification of a patient with late forms of syphilis in the family (1%).
The disease is detected mainly in people older than 40 years (up to 70%). Of these, about 65% are married.
When interviewing a patient, it is necessary to find out the timing of possible infection and the presence of signs indicating manifestations of infectious syphilis in the past. Often the anamnesis remains uninformative.
Sometimes serological studies have to be repeated after a few months.
In patients with late latent syphilis, whose age ranges from 50 to 60 years, there are a number of comorbidities that cause the appearance of false positive serological reactions.
Treatment of late latent syphilis is carried out in accordance with approved instructions and is aimed at preventing the development of a specific lesion of internal organs and the nervous system. Patients should be consulted by a neurologist and therapist. During the period of specific treatment, negative seroreactions occur extremely slowly. In some cases, after a full-fledged specific treatment, serological reactions remain positive.
The extinction and complete disappearance of specific serological reactions in latent syphilis are the only criterion for confirming the effectiveness of the treatment.
Rice. 5. Manifestations of the disease in the tertiary period - gumma of the face and gummous infiltration of the hand.
In the absence of information about the circumstances and timing of infection and the presence of positive results of serological studies, a diagnosis of latent, unspecified syphilis is established. Such patients are subject to careful clinical and serological examination, often repeated. Setting RIF, RIF-abs and RIBT, ELISA and RPHA are mandatory.
You should be aware that in patients with late and unspecified syphilis, false positive nonspecific serological reactions are often detected. Reagin antibodies produced against the cardiolipin antigen appear in the blood of patients with collagenosis, hepatitis, kidney disease, thyrotoxicosis, oncological diseases and infectious diseases such as leprosy, tuberculosis, brucellosis, malaria, typhus and scarlet fever, during pregnancy and monthly cycles, when taking fatty foods and alcohol, in patients with diabetes mellitus, myocardial infarction and concussion. It is noted that with age the number of false positive reactions increases.
Rice. 6. Hummous infiltration of the buttocks and peripapillary zone in the tertiary period of the disease.
2014-05-02 05:08:50
Victoria asks:
Hello. I went to the hospital with a temp.
According to the analyzes, blood glucose is overestimated 8.8. ESR 15, leukocytes 14.8, segmented 83% and lymphocytes are underestimated 11%. There is no sugar in the urine.
X-ray of the lungs without pathologies, the abdominal cavity without pathologies.
I was treated and discharged. A week later, the temperature rises again to 37.7, vomiting and again the hospital.
They put drug toxodermia, intestinal colic.
Videogastroscopy diagnostic with deepening. examination of chronic gastritis.
Videocolonoscopy is a normal variant.
Leukocytes 20000, ESR 40, CRP 75.11. Rheumo-factor 1.2.
They put me on prednisolone and discharged me.
So they couldn't make a diagnosis.
There was no temperature for a week, and now 37.1
Prompt it is necessary to be checked further and on what and at what doctors?
Responsible Shidlovsky Igor Valerievich:
It's hard to speak in absentia. Apparently, first of all, it is necessary to exclude rheumatic pathology: antinuclear antibodies, antibodies to DNA 1 and 2, LE cells. Also donate blood for sterility, for malaria, sowing urine and feces for flora.
What is the blood formula?
2010-05-10 13:51:36
Ksyusha asks:
Hello, I live in a small town far from Kyiv. A few days ago I was tested for syphilis - the answer was positive. The last contact was more than 4 months ago. There are no symptoms, no rashes, no chancres, no temperature, lymph nodes are normal. Absolutely no symptoms. Is this possible with a latent form of the disease?
2015-04-16 15:30:14
Alexey asks:
Hello, my partner and I constantly used protection, once we didn’t use protection, and I started itching, I gave all the smears of gonorrhea, PCR, and the blood for syphilis didn’t show anything anywhere, a week later I started to pull in the neck, near the genitals and give it to the knee from the back as if it had given to the lymph nodes, but there was no visible inflammation anywhere and the doctor said that the lymph nodes were in order, then she went for tests, they found thrush in her, the doctor prescribed one tablet of fluconazolo, we drank from her then the tests showed that everything was fine , but after a second time without a condom, everything went anew for me. And the doctor prescribed me sparogal!!! Can you tell me if this drug will help? Is it normal for female thrush to have such symptoms. Thanks!!!
Responsible Medical consultant of the portal "site":
Hello Alexey! You have been prescribed an antifungal drug based on itraconazole, which means that the doctor has found that you have a fungal infection. Having such an infection is abnormal and requires treatment. Given the relapsing nature of the disease, you should also consult an immunologist and undergo an examination to evaluate the immune system. Take care of your health!
2014-01-28 08:34:16
Andrew asks:
Hello, Doctor.
I ask you to read my questions to the end, as there is hardly an unequivocal answer to them, but the problem remains. At the same time, you need to decide how to behave with others in everyday life and antime.
The problem has been around for about 15 months, no answer has been found. Therefore, I try to analyze against the background of the totality of information.
I quote the terms from the risk.
So: beginning of September 2012. not protected P.A. with a work colleague. After 2 weeks, tests for all STIs - PCR, as well as HIV, syphilis (did not know about the timing of seroconversion) - all negative, except for gardnerella. Therefore, there could be no talk of phobias. Gardnerela was treated with secnidox + dazolik for 10 days + antifungal. About a month later, from the risk, he began to notice fever-like conditions and sore throats. Relate to stress. Severe urethritis began. They sent me to a urologist.
After 2.5 months. Urologist - the second course of antibiotics - Unidox Solutab for 10 days and prostate treatment drugs. The prostate let go. Hoping to get rid of the cause.
Repeated STI all negative.
At 3 months: T sharply rose to 37.5, submandibular, anterior cervical, posterior cervical L/U were inflamed on the right. Pain in the kidneys, spleen, liver. Pain in the groin, under. mice. There was a strong itching on the hands and legs below the knees, it itched like mosquito bites - very strongly. Small bright red dots appeared, like bursting blood vessels. Then some colors of moles became and did not go away.
Small balls appeared on the body, which were found by mild pain. Slight swelling of the face. Hands and legs began to go numb, as he had served time, tingling and itching. It lasted for 3-4 weeks.
Constant pain in the throat, white coating on the tongue and on the outside of the cheeks. Some kind of rash on ext. Side of the cheeks. Worth burning. There are teeth marks on the sides of the tongue - sharp pits. Tank crops for almost 11 months: nasopharynx twice: Staphylococcus aureus and streptococcus pnemo 10 in 5 both. The blood is sterile, intestinal dysbacteriosis. I ALWAYS SWEET. THERE WAS WEIGHT LOSS 92-80. Now 86 kg.
Burning skin type burn, very common. Baked lymph nodes under. mice, shoulders, back.
After the acute phase, tests: for 3.5 months CMV PCR: one laboratory Scraping of the urethra hidden carrier. Another, Sinevo - PCR scraping, saliva, blood CMV negative.
Complete blood count 3.5 months: a slight increase in hemoglobig, erythrocytes and lymphocytes.
for 6.5 months EBV PCR blood negative, ANTI W nuclear 13 times the threshold, M capsid negative. Rheumatic tests were negative, two courses of ENT treatment were unsuccessful.
Lungs are normal.
Now - 15 months. ELISA 13 months HIV negative, BLOT HIV.11 months. Negative. Trepomeme A\T negatively. Partner: 12 months from association HIV negative. I have Hepatitis B, C, F negative. Liver spleen - enlarged. Pain in the joints of the knees (it was at the very beginning, but antibodies to Chlamydia trachoma tick are negative A, M, G. I have never been sick.
Numb legs and arms, especially at night, sweating. Pain in the liver, spleen. Eyes, feeling of sand. There were reddenings for a long time and now.
The biggest concern is neuropathy. Numbness of the legs and more hands, itching of the hands and feet. Pain in the liver and spleen, constant sore throat. T - in the afternoon up to 37.2. In the evening it drops to normal.
Infectionists (not one) refer to the ENT and the therapist. Those to the neuropathologist. The course of treatment of tonsillitis did not give results. The HIV center - have excluded the unambiguously. Sedatives have no effect.
Why am I writing .. This is clearly not a phobia. During this time, I found the same people who have similar risks, many have protected vaginal, unprotected oral as a transmitter.
Some have contact with an HIV-infected person, some who are protected with HIV are negative on the basis of tests. After all, people do not in vain test themselves and their partners.
There are people with experience of about 5 years. Lose vision, problems with the musculoskeletal system.
The immunogram gives a drop in CD 4. There are a lot of them ... SYMPTOMS ARE VERY SIMILAR,
QUESTIONS:
- Given the specificity of neuropathy, what else can give it? THE MOST IMPORTANT QUESTION
- Which specialist can I contact?
- since there was an acute stage, this is something that the body encountered for the first time, or activation of EBV and CMV can also give an acute stage. Herpes 6,7,8 are not made in Donetsk.
-since against the background of normal immunity, any herpes should pass, some new type of virus scares. Everyone I know is about 15 people, the problem was not solved until 7 years of experience. On the Internet resources, they communicate in fob branches. In this regard, theoretically assuming a new type of HIV (sorry for the phobia) that it should have been detected in theory: PCR or immunoblot.
Although many did both blot and PCR DNA, RNA - all negative.
I repeat, unfortunately there are a lot of people with this symptomatology, by means of transmission. Doctors refer to each other. Infectionists, stating the absence of anti-M and PCR for herpes, say - not ours.
- Have there been such cases in your practice with the problem found.
Thanks for the answer. There is no one to go to for the past 17 months.
Responsible Vasquez Estuardo Eduardovich:
Hello Andrey!
There is such a phenomenon as the Internet, which not only makes it possible for us to communicate now, but also interferes with doctors and disorientates patients. Patients begin to think and think "professionally", respectively, at certain stages of medical appointments, they either partially or do not comply with medical recommendations as prescribed, adding their own or what they learned somewhere - and the process is delayed (and 3 and 5 years).
In your letter, we will mix up your reasoning, and doctors do not always have the opportunity and desire to conduct individual lessons - this is not our task, perhaps that is why I sometimes refer to other specialists.
Just for example (from the context of your questions): "... since against the background of normal immunity, any herpes should pass, some new type of virus scares." As a doctor, I don't think so, but I have not the slightest desire to prove it to you or any other patient, but I am happy to discuss this with my colleagues.
Tip: Forget about all your "medical knowledge" and start with a regular local therapist, trusting him, strictly following his instructions. without rechecking. Otherwise, the process will progress more and more: there is a violation of your immune status with the involvement of the lymphatic system, the cause of which could be any infection (from minor to serious). I would not look for an agent at the moment, I do not consider it necessary from a practical point of view.
2013-09-22 08:06:13
Karina asks:
Good afternoon. There was unprotected sexual intercourse on July 13. After 6 weeks, an ELISA test, a combo test for multi-infections (hepatitis, syphilis, HIV) also -, from the symptoms a sore throat, there was a plaque on the tonsils, there was no temperature, runny nose, pulling pain in the neck , the jaw hurt, without enlargement of the lymph nodes. Doctors' diagnoses: ENT-chronic tonsillitis, inflammation of the eardrum, Dentist-gingivitis due to the deposition of stones and plaque, Neurologist-inflammation of the trigeminal nerve. Iha-(at home. conditions). Before the onset of the disease and all the symptoms, she took 5 injections of 2.5 ml of progesterone (1 month delay). After the last injection, she fell ill the next day. I have questions. 1) Can progesterone lower immunity? 2) Are Are my symptoms symptoms of HIV? 3) How reliable are my test results for a period of 10 weeks? 4) Can IFA analysis at 12 weeks be considered reliable in my cases? Dicloberla.? a week before the ELISA test.6) What is your opinion about the Sieve tests (house tests) registered in Ukraine? Thank you in advance for your answer.
Responsible Medical laboratory consultant "Synevo Ukraine":
Hello Karina! Progesterone has a depressing effect on the immune system, but, as a rule, not to such an extent as to independently cause the appearance of the symptoms you listed. The symptoms you listed are not specific to HIV, although they often occur in the early stages of HIV infection. It will be possible to make a final conclusion about the absence of HIV infection only after 6 months after suspicious sexual contact, if the result of an HIV test performed at this time is negative. Acceptance of the preparations listed by you on results of the analysis on a HIV (IFA) do not influence. Take care of your health!
2011-10-19 17:27:33
Nikita asks:
Hello, Doctor! I have such a situation, I had sexual intercourse with a non-permanent partner with a contraceptive, after which the temperature rose to 38 for 3-4 days! I immediately went and got tested for HIV, AIDS, Syphilis and hepatitis. The result: not detected! But the next day, I began to worry about frequent urination, as if not completely, and false urges! I went to an appointment with a urologist and got tested for Chlamydia, mecoplasma homines, etc. by the smear method, the result was not found! Because the urologist worked once a week, I didn’t wait and decided that I just froze (my regular partner had chronic pylonephritis and the symptoms were similar to hers with hypothermia) because there were a lot of opportunities (air conditioner, etc.)! Drank furodonin and urological collection! After that, everything returned to normal, but after a while after stopping the pills, the symptoms reappeared and pain in the lower abdomen added! I went to the urologist again, but to another hospital, he did an ultrasound and looked at the prostate and said that it was inflamed! Then he wrote out a referral for blood tests (if I'm not mistaken, blood for DNA), as a result, they found mecoplasma homins and some kind of fungus! Treatment was prescribed: intramuscular Cycloferon according to scheme 10, after the 2nd injection acyclovir 200 2t 2 times a day for 15 days and Clocid 250 1t 3 times a day for 20 days! Almost the entire course was treated (without 3 days), but there is practically no result (the pain in the lower abdomen is gone), I continue to run to the toilet, and there was also an unpleasant sensation in the urethra and at the end of the penis! And another question on the 2nd day after going to the "left" had sexual relations with a permanent partner, which was told to the doctor and he said that she was 100% sick too and prescribed the same thing to her! But she had absolutely no symptoms, and to this day she hasn't! It’s just that she doesn’t want to continue drinking all these antibiotics. Does it make sense for her to continue treatment with me or is it worth getting tested? What should I do next? Does it make sense to change doctors? Or to hand over any other analyses? What drugs would you recommend (I understand that you do not have an appointment, but still, to roughly focus on the prescribed pills)? How to alleviate the symptoms, otherwise there is no strength (can drink some herbs)? Sorry for a lot of writing, I wanted to state the essence of the problem to the maximum! Thank you very much in advance! I'm really looking forward to your answer, otherwise my head is already spinning!
Responsible Klofa Taras Grigorievich:
I don't think your diagnosis is correct. Therefore, you should be examined in a good laboratory and in a competent specialist. Regarding the permanent girl - I think that she may not have anything, so any infection has a so-called incubation period, and after 2 days you simply could not infect her. Therefore, I recommend that you contact a urologist who treats diseases that are sexually transmitted. And regarding the drugs - be patient, because the treatment at random will only provoke the problem further.
2011-03-18 20:04:16
Yury Romanov asks:
Romanov Yu.S. born in 1962 II gr. blood(+)
I quit active sports (volleyball) in March 2008. I smoked for almost 30 years, I quit a year ago.
Case history September 2008 - pain in the shoulders, forearms (more muscular), in the chest, between the shoulder blades, accompanied by a slight dry cough. The pain is not constant, with attacks from half an hour to 1.5-2 hours. .- "twists" his hands. The therapist sent him for a consultation with a pulmonologist and a neuropathologist. Pulmonologist's diagnosis: COPD type 1-2. Pass tests for uric acid, LE cells, coagulogram. From these tests, the excess of uric acid, the rest are normal. He prescribed allopurilic acid, meloxicam, fromilid uno (I don’t know why the antibiotic). Chest x-ray: no bone changes.
Assigned to: massage, vitamin B12, mucosat 20 amp, Olfen No. 10 in amp. After the use of these drugs, no improvement was observed. The pains either disappeared on their own for 2-3 weeks, then appeared for 1-2 weeks, but they were also paroxysmal. That is, the condition is excellent and suddenly, within 10-15 minutes, the condition is like at a temperature above 38-38.5 degrees. Over time, new ones were added symptoms are pain in the calf muscles, submandibular pain.
Passed tests for: helminths: toxocar. echinococcus, opisthorchis, ascaris, trichinosis-not found. Just in case, he drank 3 days of Vormil.
Tests for: Chlamydia, Giardia-negative, HIV, syphilis-negative, Toxoplasma-lgG-155.2 at a rate of less than 8 IU / ml. lgM-not detected.
Fibrobronchoscopy - diffuse endobronchitis with moderate mucosal atrophy.
Fibroesophagogastroduodenoscopy: d\z-peptic ulcer of the duodenal bulb 12. Hp-test-positive. Passed a course of treatment.
Analyzes for antibodies to native DNA: 1Y-29.0109Y.-0.48 POS.
2nd-27.05.09-0.32 positive
3rd-14.09.09-0.11-negative.
4th-23.02.2010-44IU/ml-posit.
5th-18.05.2010-20.04 IU/ml-neg.
6th-17.11.2010-33 IU/ml-position
Immunoglobulin class M: 2.67 at a rate of 0.4-2.3 (29.01.09)
SLE test - from 05/26/2009, and 11/17/2010 - negative. Analyzes for rheumatic tests were within the normal range.
There is a CT scan of the abdomen and an MRI of the lumbar spine. No pathologies.
During this time, neither the therapist nor the neuropathologist made an accurate diagnosis. Didn't go to other doctors. I passed almost 90% of the tests without referrals from doctors, by typing. Only once the variant sounded - SLE. I drank delagil for a month, 1 tablet each, with dolaren attacks.
Symptoms of aches in the muscles (90%) and joints (10%) of the arms and legs still appeared and disappeared for 10-15 days.
Since the autumn of 2010, muscle pains began with the shoulders and forearms, submandibular pains, pains in the chest and between the shoulder blades.
On 11/16/2010, he turned to a therapist in another hospital, because such pains were accompanied by depression. Constantly on painkillers, but you need to work, the impossibility of controlling the occurrence of seizures. They don’t give a hospital, there are no pronounced symptoms!
Direction for X-ray of the cervical, thoracic, right shoulders. joint. Based on the data, he was referred to a neuropathologist. The conclusion is osteochondrosis of the cervical and thoracic regions. Assigned - lidocaine in amp No. 10, vitamin B12, massage No. 10. The neuropathologist could not explain the above listed symptoms.
Consultation of a city rheumatologist-data in favor of SLE and rheumatoid arthritis – NO. Assigned: Olfen in amp. No. 10, Vitamins B1, B6, B12. Lyrica 1 ton 2 times a day. According to the consultations of a neuropathologist and a rheumatologist, the therapist prescribed:
Olfen No. 10, Lidocaine 2.0 No. 10, Prozerin 1.0 ml No. 10, Vitamin B12 No. 10, Gabalept 1 ton per month, massage.
Started treatment on 25.11.2010. From 1.12.2010, the symptoms began to change. The muscles below the elbows, hands, fingers began to hurt more strongly. Aches in the calf muscles, ankles, knees. Feeling of swelling of the arms and legs (below the knee joints). These symptoms appear from morning until bedtime + bouts of aches are added (as at a temperature of 38 degrees) also from half an hour to 1.5 -2 hours.
From 10.12.10 symmetrical pains appeared in the small joints of the hands, in the wrist joints, and the ankles. After sleep, stiffness was felt both in the hands and in the legs. Under load, pain in the ankles increased with recoil under the heel, in the knees. There was a crunch in the joints of the arms and legs, which had never been observed before. These symptoms persisted until rest. Didn't bother at night.
At the same time, paroxysmal pain disappeared.
Since the appointment with the doctor at a certain time did not take place and was postponed, and the pain did not go away, but intensified, I started taking METIPRED 4 mg once a day. By December 20, 2010, the condition improved. The pain became weaker, but it still manifests itself in the fingers and hands, ankles and knees. The puffiness subsided, but sometimes it is felt in the hands. Pain appeared in the shoulders and hips. The crunch in the joints did not go away. Pain is especially strong in places of sports injuries of the ankle of the left, right knee joint, fracture of the wrist of the right hand. I did blood tests and everything was normal. A detailed blood test, taking into account the intake of Metipred (day 4), all indicators are normal.
The attending therapist directs to the neuropathologist and the traumatologist - reception 12/21/10. I am tired of the lack of a diagnosis. It can be very bad, but I don’t know which doctor to turn to, I don’t even know who to take a sick leave to lie down. Tell me what to do or who to contact for help!
Joint consultation of a neuropathologist and a traumatologist:
Neurologist - d\z: multiple sclerosis? An MRI of the head was recommended.
Traumatologist - there are no data for trauma and orthopedic pathologies in the acute stage.
In words, he said that you need to contact a rheumatologist about mixed collagenosis.
December 24, 2010 - underwent an MRI of the brain, the result is below.
After undergoing an MRI, the neurologist sent me to the regional clinic to see a neurologist with a diagnosis of:
- discirculatory encephalopathy, cephalgia, Sd?
To a rheumatologist:
myasthenic syndrome, SLE, rheumatoid arthritis.
From 12/23/10 I caught a cold (pain in the nasopharynx, temperature 37.8) - I started taking Arbidol, Amoxil. Three days later I felt the absence of pain in the joints of the fingers, hands, ankles, it became easier in the knees when walking.
There was a slight stiffness in the morning, disappearing after 5-10 minutes, there was a crunch in the joints. Significantly improved mood and general condition.
26.12.10 - interrupted the intake of METIPRED, taking it for 14 days from a dose of 4 mg-7 days and lowering it to 1 mg by the 14th day.
Approximately from 08.01.11. again there were pains in the small joints of the hands, ankles. Again he began to take Metipred 2 mg 1 r / d. The condition is average, the joints are crunchy. From 16.01. I take 1 mg metipred, sometimes reducing dolaren when the pain increases. Pain in the left ankle and right knee joint is especially reflected when moving up the stairs.
Consultation of the chief rheumatologist-d\z: RA.
For confirmation, he was sent to the regional clinic in the department of rheumatology. On the basis of x-rays, osteoarthritis of the small joints of the hands and feet was diagnosed.
The prescribed course of treatment by the rheumatologist of the region: arcoxia 60, 1 ton for 10 days, mydocalm 150 mg. 1r\10 days, artron complex 1t.2 r\d, calcium D-3, topical ointment.
At present, after taking these medications, the condition has worsened. The joints of 3-4 fingers of the hands are sore, swollen. In the morning there is a slight stiffness in the hands for 10-15 minutes. The joints are slightly swollen, also pain in the wrists. Pain in the hip joints in the region of the left greater trochanter and both ischial tuberosities progresses. Pain when walking under load. both ankles.
Again he turned to the glurematologist of his city. He prescribed Olfen at 100 mg 1r / d, movalis 2 mg i.m. h / d., continue artron complex.
10 day course of treatment gave nothing.
Today I was at the reception again, prescribed Metipred 2 mg r / d to the above described drugs.
I am at a loss! Unofficially, he diagnoses RA, but does not officially confirm it - if visual symptoms appear, he will confirm the diagnosis, and since the tests are clean, and pain cannot be “put to work”!
Time is running out for treatment. Tell me what should I do? Go to Kyiv? And there, too, without clinical manifestations, they kick back! And to whom - to a private clinic or to a public hospital?
Thank you for your attention! Sorry for the confusion.
Regards, Yuri.
2010-11-18 12:25:42
Sergei asks:
Hello!!! Ever since my puberty, I have a copious secretion of lubrication when aroused, and the lubrication is released from the urethra of a transparent color, if you touch it, it “stretches”. Tell me, please, is this normal or should lubrication be released from the foreskin area below the head of the penis? Now I lead an active sexual lifestyle with several unprotected partners. I have no complaints or symptoms, but one of my partners after a single sex with her after 5 days turned to a gynecologist and a vaginal smear showed acute gonorrhea in her. And before me, she hadn’t had anyone for a long time, so I should have gonorrhea. I also passed tests for many infections, now I am waiting for the results, but I have a question. Can gonorrhea be completely asymptomatic? When excited, I also, as before, profusely secrete lubricant from the urethra, transparent and viscous as before, not yellowish-white in color, as it should be with gonorrhea. I do not feel itching, pain, burning and discomfort. My temperature did not rise, now it is normal - 36.6. Should gonorrhea constantly release fluid from the urethra, can it be transparent? Or is it possible to release only when excited? Then how to explain that during my puberty, when I had no sexual contacts at all, the lubricant was also released only during arousal and from the urethra? Should the temperature rise with gonorrhea, and if it becomes chronic without treatment, should the temperature be constantly high? Please tell us something about gonorrhea that was not included in those official descriptions of this disease, which are posted here. And there is also a legal issue. In the Dermatovenerological Dispensary, where I turned anonymously, all tests are carried out for a fee, each test costs about 35 UAH. on average, and this money is taken unofficially, without checks, but as if "voluntary assistance for the development of the institution." Free only for syphilis and HIV. If there is not enough money, one or another analysis is canceled. Is such a statement of the question legal in a state institution? Or tests for major venereal infections, including gonorrhea, chlamydia, trichomoniasis, should be free of charge? Why were state medical institutions allowed to take money for “voluntary assistance for the development of the institution”? After all, this removes responsibility for the objectivity of these analyses. And now it is clear why there is such an increase in venereal diseases in Ukraine - many simply do not have money to take tests. When taking tests, should an official certificate of their results be issued, certified by the seal and signature of the institution, if applied anonymously?
Latent syphilis is diagnosed in the absence of signs of the disease, and serological reactions in the blood are positive. This form occurs in patients who in the past actively manifested diseases that resolved on their own, or as a result of specific treatment.
Table of contents:
The therapy is carried out according to. Its purpose is the rapid destruction of the pathogen in the patient's body. Negative seroreactions occur quite quickly with specific treatment. The extinction or complete negativity of seroreactions is the only confirmation of the effectiveness of treatment.
Timely diagnosis during early latent syphilis and effective treatment provide a favorable prognosis.
Patients who became infected more than two years ago, who have no symptoms of the disease, and serological tests are positive, are diagnosed with late latent syphilis. Basically, it is detected during a preventive examination.
These patients are less epidemiologically dangerous, since tertiary syphilides are not so contagious. They contain the minimum amount of the pathogen.
The disease is mainly detected in patients older than 40 years. At the same time, approximately 65% of them are married.
When interviewing a patient, they find out the timing of probable infection and the presence of symptoms indicating manifestations of infectious syphilis in the past.
In some cases, serological studies are repeated after several months.
Therapy of this form is carried out according to. The goal of treatment is to prevent the development of a specific lesion of internal organs and the nervous system. Patients need to consult a therapist and a neurologist. Negative seroreactions during the treatment period is extremely slow. In some cases, seroreactions remain positive after treatment.
Latent unspecified syphilis is diagnosed in the absence of information about the timing and circumstances of infection, as well as in the presence of a positive result of serological tests. These patients require careful clinical and serological evaluation. Mandatory are the production of RPHA, RIF, RIF-abs, ELISA, RIBT.
In patients with unspecified and late syphilis, false positive nonspecific serological reactions are often detected.
In the case of timely treatment, the external manifestations of the disease disappear quickly enough. In the most advanced cases, it becomes almost impossible to restore health.
After the illness, it is necessary to take a very responsible approach to the issue of pregnancy planning. It should be borne in mind that it will take more than a year to fully restore the health of future parents. Therefore, it is very important to take precautions to exclude the possibility of infection.
