This disease has been known for a long time, since the end of the 15th century. Refers to chronic venereal diseases.
The cause of syphilis is Treponema pallidum, which, having entered the human body, begins to actively multiply and spreads through the circulatory system to all organs and systems.
That is why this disease needs to undergo long-term therapy, and often, even after a seemingly complete recovery, a positive result can be seen in tests for its detection.
Basically, infection with the causative agent of syphilis occurs sexually. Moreover, in the case of a single unprotected sexual intercourse, the probability of contracting syphilis is about 30%.
However, do not forget about the contact-household transmission of syphilis.
So, for example, you can get infected by contact with wet things of a sick person, or through saliva when kissing, common items (for example, through cutlery).
Since the disease has a high percentage of the probability of transmitting the pathogen from mother to child, a pregnant woman with a history of syphilis will undergo constant monitoring throughout the entire gestational period.
If the expectant mother undergoes a full course of therapeutic treatment and passes all the necessary tests that confirm that the disease has been defeated, her chance for a healthy pregnancy will increase significantly.
However, couples who have undergone all the necessary procedures and studies should still wait with pregnancy planning for at least the next year or two.
After all, it will take time to restore the body after antibiotic therapy.
There are several options for the course of the gestational period in a woman with a history of syphilis.
For example:
Preventive measures during the gestational period after syphilis.
Due to the fact that the development of medicine is in front of leaps and bounds, today there are practically no cases when cured syphilis somehow affected the reproductive function of a woman or the health of her newborn child.
A much greater danger is the situation when the expectant mother becomes infected with syphilis during the gestational period.
In this case, the likelihood of a late miscarriage or stillbirth is much higher.
As for conception, unlike trichomoniasis, chlamydia and gonorrhea, cured syphilis does not affect conception in any way.
This is due to the fact that as a result of syphilis, there is no blockage of the fallopian tubes and the development of chronic inflammation in the female reproductive organs.
However, it should be borne in mind that in medical practice there are still cases when, even after several years, after undergoing a full special course of therapy, women, due to illness, give birth to children with various health disorders.
That is why, both the gestational period and delivery, in a future mother who has cured this disease, should take place under especially close regular monitoring.
The risk of infection of the fetus by a woman who has had syphilis depends on several factors. So, for example:
For a child whose mother has been ill with syphilis, the supervision of doctors is carried out especially carefully.
In a child without signs of congenital syphilis, during the first year of life, every three months, blood is taken for analysis to detect the disease.
In this case, the first time - immediately after birth from the umbilical cord. Here, antibodies to the pathogen that the child received from the mother can be detected. Further, the number of antibodies should gradually decrease.
If this does not happen or the amount of antibodies increases, the child is infected. In this case, he is treated in a hospital.
Such therapy can be carried out immediately after the birth of the baby, if he has signs of a congenital form of the disease.
Beethoven, Baudelaire, Lincoln, Nietzsche... Not only the level of world fame, but also the general diagnosis of syphilis gives us the right to mention these sonorous names in the same row. An infectious disease has been attacking humanity for centuries, regardless of rank and title, age and social environment. All the fault - pale treponema. A spiral microorganism is recognized by uniform curls and specific movements of a rotational-translational, wavy and flexion character. The causative agent of syphilis is reproduced during the transverse division into several elements, which later grow into an adult. The microorganism does not tolerate drying, prolonged exposure to high temperatures. Decomposes under the influence of ethyl alcohol. Prolong the life of pale treponema can low temperature conditions.
Over the past 10 years, syphilis has been steadily breaking records in the growth in the number of new victims. According to some reports, the army of patients with an unpleasant diagnosis has doubled over the specified period. In our country, despite the downward trend in the total number of infected people, the incidence rate is still an order of magnitude higher than in Europe. "Spoiled" the statistics mainly by representatives of young people leading an asocial lifestyle.
The risk of contracting syphilis increases exponentially for those who:
Pale treponema lies in wait for its victims in a variety of situations and easily enters the body of a new host:
I didn’t think - I didn’t guess, but I was already sick and contagious - this is how the development of syphilis occurs in the early stages. Usually, the first alarm signals appear 10 days after treponema enters the body. However, the patient can learn bad news about himself much later - in the worst case, after six months, if he takes a course of antibiotics that suppress the destructive activity of the infection.
The causative agent of syphilis is capable of producing a substance that disrupts the process of recognizing the "intervention" by the body's defenses. Under conditions of suppression of cellular immunity, treponema actively multiplies and quickly spreads through the lymphatic tracts and internal organs. From the first days of infection, there is a risk of infecting other people.
This stage lasts up to 8 weeks and leads to a noticeable increase in the lymph nodes and the formation of a hard chancre. In the bloodstream, there is an increase in the number of special antibodies that immobilize treponema and form immune complexes. The body's struggle with the causative agents of syphilis ends with the release of lipopolysaccharide and protein products into the blood. The destruction of tissue treponemas is accompanied by a local inflammatory reaction in the form of multiple rashes on the skin and mucous membranes, which signal the onset of the second stage of syphilis.
It is formed in the foci of entry of pale treponema into the body. Usually, the patient finds a neoplasm on the skin or mucous membranes of the genital organs, less often on the lips, tongue, eyelids, finger, abdomen, in the oral cavity or in any other place where the infectious agent enters. Hard chancre is an erosion with clearly defined rounded contours (in the form of a saucer) of a “varnished” red color. At the base of the neoplasm, a dense elastic seal is palpated, which does not cause pain. Recently, experts have increasingly noted the occurrence of several chancres.
A week after the formation of a hard chancre, an increase in nearby lymph nodes is noted, inflammatory processes in the lymphatic vessels are likely. Almost a quarter of patients by the end of primary syphilis have symptoms confirming the fact of generalization of the infection: a significant increase in body temperature, night headaches, discomfort in bone tissues and joints, lack of appetite, loss of strength.
The approximate starting point of this stage is the milestone of 2.5 months after infection. The average duration is 3 years. As part of the stage, fresh (early), recurrent and latent syphilis is isolated. The formation of immune complexes is in full swing, which leads to the development of inflammatory processes and provokes the mass death of treponema. Syphilis goes into a latent phase lasting up to three months. However, six months after infection, the first relapse occurs. Activation of the synthesis of antibodies becomes a response to the newly begun reproduction of pathogens. Thus, the wave-like nature of the course of the disease reflects the essence of the specifics of the interaction between the infectious agent and the body's immune system. The pathological process from the skin and mucous membranes passes to other organs and systems. Sometimes there are symptoms of intoxication. The patient poses a high degree of danger to the close environment, since the risk of infection is maximum.
This period lasts from two to four months from the moment of infection. It is manifested by the appearance of a rash on the skin and mucous membranes, which is a sure sign of secondary syphilis. The rashes are numerous, brightly colored, but do not cause concern to the patient (occasionally complaints of itching are recorded in the medical history), persist for several weeks and suddenly disappear. In some cases, hair loss is noted.
The period of short-term "return" of the characteristic symptom of the disease: a few groups of large rashes appear, forming rings and arcs.
Usually relapses occur no more than four times.
The average duration of this period is 3 months. External clinical manifestations are not observed. Diagnosis is possible if there is data from a professional examination (scars at the site of former foci of rashes, enlarged lymph nodes), as well as special studies.
It occurs in the absence of professional treatment of the existing disease and in 25% of cases leads to death. The tertiary period (stage 3 of syphilis) stretches for decades. There is damage to most internal organs (the brain and spinal cord, liver, kidneys, stomach, intestines, genital organs), as well as the nervous and cardiovascular systems. Vision and hearing deteriorate sharply. Patients experience sudden changes in mental states: from bouts of depression, paranoia to euphoria, hallucinations.
A typical skin manifestation of syphilis at this stage is the formation of infectious granulomas (gummas), which are subcutaneous groups of cells in tissues in the form of nodes that develop into ulcers. Neoplasms affect not only soft tissues, but also the skeletal system, leading to irreversible deformities (for example, nose depression). The last stage of syphilis is not as contagious as the previous ones, but certainly the most unfavorable in terms of prognosis.
It occurs in the first years after the disease with syphilis, develops gradually (over weeks and months) and is characterized by the simultaneous manifestation of cerebral and focal symptoms. So, the patient begins to complain of attacks of severe headache, vomiting, memory lapses. The nature of focal symptoms is due to the localization of the infectious lesion:
Different vascular pools can be included in the process of disease development. If the vessels supplying the subcortical nodes are damaged, the risk of parkinsonism, a neurological syndrome in which the patient is unable to perform voluntary movements, is not excluded.
Desperate Boy Disease: Men suffer from this clinical variant of neurosyphilis approximately 5 times more often than women. The first signs of the disease occur, as a rule, in middle-aged patients 15–20 years after the entry of pale treponema into the body. The reason is a violation of the work of the posterior parts of the spinal cord. Characteristic details of the clinical picture: the predominance of paroxysmal pain (in the form of an acute seizure), sensitivity disorders, distortion of the normal reaction of the pupil, impaired coordination of movements.
According to statistics, this form of syphilis is now rare.
About 85% of patients diagnosed with early congenital syphilis suffer from pathological changes in the skeletal system. Osteochondritis is symmetrical and extensive.
Against the background of the development of late congenital syphilis, lesions of the skeletal system are observed more often than in secondary and tertiary syphilis, but less often than in the early congenital form and are diagnosed on average in 40% of patients. Traditionally, the pathology is localized in the region of the skull and tibia.
In the initial stages of the disease, the clinical picture shows only individual disturbances in the work of the affected organs. However, after some time, syphilis reveals its presence in more serious diagnoses, including at the level of:
In order to avoid making an erroneous diagnosis of "syphilis", a whole range of measures is required:
The patient undergoes an individual therapeutic course under the supervision of a specialist in a hospital or on an outpatient basis. In this case, sexual contacts are completely excluded. Therapy is based on the use of antibacterial drugs. The treatment of primary syphilis prescribed by a venereologist is designed for several weeks, secondary (including late latent) - for a period of two years or more.
Syphilis, including repeated, is a curable disease. The patient must urgently go to the nearest clinic at the first suspicion of a problem.
It is transmitted to the fetus by a transplacental route. It happens early (intrauterine period, infancy and early childhood) and late (after 15 years). Requires special approaches to diagnosis and treatment.
Infection of the fetus occurs in the fifth month of pregnancy when pale treponema enters through the placenta. The disease disrupts the functioning of internal organs and affects the skeletal system. The child's chances of survival are estimated to be extremely low.
Some babies transplacenally infected with the infection survive, but the peculiarities of intrauterine development do not pass without a trace.
A child with such a diagnosis is weakened, slowly developing mentally and physically. Syphilis in newborns is characterized by damage to the eyes, brain, skin, bones, cartilage, teeth, impaired functioning of the liver, spleen, and cardiovascular system.
At the age of 1 to 2 years often appear:
In the case of latent congenital syphilis, the diagnosis is clarified using a blood test and cerebrospinal fluid.
The disease manifests itself in adolescence (15-16 years) with lesions of the eyes (including to complete blindness), the inner ear, tumors in the tissues of internal organs and skin, a semilunar notch along the edge of the incisors.
Among the signs of infection are also called “saber-shaped” shins, scars around the lips, a “saddle-shaped” nose, and a “buttock-shaped” skull.
The pathogen can be detected through microscopic analysis of the cerebrospinal fluid. But a negative result does not guarantee the absence of a latent form. In the presence of skin rashes, it is advisable to examine their discharge for the presence of pale treponema.
To make a final diagnosis, high-precision serological blood tests are carried out, as well as data from additional consultations of narrow specialists (pulmonologist, neurologist, nephrologist, ophthalmologist, and others) are used.
Pale treponema still retains high sensitivity to antibiotics. Accordingly, patients are prescribed a long course of antibiotic therapy.
Contrary to popular belief, condoms do not guarantee 100% protection against infection, since there is a possibility of infection not only sexually, but also through household contact. In this regard, you should take additional personal security measures:
Can you get syphilis through kissing? Easily! Getting rid of adversity is much more difficult. Self-medication is strictly contraindicated, since it does not lead to recovery, but it can significantly affect the course of pathological processes, which will further complicate the diagnosis. Your health should be entrusted to experienced professionals.
Latent syphilis is a sexually transmitted disease that occurs without obvious clinical signs. Diagnosis is helped by history data, the results of a thorough examination and positive specific reactions. It is possible to recognize the disease by detecting pathological changes in the cerebrospinal fluid. The need for multiple studies and re-diagnosis after a course of therapy is associated with a high probability of obtaining false positive reactions.
The diagnosis of "latent syphilis" is made to patients in the case of detection of antibodies to pallidum spirochete in the laboratory in the absence of specific symptoms characteristic of sexually transmitted infections. Often, pathology is detected during examinations associated with other diseases.
The spiral-shaped pale spirochete, under the influence of external adverse factors, begins to change to forms conducive to survival. The causative agents of syphilis can be in the lymph nodes and cerebrospinal fluid for a long time without any manifestations. When activated, the asymptomatic period is replaced by an exacerbation with a deterioration in the patient's well-being.
The reason for the formation of cysts-forms of spirochetes (treponema) is the improper use of antibacterial drugs. Often, patients are treated with this group of drugs on their own, without a doctor's prescription, when they notice signs of gonorrhea or other sexual infections.
The latent form of syphilis has a long incubation period and high resistance to drugs used in the treatment of sexually transmitted diseases. The most common route of infection is sexual.
Syphilis can be transmitted through household contact or through the placenta from a woman to her fetus.
With a latent course of syphilis, a patient can infect a partner during sexual intercourse. The danger lies in the high risk of infecting others when using dishes and cutlery, towels and other hygiene products on which biological fluids can be left. Not timely detected syphilis becomes the cause of infection of all members of the patient's family.
As the infection progresses, the pathogen spreads through the lymphatic system to the tissues of the liver, brain, and digestive tract, causing serious damage to organs. Pronounced signs of disturbances develop during the transition of the latent phase to the active one. Serious changes occur in the absence of timely treatment against the background of a decrease in the body's defenses. With strong immunity, the patient becomes a carrier of infection.
In medical practice, it is customary to classify the disease into the following forms:
The latent nature of the infection can take the following forms:
Doctors consider the disease in the early period to be the most dangerous, since uncontrolled infection occurs by the patient, who is unaware of his infection, and the people around him.
It is possible to detect an early form of latent syphilis during a preventive examination. A blood test (Wasserman reaction) is carried out not only during medical examinations, but during hospitalization for various pathologies. Such studies make it possible to determine the latent form of syphilis. The serological reaction does not show the correct results in all cases, and there is a need for other laboratory tests.
During the examination of patients with suspicion of an early form of the disease, the doctor reveals enlarged lymph nodes with characteristic seals, a rash on the skin, which went unnoticed by patients due to its short duration. These signs may indicate infection with pale treponema. The presence of a pathogenic agent in the body is often accompanied by changes in the thyroid gland, liver, joints, and digestive tract. Many patients have symptoms of disruption of the nervous system, since microorganisms violate the walls of blood vessels, the structures of the meninges.
Late latent syphilis is spoken of when infected with pale treponema that occurred more than two years ago. At this stage, the disease is considered safe for the people around the patient. In the late period, rashes on the skin are not detected, while the infection leads to the destruction of internal organs, the nervous system. In many cases, late silent syphilis is detected in elderly patients suffering from rheumatoid arthritis, cardiac ischemia, or myocarditis.
The disease is evidenced by a rash that looks like ulcers, signs of osteomyelitis, impaired functioning of the brain, changes in the gastrointestinal tract and lungs. Patients may complain of joint pain. "Neurosyphilis" is placed in case of damage to the nervous system.
The consequence of a late latent disease in the absence of therapy is severe disorders of organs and systems that threaten disability.
Latent forms of syphilis may not affect human health for a long time. The presence of a pathogen in the body should be suspected in the presence of the following symptoms:
The presence of scars and seals on the genitals, the residual phenomenon of polyscleradenitis testify to the primary form of the disease. Serological studies show positive results in 70% of patients. In 25% of patients, low titers are observed. They decrease after antibiotic therapy.
Against the background of treatment with penicillin drugs, a third of patients observe the Herxheimer-Jarish reaction, which manifests itself in the form of a sudden increase in temperature, headaches and muscle pain, nausea and tachycardia. This symptomatology occurs due to the mass death of pathogenic microorganisms and decreases when taking aspirin. When meningitis occurs, associated with latent syphilis, there is an increase in protein, a positive reaction to globulin fractions.
The anamnestic method helps doctors in diagnosing a latent form of syphilis. Data collection takes into account:
When making a diagnosis, difficulties may arise. Sometimes patients hide and misinform the doctor because of secrecy. Often the symptoms are similar to other diseases. Obtaining false positive results can also make it difficult to diagnose latent syphilis. A detailed history plays an important role in determining the form of the disease.
Carrying out specific tests, obtaining enzyme immunoassay indicators, immunofluorescence reactions help determine the presence of syphilis pathogens in the patient's body.
The examination includes a consultation with a gastroenterologist, a neurologist and a proctologist. It is necessary to confirm or exclude damage to organs and systems.
Therapy of the latent form of syphilis is carried out only after receiving laboratory data.
Examinations are assigned to the sexual partners of the patient.
If the test results are negative, prophylactic treatment is not required.
Therapy is carried out in the same way as in other forms of syphilis. It is carried out on an outpatient basis with drugs with prolonged action: benzathine penicillin and benzylpenicillin sodium salt. The occurrence of hyperthermia during treatment with antibacterial drugs means that the disease is diagnosed correctly. After an increase in temperature and the death of the infection, the condition of patients usually improves. If the form of syphilis is late, such a reaction is not observed.
Dosages of drugs:
If the patient has signs of poor tolerance to drugs from the penicillin group, the doctor prescribes antibacterial drugs of the tetracycline series, macrolides, cephalosporins. Pregnancy is not a contraindication to the use of penicillins, as they are considered safe for the fetus. Therapy during this period is necessary, since congenital syphilis can cause the development of pathologies in a child.
It is important to remember that after a completely cured disease, stable immunity is not developed. Preventive measures must be taken to prevent re-infection. All sexual contacts must be protected. A disorderly intimate life can lead to infection with syphilis and other sexually transmitted diseases. It is necessary to use only personal hygiene items, wash hands regularly. Every year, doctors recommend donating blood for tests and being examined by a general practitioner, urologist, gynecologist, and neurologist.
At the end of the course of antibacterial drugs, specific tests are carried out. Examinations are carried out repeatedly until normal results are obtained. In the subsequent control is made two more times in 90 days.
If the disease has a late form and the tests showed positive results, the period of medical observation is at least three years. Patients are tested every six months. Deregistration is made after receiving normal indicators of laboratory research. With a late latent form of the disease, the results become normal for a long time. The observation of the patient ends with a complete examination, including not only the delivery of tests, but also a consultation with a neurologist, ophthalmologist, therapist, gynecologist.
Admission to work in a children's institution and a public catering enterprise is given only with the complete disappearance of all symptoms and clinical signs of the disease.
Latent syphilis is a dangerous disease that disrupts the functioning of many systems and organs. If you have any suspicious symptoms, you should consult a doctor.
Timely detection of infection helps prevent the development of complications.
To avoid infection with syphilis and other sexually transmitted diseases, it is important to follow the rules of prevention.
A common sexually transmitted disease - syphilis - is caused by a microorganism - pale spirochete. It has several stages of development, as well as many clinical manifestations. In Russia, in the late 90s of the twentieth century, a real epidemic of this disease began, when out of 100,000 people fell ill per year, 277 people. Gradually, the incidence is decreasing, but the problem is still relevant.
In some cases, there is a latent form of syphilis, in which there are no external manifestations of the disease.
The causative agent of the disease - pale spirochete - under normal conditions has a typical spiral shape. However, under adverse environmental factors, it forms forms that promote survival - cysts and L-forms. These modified treponemas can persist for a long time in the lymph nodes of an infected person, his cerebrospinal fluid, without causing any signs of illness. Then they are activated, and there is a relapse of the disease. These forms are formed due to improper antibiotic treatment, the individual characteristics of the patient and other factors. Especially important is the self-treatment of patients for a disease that they consider gonorrhea, but in fact it is an early stage of syphilis.
The cyst form is the cause of latent syphilis. It also causes a lengthening of the incubation period. This form is resistant to many drugs used to treat this disease.
How is latent syphilis transmitted? In nine cases out of ten, the route of transmission is sexual. Much less common is the household route (for example, when using one spoon), transfusion (with the transfusion of infected blood and its components), and transplacental (from mother to fetus). This disease is detected most often during a blood test for the so-called Wasserman reaction, which is determined for each admitted to the hospital, as well as when registering with a antenatal clinic for pregnancy.
The source of infection is only a sick person, especially in the secondary period.
This is the time after infection of a person with treponema pallidum, when there are positive serological tests (blood tests are changed), but symptoms are not determined:
Usually changes in the blood appear two months after contact with the carrier. From this moment, the period of the disease is counted in a latent form.
Early latent syphilis occurs within two years of infection. It may not appear immediately, or it may be the result of a regression of early symptoms of the disease, when an apparent recovery occurs. There are no clinical symptoms of latent syphilis, it is characterized by a negative test of cerebrospinal fluid (cerebrospinal fluid). It is diagnosed using serological tests.
Latent late syphilis is characterized by a sudden activation of the process after a period of imaginary well-being. It can be accompanied by damage to organs and tissues, the nervous system. There are low-contagious elements of the skin rash.
In this case, neither the patient nor the doctor can determine when the infection occurred, since there were no clinical symptoms of the disease, and it was revealed, most likely, as a result of a blood test.
There is also the possibility of a false positive result of the Wasserman reaction. This happens in the presence of a chronic infection (sinusitis, caries, tonsillitis, pyelonephritis and others), malaria, liver diseases (hepatitis, cirrhosis), pulmonary tuberculosis, rheumatism. An acute false-positive reaction occurs in women during menstruation, in the third trimester of pregnancy, in the first week after childbirth, myocardial infarction, acute diseases, injuries and poisoning. These changes disappear on their own within 1-6 months.
If a positive reaction is detected, more specific tests are necessarily carried out, including a polymerase chain reaction that determines the antigen of pale treponema.
This form covers all forms by terms from primary seropositive (hard chancre) to secondary recurrent (skin rashes, then their disappearance - a secondary latent period, and relapses for two years), but there are no external signs of syphilis. Thus, the disease can be recorded in the period between the disappearance of the hard chancre (end of the primary period) until the onset of the formation of rashes (the beginning of the secondary period) or be observed at the moments of remission in secondary syphilis.
At any time, the latent course can be replaced by a clinically pronounced one.
Since all of the listed forms are contagious, due to the coincidence in time with them, the early latent variant is also considered dangerous for others and all the prescribed anti-epidemic measures (identification, diagnosis, treatment of contact persons) are carried out.
The disease is detected most often by chance, for example, during hospitalization for another reason, when a blood test is taken (“unknown syphilis”). Usually these are people aged 50 years and older, their sexual partners do not have syphilis. Thus, the late latent period is considered non-contagious. In terms of timing, it corresponds to the end of the secondary period and the entire Tertiary.
Confirmation of the diagnosis in this group of patients is more difficult, because they have concomitant diseases (rheumatoid arthritis and many others). These diseases are the cause of a false positive blood reaction.
To make a diagnosis, you should ask the patient all the same questions as with the early latent variant, only change the condition: all these events must have occurred more than two years ago. Serological tests help in the diagnosis: more often they are positive, the titer is low, and ELISA and RPHA are positive.
When confirming the diagnosis of latent syphilis, ELISA and RPHA are of decisive importance, because serological tests (rapid diagnostics) can be false positive.
Of these diagnostic methods, the confirmatory reaction is RPHA.
With latent syphilis, a puncture of the cerebrospinal fluid (CSF) is also indicated. As a result, latent syphilitic meningitis can be detected. Clinically, it does not manifest itself or is accompanied by minor headaches, hearing loss.
The study of cerebrospinal fluid is prescribed in the following cases:
Most often, syphilis has an undulating course with alternating remissions and exacerbations. However, sometimes its long course without symptoms is observed, ending several years after infection with syphilis of the brain, nerves, or internal tissues and organs. This option is associated with the presence in the blood of strong treponemostatic factors resembling antibodies.
Pain in the legs with latent late syphilis may result from damage to the bones, joints, or nerves.
If a woman has a positive serological reaction during pregnancy, but there are no clinical signs of the disease, she must definitely donate blood for ELISA and RPHA. If the diagnosis of "latent syphilis" is confirmed, she is prescribed treatment according to general schemes. Lack of therapy entails serious consequences for the child: congenital deformities, abortion and many others.
If the disease is cured before 20 weeks of pregnancy, childbirth proceeds as usual. If the treatment was started later, then the decision on natural or artificial delivery is made by doctors based on many concomitant factors.
Specific treatment is prescribed only after confirmation of the diagnosis by a laboratory method. The sexual partners of the patient are examined, if they have negative laboratory tests, then they are not prescribed treatment for the purpose of prevention.
Treatment of latent syphilis is carried out according to the same rules as its other forms.
Long-acting drugs are used - Benzathine penicillin, as well as Benzylpenicillin sodium salt.
Fever at the beginning of penicillin therapy is indirect evidence of a correctly established diagnosis. It accompanies the mass death of microorganisms and the release of their toxins into the blood. Then the state of health of patients is normalized. With a late form, such a reaction may be absent.
How to treat latent syphilis:
In case of intolerance to these antibiotics, semi-synthetic penicillins (Oxacillin, Amoxicillin), tetracyclines (Doxycycline), macrolides (Erythromycin, Azithromycin), cephalosporins (Ceftriaxone) can be prescribed.
Latent syphilis during pregnancy is treated according to general rules, since penicillin drugs are not dangerous to the fetus.
After treatment of early latent syphilis, serological control (ELISA, RPHA) is carried out regularly until the indicators are completely normal, and then twice more with an interval of three months.
With late latent syphilis, if RPHA and ELISA remained positive, the follow-up period is 3 years. Tests are carried out every six months, the decision to deregister is made on the basis of a set of clinical and laboratory data. Usually, in the late period of the disease, the restoration of normal blood and cerebrospinal fluid is very slow.
At the end of the observation, a complete examination of the patient is carried out again, examination by a therapist, a neurologist, an otorhinolaryngologist and an oculist.
After the disappearance of all clinical and laboratory manifestations of the disease, patients can be allowed to work in children's institutions and public catering establishments. But once transferred and cured, the disease does not leave stable immunity, so re-infection is possible.
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Latent syphilis is a form of the disease that occurs without symptoms. It is dangerous because patients are unaware that they are infected. At this time, the infection develops, affecting the internal organs.
In the first two years after infection, patients pose a threat to other people and sexual partners, since the disease is contagious. Infected people are always interested in how latent syphilis develops.
The development of latent syphilis is no different from the causes of infection with the classic form of the disease. Bacteria - pale treponemas - enter the patient's body. Microorganisms begin to multiply. But after the incubation period, the latent form of the disease does not show symptoms.
The fact is that treponemas throw off the shell and penetrate through the membrane into the nucleus of phagocytes. These cells are responsible for the human immune defense. It turns out that bacteria develop, affect the internal organs, hiding behind the shell of phagocytes. The immune system does not recognize bacteria and does not respond.
There are three types of latent syphilis:
Infection is possible after unprotected sex, in a household way (with the constant use of the patient's personal belongings), through saliva, breast milk (from mother to child), during childbirth and through blood (for example: during transfusion).
There are no pronounced symptoms of the disease. But after a thorough examination and history taking, doctors discover indirect signs of latent syphilis. It is similar to other diseases, and therefore there are difficulties in diagnosing the infection.
Indirect symptoms of an early form of the disease include:
In the late type, these symptoms are absent, serological reactions show low titers of reagins. Significant degenerative changes are revealed in the cerebrospinal fluid.
Sometimes in patients in both cases, there is an unreasonable increase in temperature up to 38 degrees, weight loss, weakness and frequent ailments.
The type of disease depends on how long ago the patient contracted the infection. Early latent syphilis is a disease in which infection occurred earlier than 24 months ago. The disease proceeds without symptoms, it is detected during routine medical examinations or in the treatment of other diseases.
An early variety is dangerous because the patient is contagious at this time. It endangers sexual partners and family members, since pale treponema is also transmitted by household means.
Sometimes patients remember that for a short period of time they had a rash on the body of an incomprehensible etymology. But the rashes went away on their own after a short period of time. When examining a patient, it is revealed. And at the site of the rash, small scars (or syphilomas) are noticeable. To a greater extent, latent syphilis of an early form affects people under 40 years of age, who more often enter into casual sexual relationships.
Some of the patients with early latent syphilis claim that over the past two years they have had erosive rashes in the mouth and on the genitals.
If the infection is detected when the infection occurred more than two years ago, then the patient is diagnosed with late latent syphilis. During the latent development, pale treponema affects the internal organs and the nervous system. A person suffering from this type of disease is safe for others, since he is no longer contagious.
According to statistics, late infection is found in family people older than 40 years of age. Partners of those infected usually also have syphilis, and the disease also occurs in a latent form.
According to the results of tests in patients, the Wasserman reaction shows a positive result. Also, patients have positive results of RIF and RIBT. These serological reactions are present in low titers, only in 10% of patients - in high titers.
Doctors carefully examine patients with a late form of infection, but there are no signs of a rash on the skin, there are no scars, scars or syphilomas.
Latent undiagnosed syphilis is a form of the disease in which it is impossible to establish the period of infection of the patient. Doctors cannot find out the timing of infection, and the patients themselves do not know when and under what conditions they became infected. This question is important to determine whether a person is contagious to other people, or the dangerous period has already passed.
Sometimes doctors manage to find out the time of infection if the patient is treated with antibiotics from the prolonged penicillin series. In the early stages of the disease, taking antimicrobial drugs causes a sharp increase in temperature, the patient experiences intoxication. If the syphilis of the old form is not specified, then the use of antibiotics does not cause any reactions from the body.
Patients must take a complete blood count. To detect pale treponema, serological studies are carried out: RIBT (immobilization reaction) and RIF (immunofluorescence reaction). It is possible to conduct ELISA (enzymatic immunoassay).
Based on all the results, the doctor makes a diagnosis, finds out whether the patient has an infection, and how long ago the infection occurred.
Patients are always interested in questions about how to treat a latent infection and whether it is possible to fully recover. Therapy is carried out by venereologists. Each patient is prescribed individual treatment depending on the form of the disease, the patient's condition, possible contraindications.
The treatment of latent syphilis does not differ from the treatment regimen for the common form of the disease. Pale treponema is a bacterium, it is sensitive to antibiotics, so therapy is carried out with antibacterial drugs. In parallel, the patient takes immunomodulators, vitamins and drugs that improve the functioning of the intestines and liver (antibiotics kill the entire microflora of the gastrointestinal tract).
The duration of treatment depends on the form of the disease, it can last from two to three months to several years.
The most effective drugs are the penicillin series. They can be short, long (long) or medium action. Penicillins are administered intramuscularly, in this way they are better absorbed and more active. Common drugs include: "Bicillin 1", "Benzathinepenicillin G", "Retarpen".
10% of people are allergic to penicillin antibiotics. In this case, the drugs are replaced with cephalosporin antibiotics. One of the best drugs is Ceftriaxone. In case of allergic reactions to these drugs, patients are prescribed:
Latent syphilis can occur in three forms: early, late and unidentified. Usually it is detected by chance, during a routine examination by doctors or during the treatment of other pathologies. Diagnosis is complicated by the fact that the infection occurs without symptoms.
Patients do not suspect about the disease, they live peacefully. At this time, microorganisms infect the internal organs, and the infected themselves infect other people. Treatment of the disease takes place under the control of a venereologist and depends on the form of the disease.
