Symptoms of syphilis
Syphilis is a highly contagious bacterial infection, a human disease caused by pale treponema( Treponema pallidum).The disease in most cases is sexually transmitted and characterized by a chronic undulating course with periods of exacerbations and prolonged latent periods. Syphilis can be acquired and congenital. Once infection has occurred, bacteria quickly spread through the bloodstream and the lymphatic system and cause a variety of symptoms. In the absence of treatment for syphilis, there are three main stages of development: primary( three to four weeks after infection), secondary( four to eight weeks) and tertiary( from one year to 30 years after infection).
Skin lesions in primary and secondary syphilis heal spontaneously for several weeks or months. The secondary and tertiary stages are separated by a latent period during which the patient does not show any symptoms and seems healthy. The latent period usually lasts for years and often throughout life. A person infected with syphilis is extremely contagious during the primary and secondary stages, but is not infectious during the latent period and the tertiary stage. Adequate treatment with antibiotics during the primary or secondary stages makes it possible to get rid of the infection.
In the absence of treatment, syphilis, which has developed to the tertiary stage, can cause damage to the tissues of the heart, brain and spinal cord, eyes and other organs;these injuries can be fatal. Although tertiary symptoms appear only in about 30 percent of patients left untreated, by the time these symptoms appear, tissue destruction is widespread, and antibiotic treatment no longer has an effect. Therefore, early detection and treatment of syphilis is crucial.
Syphilis classification( ICD X, 2007)
• Primary syphilis ( three to four weeks after infection): painless ulcer on the penis, vagina, cervix, rectal area or in the mouth;enlarged lymph nodes in the area of the ulcer.
The incubation period of syphilis lasts from 9 to 90 days. The primary stage of syphilis is characterized by the appearance of a spot at the site of penetration of pale treponema. Then the lesion is quickly transformed into a papula, which is subsequently eroded and ulcerated.
Primary syphiloma( primary chancre) - more often single erosion or ulcer, painless, with no signs of inflammation around, relatively poorly vascularized, has a cartilage-like infiltrate with a clear border. Primary syphilis is often accompanied by a moderate increase in regional lymph nodes;in the case of localization of the primary chancre in the external genital area, a bilateral limited increase in inguinal lymph nodes of moderate density( inguinal lymphadenopathy) is observed.
• Secondary syphilis ( four to eight weeks after the initial stage): mild fever;headache;sore throat;general feeling of poor health;hair loss;skin rash, especially on the palms and soles;gray coating in the mouth;painless, enlarged lymph nodes in the neck, in the armpits or in the groin.
Secondary syphilis is the most contagious stage of the disease and is characterized by the presence of a variety of rashes on the skin and mucous membranes.
In secondary syphilis, other symptoms can also occur: fever, fatigue, headache and an increase in all groups of lymph nodes. These symptoms can be very mild and, like the primary syphiloma in primary syphilis, disappear without treatment.
In secondary, syphilis, there may be signs of damage to internal organs and the nervous system.
• Tertiary syphilis ( five to 30 years after infection): loss of balance;loss of control of the bladder;sudden severe pain;loss of touch in the legs, paralysis;erectile dysfunction( impotence);personality changes;dementia or insanity;blindness;symptoms of congestive heart failure due to damage to the aortic valve.
After many years of latent flow, in the absence of treatment, the disease can go to its most destructive stage - tertiary syphilis. In this case, lesions of the skin and mucous membranes, the morphological basis of which is granulomatous inflammation, can be observed, and clinical manifestations are characterized by tubercular and gummy eruptions. In addition to skin and mucous membranes, the heart, liver, nervous system, musculoskeletal system can be affected, which leads to mental disorder, blindness, neurological problems, heart disease and death. Neurosyphilis can occur as asymptomatic, as manifested in the form of meningovascular syphilis, dorsal or progressive paralysis. Cardiovascular syphilis - in the form of mesaortitis, which often proceeds asymptomatically and can be complicated by stenosis of the coronary arteries, aortic valve insufficiency, aortic aneurysm, mainly ascending.
Tertiary syphilis is diagnosed on the basis of a combination of clinical signs and the results of serological reactions.
When a pregnant woman is registered, a screening test for syphilis should be carried out, which is repeated in the second and third trimesters of pregnancy. If a woman was not registered for pregnancy, a syphilis check is performed during childbirth. Newborns are not discharged from the maternity hospital until the result of the analysis for syphilis is obtained, especially if during the antenatal observation the mother's serological status was questionable.
Like acquired infection, congenital syphilis is divided into early and late.
Some children with early congenital syphilis may have clinical manifestations of the disease at birth, but most develop within two weeks to three months after birth. Some newborns may have a latent infection.
Clinical manifestations of early congenital syphilis: wrinkled skin of gray-yellow color with specific eruptions, including those characteristic only of congenital syphilis( syphilitic pemphigus, diffuse papular infiltrations).Other manifestations of early congenital syphilis include syphilitic osteochondritis of Wegener, fever, enlargement of the liver and spleen, anemia and various malformations.
Later( after 1 year or more), symptoms of late congenital syphilis may develop, including damage to bones, teeth, eyes, the organ of hearing and the brain. Signs pathognomonic for late congenital syphilis include the Getchinson triad: parenchymal keratitis, specific labyrinthitis( labyrinthine deafness), and Getschinson's teeth.
• To prevent the spread of syphilis, avoid sexual intercourse during treatment and until at least two follow-up examinations show any signs of infection.
• Consult your doctor if you or your sexual partner have a painful ulcer in the mouth or in the genital area.
• Contact your doctor if you have had sexual contact with someone who may have syphilis.
• Intramuscular penicillin injections can cure primary or secondary syphilis. Other antibiotics are used for those who have an allergy to penicillin. Sexual partners should undergo the same course of treatment.
• Use latex condoms for sexual intercourse to reduce the risk of transmission of the disease. Mutually monogamous relationships are the safest.