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It is proved that syphilis is the most widespread illness among venereal diseases – the most widespread venereal disease. At syphilis there is a defeat of a number of internals and skin. Especially the cardiovascular system, a stomach and a liver suffers from a disease, mucous membranes, nervous and bone and joint systems are also surprised.
Syphilis is the general venereal illness which in case of lack of due therapy can last for many years. Wavy development is characteristic of syphilis, at the same time phases of the hidden disease are replaced by aggravation phases. At an active form of an illness symptoms of syphilis arise on skin, and also on mucous membranes of an organism. At the same time at the eclipse period of syphilis clinical symptoms of an illness are not shown.
Distribution of syphilis
Today the incidence of syphilis at men and women constantly raises. The causative agent of this illness is the pale treponema. This very mobile microbe has the spiral-shaped form. In the course of reproduction the microbe begins to be divided into parts. The pale treponema for thirty three hours breeds. If for reproduction of a microbe of a condition improper, then there is a regeneration of a treponema then it remains in cysts and in L-forms.
Syphilis is transmitted mainly sexually. On a mucous membrane of generative organs, oral cavities, a rectum can always be present small defects through which there is infection. In more exceptional cases the household way of infection with an infection is possible during direct contact with the person which is sick with syphilis. Very seldom infection with syphilis occurs through various household items – in this case it is about so-called household syphilis. Objects through which household syphilis is transmitted have to be contaminated separated syphilitic elements of the patient.
Besides, the child from sick mother, either vnutriutrbno, or at the time of delivery can catch. Besides, infection can happen also during breastfeeding.
From the point of view of theoretical infection with syphilis is possible and during hemotransfusion, and also organ transplantation of donors. However in practice the similar phenomenon is excluded, in the conditions of medical institutions there takes place careful check of bodies and blood.
Course of syphilis
The course of syphilis can be subdivided into an incubation interval, and also primary, secondary and tertiary periods.
Incubation interval duration usually proceeds about a month. This time from infection with an illness before emergence in a sick hard ulcer. If the person is in parallel treated by antibiotics from there is nobody other disease, then the incubation interval of syphilis can be extended. During this period it is impossible to catch syphilis from the person therefore at a serological test of blood the result will be negative.
At primary syphilis pale treponemas begin to breed quickly in that place where they got into an organism. On this place there is a small ulcer which has a smooth and equal bottom. Emergence of several round ulcers is in certain cases possible. It is also a hard ulcer. Such ulcer does not bring notable discomfort and pain, therefore, very often the person does not notice its emergence at all. Approximately in a month the ulcer disappears without treatment, there is only a small hem. But at the same time syphilis in a human body continues to develop. At primary syphilis of the patient can already infect other people though symptoms of syphilis are expressed still softly. A certain part of bacteria which contain in a hard ulcer begin to migrate in lymph nodes which are located a row. At the same time lymph nodes will be increased, however morbidity is not observed. Further bacteria get to a bed of blood and a blood-groove extend on a human body.
On the sixth or seventh week after infection syphilis can be found as Wassermann reaction becomes positive.
Symptoms of syphilis secondary begin to be shown at the patient during the different period – approximately 2-10 weeks later after infection. On skin of the person after all trunk there can be small knots, pustules, spots. However such phenomena seldom disturb painfully and they disappear independently, without treatment, several weeks later. At this stage there is a beginning of the secondary latent syphilis. Return of symptoms of syphilis is characteristic of recurrent secondary syphilis: the person has a change of skin on different sites, the hair loss, emergence of small spots on a neck is characteristic. At the same time all these elements are very infectious, however they do not cause pain. At this time there is the highest risk of infection from the person with syphilis in life. The wavy current is characteristic of an illness at this stage: symptoms of syphilis appear and again disappear. The similar course of an illness can proceed even several years. When carrying out serological tests of blood they will be positive.
At a tertiary stage of a disease there is a formation of the centers (gummas) in bones, skin, internals, eyes. Later these centers break up, and at the same time there is also a partial destruction of body in which they were shown. At especially started stages of an illness there is an ulceration of mucous membranes of a nose, throat, a hard and soft palate. Very often the person has a defeat of a nasal partition owing to what the nose fails. However the most terrible effects of development of syphilis is death of nervous cells of both a head, and spinal cord. At the person paralysis, weak-mindedness can develop. Development of tertiary syphilis in men and women happens later 5-10 after there was infection, sometimes this stages can come later. Serological tests of blood at this stage happen slabopolozhitelny or negative.
Transfer of syphilis at women during pregnancy happens through a placenta from 10th week of pregnancy. In most cases infection of a fruit happens on 4-5 month of pregnancy. Most often (practically in all cases) infection of a fruit happens if at the woman secondary syphilis takes place. At late forms of an illness infection vnutriutrobno happens less often. Extremely seldom syphilis is transmitted to future child from mother sick with primary syphilis.
After there was transplacental infection, the fruit sometimes perishes, and there is abortion. There is also a possibility of the birth of the dead child in time. The newborn can survive, but in process of growth he will show symptoms of syphilis. Display of syphilis at the child aged from one year till two years is similar to symptoms of secondary syphilis.
The main first symptom of syphilis at men and women is the hard ulcer described above. It can appear practical on any place of a body where the activator was implemented. The chancre can have the different sizes: from 1-3 mm (so-called dwarfish chancres) to 2 and more centimeters (chancres huge).
Besides, at the end of primary period of syphilis some patients complain of a febricula, a headache, lack of appetite, morbidity of joints and bones. Periodically body temperature can increase up to 38 degrees. Display of indurative hypostasis of genitalias is also probable.
In the secondary period of syphilis on skin multiple syphilitic rashes are shown. Such rashes can be shown anywhere, and they pass into nothingness. The menocelis which appears symmetrically, very bright and plentiful is considered the most frequent display of secondary syphilis. Approximately in two months it disappears. At recurrence of syphilis already less bright rashes appear. Generally they arise on those places where there is a mechanical impact on integuments: in inguinal folds, under a breast, on mucous membranes, etc. Often papular connects to such rash sifilit – rash in the form of small knots. Besides, at recurrence of syphilis often there is baldness of pilar part of the head and other covers of skin covered with hair. Perhaps both focal, and continuous baldness.
Most of patients in the secondary period of syphilis do not note disturbance of the general state. Seldom there are head fights, body temperature increases.
The headache, temperature increase, indisposition, appetite loss is sometimes noted.
At patients at a stage of tertiary syphilis rashes in the form of nodes or hillocks are often shown. Later hillocks are exposed to involution or are softened, and on their place sifilisny ulcers develop. As a result fabrics collapse.
Diagnosis of syphilis
To establish the diagnosis "syphilis", the doctor studies data of the anamnesis in detail, and also appoints carrying out laboratory and clinical trial.
By means of the laboratory analysis research of the separated hard ulcer, erosion, papules which origin can be syphilitic is conducted. Very often symptoms of syphilis can remind symptoms of other diseases. Therefore confirmation of the diagnosis requires carrying out specific laboratory diagnosis. The dl of it is applied serologic assay of blood by which it is possible to define existence of the antibodies produced by an organism for fight against a pale treponema. Besides, Wassermann reaction – a special blood analysis from an elbow vein is carried out.
Perhaps also use of a method of an immunofluorescence which is based on existence of a specific luminescence of pale treponemas in a luminescent microscope. By means of reaction of an immobilization of pale treponemas it is possible to distinguish false positive result of RV that sometimes takes place at healthy people.
In an individual order the doctor can appoint also computer tomography and other methods of research, however it occurs seldom.
Complications of syphilis
The most serious effects of syphilis is, first of all, defeat of the central nervous system. It is fraught with display of meningitis, neuritis, hydrocephaly. Very often at patients with neurosyphilis functioning of acoustic organs and sight is broken.
Rather often as effects of syphilis the osteoarthritis is shown. The cardiovascular system is also exposed to complications: syphilitic myocarditis is sometimes shown, functioning of valves of an aorta is broken later, periodically there are stenocardia attacks. Owing to the broken blood circulation at the patient there comes the myocardial infarction.
Work of respiratory system is interfered by cough, short wind, manifestation of symptoms of tubercular pneumonia is possible. The digestive tract strikes syphilitic gastritis. In process influence of a disease on a condition of a liver hepatitis symptoms can be shown. Perhaps also emergence of the hepatic coma leading to a lethal outcome.
Often as complications of syphilis at patients the balanitis, a balanoposthitis, a phymosis, a gangrenization develops. At defective treatment of an illness the illness passes into a tertiary stage, and an effect of syphilis are fraught with death. Therefore important full diagnosis and treatment of syphilis at both sexual partners.
Treatment of syphilis
First of all, it is important to consider that treatment of syphilis has to be carried out in a complex and at the same time it is necessary to finish the cure of the patient fully. It is important that treatment of syphilis was carried out by the specialist of a narrow profile, that is the dermatovenerologist. Besides it is necessary to begin therapy process as soon as possible. Self-treatment in this case is absolutely inadmissible.
The most important part of complex therapy of syphilis at women and men is treatment by means of antibiotics. These drugs will be effective at all stages of syphilis. The most effective method of treatment of syphilis is therapy by water-soluble penicillin that allows to provide constant necessary concentration of an antibiotic in blood. At the same time the way of infection with an illness does not matter: by means of antibiotics also syphilis which is transmitted sexually, and household syphilis recovers.
However even at treatment by antibiotics of recovery of damages which arose at the last stage of syphilis will not occur any more, and effects of syphilis will remain forever. Sometimes at treatment of syphilis also other drugs antibiotics, for example, tseftriakson are applied.
In parallel in process treatment immunostimulation, antiallergic means, and also purpose of vitamin complexes is applied. In general at purpose of drugs for treatment of syphilis the doctor surely considers specific features of a course of syphilis at women and men. Besides, the technique of treatment of syphilis directly depends on what stage of an illness takes place at the patient.
On the termination of a basic course of treatment of syphilis it is important to control a condition of the patient laboratory for one year. The analysis of RV is for this purpose carried out.
Prevention of syphilis
For the prevention of a disease it is important to treat the choice of sexual partners, first of all, responsibly. It is necessary to remember that the most dangerous is contact with the person at which an enanthesis was already shown. It is impossible to allow the unprotected sexual contacts at all. Besides, restriction of number of sexual partners, and also their responsible sexual behavior considerably reduces risk of a disease. But the healthy relations with the only sexual partner by right are considered as the most correct approach to prevention of syphilis.
If you are forced to contact close to the person who is sick with syphilis, then it is important to take all measures that the disease did not extend. For this purpose rather strictly to follow all rules of hygiene, and also to avoid close corporal contacts with the infectious patient. If to follow all these rules, then the risk of infection considerably decreases.
It is important to remember prevention of syphilis in case of risky sexual contact. If there is a suspicion that infection with an illness took place, it is necessary to carry out preventive therapy as soon as possible (it is desirable to do it not later, than in two hours after sexual contact). Several weeks later it is necessary to make all necessary laboratory researches surely.
All patients with syphilis consist on special accounting, behind them dispensary observation and after treatment is made. Besides, serological examination of pregnant women for the prevention at future child of inborn syphilis is without fail conducted.
Section: Infectious diseases
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