How to identify syphilis in a woman. Possible manifestations and treatment of syphilis in women. Syphilis in women - what is it

22.06.2017

One in 20 girls exposes themselves daily to the danger of getting an infection that is transmitted sexually by contact or STIs, like chlamydia, gonorrhea and, of course, syphilis.

By neglecting their health, sexual partners become victims of their frivolous attitude towards life.

Each year, the rate of persons with STIs reaches 357 million, of which 5.6 million acquire male and female syphilis. And, if in men the first manifestations of a sexually transmitted disease appear after 3-4 weeks, then the first signs of syphilis in women can be recognized no earlier than 1-1.5 months. The asymptomatic course significantly complicates timely diagnosis and prevents the rapid recovery of patients.

What is syphilis

Systemic bacterial disease, which belongs to the group of sexually transmitted infections. Gram-negative spirochete, anaerobic treponema pallidum, or Treponema pallidum, is the only causative agent of syphilis. Does not require oxygen for development and life in the human body. The breeding process takes place at a temperature of 37 ° C once every 1.5 days. The pathogenic bacterium infects cells, tissues and organs, the heart, blood vessels, the central nervous and digestive systems, the musculoskeletal system and the spinal cord.

Infection with syphilis occurs during promiscuous and casual sexual relations. The risk is significantly reduced when using barrier methods of contraception, but they also do not guarantee that the partner is safe. Infection with syphilis occurs in the presence of wounds, injuries on the genitals of a woman or an inflammatory process of the pelvic organs, violation of the integrity of the condom during sex. Even microcracks on the lips of a girl contribute to the penetration of pale treponema into the body.

The deliberate or accidental use of the same syringes, which is often observed in people with drug addiction, becomes the cause of infection with syphilis through the blood. Inexperienced medical personnel are exposed to the same danger when taking tests and carrying out droppers, intravenous and intramuscular injections to a patient.

Without sufficient information about how sexually transmitted infections are transmitted, many underestimate domestic syphilis.

Shared items of common use and personal hygiene items, which are touched by a sick person with pronounced ulcers, are dangerous to others. The spirochete remains in warm, damp linen for 2-3 days.

The first signs of syphilis in women

Optimal favorable conditions for the development of gram-negative bacteria are lymph nodes and mucous membranes. Until the moment when it will be possible for a woman to identify the first symptoms of syphilis, it will take at least 21-30 days. During this time, anaerobic treponema spreads throughout the body and multiplies. It is difficult to determine the incubation period of the course of the disease even in laboratory conditions. The primary manifestations of syphilis usually last 6-8 weeks:

• hard chancre, a small ulcer with a dense infiltration inside the mammary gland, pubis, labia, around the anus, in the vagina and on the cervix. Absorbs without treatment. In its place, scars or age spots form;
• atypical erosion with edema of a pale pink or bluish tint on the lips, in the genital area;
• suppuration of soft tissues in the area of ​​the fingers;
• a significant increase in the tonsils. Accompanied by temperature;
• inflammation of the lymph nodes. It manifests itself in the small pelvis, elbow bend, on the neck and back of the head, chin.

A characteristic feature in women is a foul-smelling thick discharge with syphilis, which is accompanied by burning, itching in the perineum and the skin around. Very often, patients notice menstrual irregularities, painful bleeding and an increase in blood volume.

Secondary manifestation of syphilis

A feature of an infectious disease is a periodic acute manifestation followed by a temporary absence of signs. This alternation of relapses and their frequency are interrelated with the response of the immune system to bacteria. Secondary symptoms of syphilis in women are usually observed 2-4 months after infection. They can last for several years in both latent and pronounced form.

Secondary rashes, syphilides, differ from those that were at the beginning of the development of the infection. They arise everywhere, the skin and mucous membranes are no longer affected by single ulcers, but by red roseola, pearlescent papules and purulent pustules. They disappear without the formation of scars characteristic of chancre.

In an infected woman, seizures appear in the corners of the lips, spots on the face in the form of pigmentation, the so-called "necklace of Venus" develops in the neck area, which is a set of small lightened discolored areas of the skin. Hair begins to thin, multiple hair loss occurs in the temporal and parietal regions, eyelashes and eyebrows lose their density.

Almost the entire body is affected by syphilis, including the organs of hematopoiesis and digestion, joints and bones, the nervous and cardiovascular system.

Possible impairment of vision and hearing. Often, patients have fever, fever up to 38 ° C, migraine, sleep disturbance and lack of appetite.

Tertiary syphilis - the last stage

Insufficiently qualified treatment or its absence due to a woman's unwillingness to be healthy becomes the cause of a tertiary neglected form, in which a violation of the functional work of all systems and organs occurs, the likelihood of disability and death increases. Here is how syphilis manifests itself in women at the last stage of the disease:

• gummy syphilide. A granuloma that destroys tissue. Damages the skin and subcutaneous tissue, bones, cartilage, internal organs;
• neurosyphilis. CNS dysfunction and brain damage. Provokes a weak transmission of nerve impulses. The result is paralysis, dementia, neuralgia, epilepsy.

The severe consequences of the tertiary period of syphilis cause partial or complete loss of vision and hearing, renal failure, syphilitic hepatitis, myocarditis, arthritis. Naturally, a woman is also deprived of her main function: procreation.

Syphilis during pregnancy

Statistics show that syphilis is not so rare in pregnant women. More than 900 thousand expectant mothers are infected, intrauterine infections affect the fetus, and then the newborn baby in 30-40%. And only in 20% of cases it is possible to give birth to a healthy baby without developmental pathologies.

Syphilis affects the eyes, ears, bone marrow and heart of the fetus, which increases the likelihood of a stillbirth or spontaneous abnormal termination of pregnancy.

In surviving babies, the bacterium may not express itself for more than 2 years, and the disease may proceed in a latent asymptomatic form.

After a confirmed diagnosis and established presence of infection for the treatment of syphilis during pregnancy, it is prescribed to take "Penicillin", which provokes dizziness, false contractions, migraines and muscle pain. Sexual intercourse is strictly prohibited during the treatment period. The patient is under the constant supervision of an obstetrician-gynecologist within the hospital.

Diagnosis of syphilis in women

Clinical laboratory tests can help identify and detect bacteria such as treponema pallidum. If you suspect a sexually transmitted disease and in order to confirm the diagnosis of syphilis, after the initial examination, the attending gynecologist must prescribe an examination.

RPR test. Provides for the reaction of IgG and IgM antibodies to specific cardiolipin antigens, the appearance in the body of which is characteristic of syphilis. The effectiveness of the conduct depends on the duration of the course of the disease. A 100% result can be guaranteed only if the gram-negative spirochete is in the body for more than 5 weeks. A titer of 1: 2 or more indicates the presence of bacteria and the need for immediate treatment.

Bacteriological research. To study and search for a microorganism, a biological material is taken from a patient, excretion, followed by placing it in a special nutrient medium. A positive test result is observed with the growth of bacteria and an increase in their number.

PCR diagnostics provides about 98% of reliable data. To get tested for syphilis, a woman takes blood samples, skin areas affected by chancre, pustules and erosions, scraping. During pregnancy, it will be enough to donate breast milk. After determining the DNA of the bacteria, the result is compared with previously obtained materials.

Transvaginal ultrasound. The specialist has the opportunity to assess the condition and structural changes of the uterus, fallopian tubes and ovaries using a specially equipped sensor with a light diode, to identify pathologies and their development.

Colposcopy. Procedure for a thorough examination of the cervix. A binocular microscope allows you to obtain the necessary information about the state of the vagina, find foci of infection, and conduct a biopsy.

Syphilis treatment regimen

Based on the exact data obtained after laboratory and hardware researcha woman is offered to undergo specific drug treatment, for which special drugs are used against primary and secondary syphilis:

• "Bitsillin". Antibacterial agent for intramuscular injection from 2.4 to 4.8 million units. The duration of the course is 1 week. The drug is also effective for the treatment of tertiary syphilis. In an advanced form, the duration of administration is 3-5 weeks. The amount of active ingredient per week should not exceed 2.4 million units twice;
• Benzylpenicillin novocaine salt. Biosynthetic penicillin for intramuscular injection with 0.9% sodium chloride solution. Dosage - 300 thousand units twice a day;
• "Extensillin". Natural bactericidal agent. Acts on the cell wall of the microorganism and disrupts its synthesis. The introduction is mandatory in different buttocks. A single dose - 2.4 million units. The second injection is carried out after 7 days.

If the patient has concomitant infections that have arisen against the background of the disease, tablets are additionally prescribed: "Azithromycin", "Sumamed", "Doxycycline". The treatment regimen for tertiary syphilis involves the use of more potent drugs.

Biyoquinol. Preliminary preparation for the upcoming antibiotic therapy. Every 2-3 days, intramuscular injection of 2-3 ml of the drug is necessary, followed by an increase in dosage to 25 ml per day.

"Penicillin". Use only once every 2 days. An approximate scheme is drawn up with a subsequent increase in drug administration. 1 time - 50 thousand units, 2 times - 100 thousand units, 3 times - 200 thousand units, 4 times - 400 thousand units.

Oletetrin. Combined antibacterial agent. Prescribed in tablets, acts against most gram-negative microorganisms. The daily dosage is 0.25 grams 4 times.

Medicinal electrophoresis under the action of current strength contributes to the rapid introduction and distribution of drugs throughout the body. To eliminate deformation of the skin in the form of scars, adhesive processes, use "Lidaza", the analgesic effect is provided by "Novocain", women with vascular and heart diseases are provided with calcium.

To restore women's health and activate the immune system, it is recommended to take vitamins A and B, calcium, ascorbic, niacin, riboflavin, aloe extract, "Aevit".

It is imperative that drug therapy is carried out by partners at the same time. During treatment, sexual intercourse and alcohol intake should be excluded.

- an infectious venereal disease caused by Treponema pallidum bacteria. It is transmitted through sexual contact with an infected partner, through blood transfusions and when a pathogen enters through wounds. Since the discovery of penicillin in the mid-20th century, the spread of the disease has been largely controlled, but efforts to eradicate the disease have so far been unsuccessful.

Physician-therapist: Azalea Solntseva ✓ Article reviewed by a doctor

Syphilis in women - 4 stages

Without treatment, the disease progresses and goes through 4 stages: primary, secondary, latent and tertiary. It can be acquired or congenital (the route of transmission is in utero from an infected mother).

Syphilis manifests itself in different ways and can mimic many other infections and immunological processes in its later stages. That is why he has earned the nickname "the great impostor".

The causative agent of the disease Treponema pallidum (treponema pale) can hardly survive outside the body. The transmission of the microbe requires direct contact with the carrier of the infection; the microorganism is exclusively a human pathogen.

Treponema cannot withstand drying or exposure to disinfectants; therefore, household transmission (for example, when sharing toilets) is almost impossible. Unprotected sex is a major risk factor for infection.

Syphilis remains a common ailment in many developing countries and in parts of North America, Asia and Europe, especially in its eastern part. Most of the new cases occur in women aged 20-29.

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How does the disease manifest itself - signs

How does syphilis manifest in women? After the initial stage, the symptoms of which are the appearance of a painless ulcerating chancre (node) at the site of infection, and enlargement of the lymph nodes, the next stage of the disease begins.

Secondary syphilis manifests itself in different ways. It usually presents as a skin rash that appears within 2-10 weeks after the primary chancre. The rash is most pronounced 3-4 months after infection. Lesions are also mild: 25% of patients may not be aware of skin changes.

Typical is a localized or widespread mucous rash (usually non-itchy and symmetrical bilaterally) with systemic, nonintense enlargement of lymph nodes. Inhomogeneous baldness and condylomatosis may also occur.

Common symptoms of syphilis in women are present: malaise, migraine, anorexia, nausea, bone pain and fatigue, as well as fever and spasm of the occipital muscles. A small number of those infected develop acute syphilitic meningitis (inflammation of the lining of the brain) and deafness.

Other less common manifestations include hepatitis, nephropathy, proctitis, arthritis, and optic neuritis.


The stage of latent syphilis in women, which follows the secondary phase, can last from several years (up to a maximum of 25). Patients can remember the symptoms of the primary and subsequent stages of the disease.

In the latent phase, there are no symptoms, and the disease is detected only by serological tests. At the stage of late latent syphilis, women can transmit the disease in utero to the fetus.

During the tertiary phase, the disease progresses slowly, can spread in the body and affect any organ. At this stage, the disease is usually not considered infectious (capable of infecting others).

How does the disease manifest itself:

• chest pain, back pain, stridor (noisy and wheezing), or other symptoms associated with aortic aneurysms;
• imbalance, sensitivity disorders (paresthesia), urinary incontinence;
• neurological problems, including hearing loss and loss of vision;
• dementia.

Lesions usually develop within 3-10 years after infection. Symptoms of damage to the central nervous system depend on the area affected: headache, dizziness, psychoemotional reactions in the form of mood swings, spasm of the neck muscles, blurred vision, muscle weakness in the shoulder girdle and limbs.

In some patients, behavioral changes and other signs of dementia appear 10-20 years after infection, indicating paresis.

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The first symptoms of syphilis on the genitals

How long does syphilis manifest? The initial signs of syphilis in women appear 10-90 days after the bacteria enter the body. The first symptoms appear mainly on the vulva or cervix.

Ten percent of syphilitic lesions are found around the anus, in the mouth, on the fingers, tongue, nipples, or other non-genital organs. The invasion is followed by a local, unexpressed enlargement of the lymph nodes (lymphadenopathy).

Lesions (chancres) usually begin as solitary, raised, hard, and red papules (nodules) up to several centimeters in diameter. They collapse, creating a crater with slightly raised edges around the central ulcer and a red border. It usually heals with coarse scars within 4 to 8 weeks, regardless of treatment.

Although genital chancres are often solitary, some patients may have multiple chancres. They sometimes appear as "kissing lesions" on opposite skin surfaces, such as the labia.

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How much does the disease manifest

After contact with the carrier and entering the body, bacteria quickly penetrate into unaffected mucous membranes or microscopic skin abrasions and, within several hours, end up in the lymphatic system and bloodstream, contributing to the development of systemic infection.

The incubation time from exposure to the development of primary lesions that appear at the site where pathogens enter the body is on average 3 weeks, but can vary from 10 to 90 days.

Research shows that spirochetes (the order of bacteria that treponemas belong to) can be found in the lymphatic system as early as 30 minutes after initial implantation. This suggests that syphilis is a systemic disease from the very beginning.

Primary syphilis in women is characterized by the development of a painless chancre (hard nodule) at the site of infection after 3-6 weeks of the incubation period.

The incubation period of the secondary stage, i.e. how long the disease develops is 4-10 weeks after the onset of the initial lesion. At this stage, the spirochetes multiply and spread throughout the body.

The central nervous system (CNS) becomes infected early in the infection; studies show that in the secondary stage, more than 30% of patients have abnormal results in the cerebrospinal fluid. During the first 5-10 years after the onset of the disease, lesions of the meninges, tissue and blood vessels are found, which leads to neurosyphilis.

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Allocations for this pathology

An atypical phenomenon in this disease. It is important to understand that the female body normally secretes secretions from the genital tract, which are designed to maintain the constancy of the environment and flora of the genital organs, as well as to ensure the physiological functions of the body.

In the case of the location of the primary focus (chancre), on the genitals, there are unexpressed mucous discharge, transparent, without an unpleasant odor. A change in these parameters may indicate the addition of another infection, for example, chlamydia or candidiasis.

With ulceration of a chancre located in an area rich in blood vessels, blood streaks may appear.

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Rash in the fair sex

In the primary phase, one, painless nodule (papule) usually appears, which quickly collapses and hardens. The edge and base of the ulcer have a cartilaginous consistency to the touch.

While classic chancres are painless, they can be uncomfortable if contaminated with bacteria or located in the anal canal. Non-genital chancres occur most commonly over the neck, usually affecting the lips or mouth.

Secondary syphilis in women manifests itself in different ways, but usually includes a localized or diffuse mucous rash. Exanthema can be spotty, nodular, or mixed.

The initial lesions are usually bilateral and symmetrical, pale red to pink (fair-skinned) or pigmented (dark-skinned).

The rash is separate, round, consists of uniformly colored spots with a diameter of 5-10 mm, distributed over the body and extremities. After a few days or weeks, red nodules of 3-10 millimeters in size appear. The elements become necrotic (purulent) and often spread to the palms and feet.

In 10-15% of patients with secondary syphilis, painless superficial erosions of the mucous membranes in the palate, pharynx, larynx, vulva or in the anal canal and rectum develop.

These spots are round, silvery-gray defects with a red areola (border). They are a reservoir of treponema and a source of infection.

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Analyzes and diagnostics

Treponema pallidus cannot be cultured and is too small to be seen under a light microscope. Serological testing is considered the standard method for detecting all stages of the disease.

If acquired syphilis is suspected, the traditional approach is to first have a non-treponemal syphilis response, or a newly developed antigen test, and then a specific test.

A distinctive feature of laboratory diagnosis of syphilis in a woman is the absence of 100% of the results. The specificity of the development of microorganisms is cyclicity, even with obvious symptoms, the test can give a negative result. Therefore, regular examination by a gynecologist and laboratory check is recommended.

The sensitivity of the first analysis is 78-86% for detecting the primary phase, 100% for detecting the secondary and 95-98% for the tertiary process.

The specificity ranges from 85 to 99% and may be less in people with vascular collagen (connective tissue) diseases, pregnancy, intravenous drug use, tuberculosis and malaria. The test results become positive within 1-2 weeks after the formation of the chancre.

Due to the potential for false positive results, confirmation of any positive or ambiguous result of the above assay must be accompanied by a treponemal test, (eg, fluorescent antibody uptake). The sensitivity is 84% ​​for detecting primary infection and almost 100% for other stages.

Darkfield microscopy is a possible way to assess wet skin lesions, such as chancre of primary syphilis or warts of secondary.

Confirmed patients are tested for other sexually transmitted diseases, including HIV infection.

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How to treat a disease

Penicillin was created as an effective remedy for the fight against syphilis. It remains the foundation of treatment and the standard by which other therapies are judged.

How to treat syphilis in women while using penicillin:

1. Primary or secondary syphilis - benzathine penicillin 2.4 million units intramuscularly in a single dose.
2. The early latent stage is the same.
3. Late latent syphilis or unknown duration - benzathine penicillin 7.2 million units. It is administered in 3 doses of 2.4 IU at intervals of 1 week.

The principles of disease therapy include the following:

1. Penicillin is the main drug for treating ailments.
2. Doxycycline is the best alternative in the treatment of early and late latent stage of the disease. Syphilis in a woman associated with HIV infection does not require any enhanced antimicrobial therapy.
3. When treating the disease with weekly injections at a later stage, skipping a dose for 10-14 days does not require restarting the entire course of injections.
4. An interval of 7-9 days between medications may give the best results.

Surgery is intended to treat complications of tertiary syphilis (eg, aortic valve replacement).

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Correct disease prevention

The main goal is to limit the spread of syphilis. This entails advising people on safe sex practices and educating patients who abuse intravenous drugs. The latter should never share needles and are required to use clean syringes.

Identifying and treating sex partners and drug companions is of the utmost importance. Prevention also involves training health-care workers to take precautions when treating such people.

A single dose of 2.4 million units of benzathine penicillin intramuscularly is recommended for all individuals who have had sexual contact with a partner who tested positive for primary, secondary, or early latent syphilis within the previous 90 days.

Circumcision does not help prevent transmission of the disease, although it can help reduce the spread of other sexually transmitted diseases such as HIV infection.

A common sexually transmitted disease is syphilis. The causative agent of syphilis is the microorganism pale treponema, which enters the human body immediately after unprotected sexual intercourse.

This is a serious and chronic disease that is especially dangerous for women. It is very important to see a specialist at an early stage, since the timely detection of a dangerous disease can prevent further complications.

Syphilis develops in several stages, with characteristic signs and symptoms that may not appear immediately. Syphilis poses a threat to the health of not only the patient, but also those who are in contact with an infected person. This article will discuss the symptoms of syphilis in women (photo).

Syphilis occurs in three stages and with different symptoms for each phase. The disease is very dangerous, since the characteristic features of this disease may not appear for a long time. The duration of the latent (incubation) period can vary from two to six weeks. The duration of this period depends on various factors, for example, on the use of antibiotics to prevent another disease, the state of the patient's immune system and age.

The first manifestation of syphilis in women occurs a maximum of a month after unprotected sexual intercourse. The disease is transmitted not only sexually, but also by the patient's personal belongings. Such personal items include a washcloth, a towel, dishes, and even a patient's lipstick. Personal hygiene is very important, as white treponema multiplies in fluids, namely saliva, urine, and blood.

The first symptoms of syphilis are expressed in the formation of ulcers on the genitals in women, differing in size and color. These ulcers are hard and coin-shaped. Despite the fact that these ulcers do not cause inconvenience, painful sensations still appear with pressure. These ulcers can appear not only on the labia, but also in the uterus, vagina, which makes it difficult to self-identify the disease.

These symptoms include weakness throughout the body, malaise, swollen lymph nodes, and rashes. Microorganisms circulate in the human body, multiply and cause the spread of a dangerous disease. Discharge in women becomes profuse, with a purulent content and an unpleasant odor.

Often women do not pay attention to the symptoms of this disease, mistaking it for a common rash, fatigue, and a cold. This is because syphilis has similar symptoms to other diseases, making it difficult for a specialist to detect it early on.

Another important change in a woman's body is the first irregularities in the menstrual cycle, characterized by unpleasant sensations during bleeding. It is very important to take into account that all these rashes and ulcers may disappear over time, and the disease will enter the second phase of development. All this leads to the fact that the disease will wear hidden character and even the patient's well-being will improve.

So, how does syphilis manifest in women in the second stage? The subsequent stage is characterized by an exacerbation of the disease by raising the temperature to 38 degrees, the appearance of pale spots with localization of the palm and soles of the feet.

Most often at this stage, a woman suffers from deprivation of body hair, that is, eyelashes, hair on the head and in the inner thighs fall out. All this evidence of syphilis is difficult to ignore, as it is clearly expressed at this stage.

In the first stage, it was difficult to distinguish a rash or syphilis malaise from ordinary fatigue. In the second stage, the rash does not cause discomfort, but if personal hygiene is not observed, it can develop into unpleasant purulent formations. This stage of the disease can last for a long time and be characterized by complications.

Pathogenic microorganisms, spreading throughout the body, can lead to its disturbances and malfunctions. All these complications at the second stage lead to the development of the disease and flow into the next logical phase.

The third stage of syphilis in women is characterized by great danger, since white treponema develops and destroys the internal tissues of the female body. All those ulcers that have appeared turn into scars. The danger lies in the fact that the pathogen, affecting the internal organs, is fatal. The risk of death is high, since the vital organs of a person stop working. In the last stage of the disease, the oral cavity and nasal membranes are also destroyed, which leads to the appearance of tumors.

Treatment

Thus, in this article we found out what the symptoms of syphilis are. Now it is important to consider what is the treatment for this disease. Given the destructive effects of this disease, treatment is urgently needed.

Specialists prescribe a treatment regimen depending on the stage of the patient's illness. Before starting treatment, the specialist takes into account all the patient's factors. These factors include age, drug tolerance, and a woman's well-being. After establishing an accurate diagnosis, the patient is admitted to a dispensary and treatment begins.

It is quite possible to solve this problem at the first stage if you use modern medications, and most importantly, contact a specialist in time. At the first stage, the doctor prescribes a drug that has a penicillin origin. This drug is given over 16 days. If no changes occur and the pathogen does not respond to the drug, then derivatives, additional drugs, also of penicillin origin, are used.

Additional drugs include antibiotics such as benzylpenicillin used in sufficient quantity. The doctor prescribes the use of orally and B vitamins, drugs that increase the patient's immunity, as well as probiotics. All these drugs are prescribed strictly according to the doctor's prescription, as they have an increased level of toxicity.

In this case, it is necessary to periodically maintain the presence of antibacterial drugs in the patient's blood.

Medicines are injected into the patient's body by injection into both buttocks. After completing treatment at the first stage, a woman should be constantly examined by a gynecologist and venereologist for 6 months. The patient, in addition to the use of these drugs, must refuse to drink alcohol and have sexual intercourse.

As a rule, patients with this terrible disease do not have the right to be blood donors. There were also situations in which a person infected with syphilis became a donor and infected another person, so it is very important to identify this disease at an early stage. The most important thing to remember is not to try to self-medicate, as this will only exacerbate the disease and lead to its latent form.

The disease is dangerous in that it can lead to the development of a severe form of other diseases. These diseases can manifest themselves as deterioration or loss of vision, paralysis, harm to those people with whom the patient comes into contact. With the development of the disease, the most important organs and even the human brain are affected, which leads to irreversible processes.

If the treatment at the first stage was unsuccessful, then the prescribed drugs are continued to be administered and Ceftriaxone and Doxycycline are also added to them. In this case, the duration of treatment can be up to a month. In the event that the disease has smoothly passed to the last stage, then treatment with penicillin drugs, including Biyonquinol, continues. This medication can be used if there is no allergy.

At this stage, the knowledge and experience of the attending physician is important, since it is these factors that can affect the positive result in the treatment process.

The patient's attitude and timely treatment can give a positive result. In the future, in order to completely get rid of a serious illness, you need to constantly be examined and tested. In any case, you need to remember that you need to give up unprotected intercourse, to identify symptoms in time that may appear at any time.

Only a respectful attitude towards your body and a timely visit to a doctor will help to cope with this disease.

Syphilis occurs in women as a result of infection with a microorganism - treponema pale (Treponema pallidum). An infectious agent, having entered the body, is introduced into the primary focus, enters the blood and lymph and spreads throughout all organs and systems. In the early stages, the symptoms of syphilis in women are blurred, the disease flows sluggishly, often disguised as other diseases. In the later stages, the infection affects the internal organs, joints, nerves and bones.

The reasons for the development of syphilis include:

• unprotected intercourse with an infected partner;
• transfusion of blood containing treponema;
• negligent adherence to the rules of sterility in medical institutions;
• ignoring the rules of hygiene in everyday life: household items are in common use among sick and healthy people;

Representatives of the weaker sex 15-45 years old fall into the risk group. Most of the infected are detected among 20-30 year old women.

Features of the incubation period

Usually the incubation period lasts 2-6 weeks. In some cases, it decreases to 7-15 days, or increases to 3-6 months. If syphilis in girls or women was preceded by massive infection with treponema, then the incubation period is greatly reduced.

The incubation period may vary under the following circumstances:

• when infected in old age;
• in physically weakened patients with reduced immunity;
• when using corticosteroids, antibiotics and potent drugs prescribed for the treatment of other severe pathologies.

With a prolonged incubation period, the symptoms of the disease may not appear, the pathology in this case takes a latent form of the course.

An infected woman is dangerous to others, regardless of the length of the incubation period. She is able to transmit syphilis from the moment treponemes enter her blood and lymph.

Symptoms of the primary form

Symptoms of the disease appear several weeks after infection. Hard chancres (syphilomas, ulcers, erosion) form on the body. Pathological formations with a dense base and a smooth surface have the correct shape. The edges of the ulceration, reaching 1 cm in diameter, are evenly outlined and slightly raised. The bottom of the syphilus is colored bluish-red.

Chancres spontaneously disappear after several weeks without any treatment for syphilis. Women do not pay much attention to them, as they often do not cause pain and discomfort. However, missing chancres are not a sign of healing. The disease continues to progress after their disappearance. Treponemes transported with the blood and lymph flow destroy the body, involving healthy organs and tissues in the pathological process. In this case, infected women feel only weakness.

Chancre is the first sign of primary syphilis. It is formed:

• on the external genitals;
• cervix;
• near the anus;
• on the mucous membranes of the intimate zone and the rectum;
• pubis, thighs and abdomen;
• on the skin of the hands;
• on the mammary glands, next to the nipple.
• in health workers, the first symptoms of syphilis occur on the lips, tongue, fingers of the upper extremities.

A thickened infiltrate (chancre) resolves on its own after 1-1.5 months. Small erosions do not leave marks on the skin. In place of large formations, spots of black or bluish color appear. After ulcers, round scars appear, framed by a pigment ring.

Other manifestations of the first stage

Instead of the classic chancre on the skin, syphilis is manifested in a woman and symptoms such as specific skin defects. They make it difficult to recognize a syphilitic infection. The following abnormal manifestations occur:

• Felon. Syphiloma occurs under the guise of an inflamed nail bed. When treponema is affected, the finger swells, becomes bluish-red, hurts. The nail plate is rejected over time. The pathological process differs from true panaritium (purulent inflammation of soft tissues) in that it takes weeks to heal a wound.
• Amygdalitis. The glands swell, thicken, redden, make it difficult to swallow, and cause pain. Signs of amygdalitis are similar to those that develop with typical tonsillitis. Women feel unwell, get tired quickly, they have a high temperature, a headache in the back of the head.
• Inductive edema. A large burgundy-red or pale pink syphilis forms on the labia. The same papule appears on the lower lip of the mouth. Seals extend beyond the periphery of the erosive pustule. If a woman ignores treatment for syphilis, the ulcer worries for months.
• Mixed chancre. Initially, mild ulceration occurs (it has a shorter incubation period), then a solid syphiloma forms. The detection of infection with this type of chancre is delayed by 3-4 months. Lymph nodes enlarge 7 days after the appearance of the papule. If it occurs in the oral cavity, the lymph nodes located in the neck, back of the head, under the jaw and chin swell.

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At the end of the initial stage, the first signs of syphilis in women are supplemented by the following manifestations: muscle pain, arthralgia, decreased hemoglobin, bone tenderness, increased concentration of leukocytes in the blood.

Signs of a secondary form

Before the onset of the second stage of syphilis, an increase in lymph nodes occurs. Lymphadenitis appears 7-14 days after the formation of the chancre and indicates that treponemes have entered the lymphatic system, multiplying freely in it. Spirochetes, taken up by the lymph flow, migrate throughout the body. If a woman is not treated, then the secondary form develops into phase 3 after 3-5 years of development.

At stage 2 of syphilis, the following symptoms are observed in women:

• extensive pale rashes all over the skin of the body, including the palms and soles;
• headache;
• lack of appetite;
• weakness, fatigue;
• heat;
• disturbed sleep;
• loss of hair, eyelashes, eyebrows;
• at the anus and on the external genital organs, extensive warts grow;
• pustules form in the mouth, on the tongue;
• if erosion has formed on the vocal cords, specific hoarseness appears;

The rash disappears without a trace after 2.5 months, even if the woman does not accept treatment. Syphilis flows stealthily again. The asymptomatic period is short in duration, and a relapse soon occurs.

Signs of a tertiary form

The diagnosis of tertiary syphilis is infrequent, as the disease is usually diagnosed at an earlier stage. When the disease is not treated, within 3-5 years it passes into the 3rd degree, in which the pathological process covers the internal organs, bone and nerve tissues, joints, endocrine glands, and sensory organs.

• The skin of the patients is completely covered with syphilis and gummas. In place of the opened and healed formations, ugly scars remain. If ulcers form on internal organs, the infection can be fatal.
• In the tertiary phase of the development of the disease, all organs and systems are affected in a woman. Cartilage tissue is deformed. They melt and degenerate into pathological tumors - gum. During this period, patients are not dangerous to others. Since they are not contagious, syphilis cannot be transmitted.
• On the mucous membranes of the nasopharynx, affected by ulcers, deep damage occurs. The palate and septal bones are perforated. The nasal back collapses. When a woman eats, food pieces are thrown into the nasal cavity.
• The soft palate with syphilitic nodes is immobile. It is compacted and colored dark red. Syphilomas, having broken through at the same time in several places, form ulcers that are difficult to heal.
• Erosions on the tongue lead to gummy or sclerosing glossitis. In the first case, the surface of the tongue is covered with small sores, in the second, it is compacted and inactive. In the future, tissue shrinkage occurs, they atrophy. Women have trouble speaking, chewing, and swallowing food.

Syphilis, a life-threatening pathology. It is able to flow asymptomatically, to manifest itself in the last stage, when it is difficult to deal with it. The first symptoms of syphilis are a serious reason to see a doctor.

During pregnancy

Syphilis in infants occurs in the womb. Treponemas enter the fetus through the placenta. The primary symptoms of pathology appear within 2 years after the birth of the baby.

The disease affects:

• skin;
• organs of vision;
• oropharynx (causes pharyngitis);
• bone and nerve tissue;
• internal organs.

Symptoms of late congenital syphilis occur in children 2-5 years old. In babies, teeth are formed incorrectly, eye diseases and deafness occur.

In severe syphilis, death occurs in children in the first year of life. Miscarriages occur in 25% of infected pregnant women. If the pathology is not treated before conception and at the time of gestation, then there is a risk of premature delivery and the appearance of a stillborn child.

Only 10% of pregnant women have a chance to give birth to a healthy baby. Despite this, it is believed that syphilis and pregnancy are compatible. Timely started therapy reduces the likelihood of having an infected baby.

Diagnostics

The choice of methods for examination depends on the stage of development of the infection. First, treponemal and screening tests, dark-field microscopy are done. Antibodies are detected using treponemal methods. It takes 2-4 weeks from the moment of infection to the appearance of markers in the blood.

STDs Syphilis belongs to the group of infectious diseases with predominantly sexual transmission. It is characterized by a chronic undulating course with a phased defeat of all organs and systems.

Classic syphilis includes 4 periods: incubation (3-6 weeks), primary syphilis (6-7 weeks), secondary forms of the disease (2-4 years), the tertiary period (many years after infection).

The disease is caused by pale treponema, a spiral-shaped microbe capable of active movement and well preserved in a humid environment at room temperature.

The source of infection is a person who has symptoms of syphilis of any stage, while all biological fluids of the patient are dangerous - saliva, blood, urine, semen.

The most common route of infection for women is considered to be sexual contact with a sick partner, but infection is possible through kissing, sharing hygiene items, dishes and toiletries, and smoking one cigarette or hookah together.

A sick woman can infect her baby in utero or while caring for him, while breastfeeding.

The first signs of syphilis infection

When women become infected with syphilis, the first signs appear at the site of the introduction of treponema into the body: a hard chancre appears on the walls of the vagina, cervix, nipples, mouth or rectum, which looks like a dense rounded ulcerative skin defect.

Chancre does not cause any subjective discomfort (no pain, burning or wetness). Vaginal discharge in women with syphilis can become thicker, viscous, with the appearance of an unpleasant odor.

Sometimes the lymph nodes may enlarge, the body temperature may rise slightly, and general malaise may appear.

All these symptoms go away on their own without treatment, but this cannot be considered a recovery, this is the transition of the disease from the primary to the next stage.

The secondary period of the disease is characterized by the cyclical appearance of syphilis (various rashes in the form of spots, nodules, pustules) on the skin throughout the body and an increase in lymph nodes. The rash lasts for several weeks, then goes away spontaneously.

Episodes of rashes for several years alternate with an asymptomatic stage.

The fresh process is manifested by a bright, small, symmetrical, profuse rash without peeling. With relapse, syphilides are darker, large, asymmetrical, prone to fusion with the formation of patterns on the skin, with signs of peeling along the edges.

Common signs of the 2nd stage are the appearance of pigmentary syphilis in the form of a "necklace of Venus", after the disappearance of which, white rounded spots remain. Rashes with secondary syphilis contain a large number of active treponemas, therefore, during this period, patients are very contagious.

Manifestations of tertiary syphilis

About 4 years from infection in 40% of cases, signs of tertiary syphilis develop.

For this stage, the characteristic symptoms are syphilitic tubercles and nodes (gum), which are located in the deep layers of the skin and internal organs.

During their decay, gums deform tissues, form poorly healing ulcers and large stellate scars, which worsen the functioning of organs.

Tertiary syphilides contain little treponema, so such patients are not very infectious to others.

Complications of the disease

Syphilitic infection without treatment has a long-term course and leads to destructive processes in various organs.

Neurosyphilis ends with paresis and paralysis, partial or complete loss of vision, damage to the meninges with the development of meningitis.

If the joints are damaged, there is a violation of the motor function of the limbs. Syphilides can form on all large vital internal organs, which is fatal.

Diagnosis of syphilis

To conduct an examination for syphilis, you need to consult a doctor - gynecologists and dermatovenerologists are well aware of how syphilis manifests itself on the genitals, therefore, a diagnosis is often possible already at the stage of clinical examination.

A scraping is taken from suspicious skin elements, which is then examined under a microscope in a dark field and sown on special media to determine the sensitivity of the microbe to antibiotics.

The most modern diagnostic method is considered to be able to detect the disease at any stage, but it is not available in all medical institutions.

Therefore, the first place in the mass diagnosis of syphilis belongs to the detection of antibodies to syphilis in the blood (Wasserman reaction - RW), which becomes positive at 3-4 weeks from the onset of the disease.

Syphilis in pregnant women

For the timely detection of syphilis in pregnant women, a three-time blood test for RW is provided: at 8-12, 30 and 38-40 weeks. Infection at any stage of pregnancy is not considered an indication for termination, but if an infection is detected, treatment should be started as soon as possible.

The course of antibiotic therapy in the initial forms of syphilis in the 1-2 trimester allows you to completely prevent infection of the child.

The presence of a tertiary form in a pregnant woman or infection in the last trimester cannot guarantee the safety of the fetus: even after successful treatment, such children should be under medical supervision in the first years of life for the timely detection of various manifestations of the congenital form of the disease.

Drugs for the treatment of syphilis in pregnant women cannot be considered completely harmless, but their selection is carried out based on the lowest toxicity to the fetus (cephalosporins and macrolides are recommended).

Without treatment, only 1 in 10 babies from mothers with syphilis will be relatively healthy. In the rest, after the fourth month of intrauterine development, symptoms of infection appear: changes occur in the liver, kidneys, skeletal system, mucous membranes.

Severe lesions of internal organs lead to the nonviability of the fetus, and such a pregnancy ends in late miscarriage or stillbirth.

Each specific situation should be considered separately, taking into account the form of the disease, the degree of severity, the amount of treatment performed, and the duration of the process.

Ideally, a woman should come to a gynecologist at the stage of conception so that the doctor assesses all the features of the body and the disease she has suffered and decides whether the patient can give birth to a healthy child after syphilis.

Statistics show that women who have been successfully treated before pregnancy for primary and secondary syphilis give birth to completely healthy children.

After the treatment of tertiary syphilis, several years must pass before the moment of conception, while monitoring the state of health is necessary to exclude the reactivation of the infection.

When good results are obtained within 3-4 years, doctors usually give the go-ahead for pregnancy, since there is no risk of infection of the fetus.

Treatment of syphilis in women and men

The early periods of the disease can be treated on an outpatient basis - within 1 month, patients receive injections of bicillin (this is a long-acting penicillin antibiotic) several times a week.

In stationary conditions, the standard treatment regimen for syphilis (primary and secondary forms) includes intramuscular injections of penicillin 6 r / day for 14-28 days in combination with bicillin, antihistamines.

In the presence of local elements, their treatment with antiseptic solutions is shown.

In late or latent forms of the disease, preparation is first carried out with the help of bismuth preparations (bioquinol) for 10-14 days, then penicillin therapy (at least 28 days) and drugs to maintain the normal function of internal organs affected by treponema pallidum (hepatoprotectors, cardiotonics , nootropics).

The course of treatment for syphilis at any stage ends with the appointment of immunostimulants (retarpen, aloe, extensillin, splenin) to increase the body's own defenses.

After treatment, patients are under the supervision of doctors for 3-6 months. (with primary syphilis) up to three years (with complicated forms).

Modern qualified therapy for syphilis makes, in most cases, the prognosis for this disease very favorable, so you should not self-medicate and hesitate to contact a doctor for examination for this disease.