Syphilis

Syphilis is classified as a classic sexually transmitted disease (sexually transmitted diseases). The causative agent is pale treponema (Treponema pallidum). Syphilis is characterized by a slow progressive course. In the later stages, it can lead to severe lesions of the nervous system and internal organs.

In most cases, infection with syphilis occurs during sexual contact in the vagina, mouth or rectum. The most contagious are patients with primary syphilis (with ulcers on the genitals, in the mouth or in the rectum). In addition, it is possible to transmit infection from a sick mother to the fetus during pregnancy, as well as infection with blood transfusion. Household infection is extremely rare. Most of the cases that are associated with domestic infection are actually unproven cases of sexual infection. This is due to the fact that pale treponema (Treponema pallidum) quickly dies outside the human body.

The probability of infection with a single sexual contact with a patient with syphilis is about 30%. The incubation period of syphilis is usually 3-4 weeks (from 2 to 6 weeks). The symptoms of syphilis are very diverse. They vary depending on the stage of the disease.

There are three stages of syphilis:

Primary syphilis occurs after the end of the incubation period. At the site of penetration of the pathogen into the body (genitals, oral mucosa or rectum), a painless ulcer with a dense base (solid chancre) occurs. 1-2 weeks after the appearance of the ulcer, the nearest lymph nodes increase (when the ulcer is localized in the mouth, the submandibular ones increase, when the genitals are affected, the inguinal ones). The ulcer (solid chancre) heals independently within 3-6 weeks after its occurrence.

Secondary syphilis begins 4-10 weeks after the appearance of the ulcer (2-4 months after infection). It is characterized by a symmetrical pale rash all over the body, including the palms and soles. The appearance of a rash is often accompanied by headache, malaise, and an increase in body temperature (as with the flu). Lymph nodes are enlarged throughout the body. Secondary syphilis occurs in the form of alternating exacerbations and remissions (asymptomatic periods). At the same time, hair loss on the head is possible, as well as the appearance of flesh-colored growths on the genitals and in the anus (wide condylomas).

Tertiary syphilis occurs in the absence of treatment many years after infection. In this case, the nervous system (including the brain and spinal cord), bones and internal organs (including the heart, liver, etc.) are affected. If infected during pregnancy, a child may have congenital syphilis. According to the results of scientific research, in the absence of treatment, about a third of patients develop tertiary syphilis. About a quarter of patients die because of it.

Congenital syphilis can lead to severe lesions or death of the child.

Diagnosis is based on blood tests for syphilis. There are many types of blood tests for syphilis. They are divided into two groups - non-treponemal (RPR, RW with cardiolipin antigen) and treponemal (RIF, RIBT, RW with treponemal antigen).

For mass examinations (in hospitals, polyclinics), non-treponemic blood tests are used. In some cases, they can be false positive, that is, they can be positive in the absence of syphilis. Therefore, the positive result of non-treponemal blood tests is necessarily confirmed by treponemal blood tests.

To assess the effectiveness of treatment, non-treponemic blood tests are used in quantitative execution (for example, RW with cardiolipin antigen). Treponemal blood tests remain positive after syphilis for life. Therefore, to assess the effectiveness of treatment, treponemal blood tests (such as RIF, RIBT, RPGA) DO NOT apply.