Everyone knows that syphilis is a sexually transmitted disease.
How infection occurs
Infection with syphilis mainly occurs through contact of a healthy person with a sick person, much less often - through indirect contact. The main form of direct contact is sexual contact. Also, infection can occur with kisses, bites, etc. It is necessary to emphasize the possibility of direct infection of medical personnel. Treponema can enter the body even through the smallest damage to the epidermis, invisible to the eye, as well as through the macerated mucous membrane.
Development of the disease
The incubation period for syphilis is approximately 3-4 weeks. Sometimes it can be reduced to 15-10, and sometimes up to 8 days. But more often there is a longer period - up to 2-3 months or more. The incubation period ends with the appearance of a hard chancre, when the primary period of the disease begins.
The primary period of syphilis lasts 6-8 weeks. During this period, spirochetes continue to multiply intensively and spread in the body. The first signs of their spread appear at the end of the first week after the onset of the primary disease - the chancre, while the regional lymph nodes increase. Lymphadenitis due to its inherent density is called scleradenitis. Lymphadenitis is initially unilateral, but becomes bilateral by the end of the second week.
The duration of the existence of a chancre from the moment of its occurrence until its disappearance depends on a large number of factors: erosive or ulcerative form, size, depth of the lesion, nilium or the absence of secondary infection, etc. Often, hard chancre disappears only in the secondary period of the disease. In the third (less often - in the fourth week) after the appearance of the chancre, patients experience reactive changes, primarily in the blood (positive Wasserman serological reactions and sedimentary reactions). On this basis, primary syphilis is divided into primary seronegative and primary seropositive.
At 5-6 weeks there is a progressive increase in all lymph nodes available for palpation (polyadenitis).
Until the end of the primary period of syphilis (on average, 6 weeks after the onset of primary syphiloma), most patients develop general symptoms: malaise, loss of appetite, increased fatigue, headaches, aching bones and joints, fever. Often patients with primary syphilis complain of pain in the back of the head due to irritation of the meninges. Gastroenteritis and jaundice develop less frequently.
In the absence of treatment in patients with syphilis, 6-8 weeks after the onset of a hard chancre, symptoms of the secondary period appear - multiple rashes on the skin and mucous membranes, polyadenitis and positive serological reactions. If a patient with secondary syphilis is not treated, this period can be delayed for 2-4 years. The course of syphilis in the secondary period is characterized by an undulating course:
- polymorphic rashes disappear in a few weeks;
- for some time there is a complete absence of external signs of the disease;
- a recurrence of rashes occurs, which will have their own characteristics;
- after a certain period of time, the rashes disappear on their own.
The tertiary period of syphilis often manifests itself after the latent course of the disease of different duration, that is, after a certain period of time after the last recurrence of the secondary period. The duration of the latent period in some cases lasts 2-3 years, and in others - 5-6 years. Manifestations of tertiary syphilis can be observed even earlier.
The most dangerous source of infection are patients with primary and secondary manifestations of syphilis on the skin and mucous membranes. It is believed that the saliva of a patient with syphilis contains pale treponema, and is contagious only when patients have specific lesions of the oral mucosa. However, there is evidence in the literature that in some cases treponemas can mix with saliva, penetrating the oral mucosa in the absence of visible specific lesions.
The features of the development of syphilis are reduced to a wave-like course due to a change in the active manifestations of the disease, periods of a latent state of different duration and a gradual, sequential change in clinical and pathoanatomical changes, which become more pronounced and severe with the development of the disease.
In syphilis, the following periods must be distinguished: incubation, primary, secondary, tertiary (humous).
It should be noted that in some cases the manifestations of syphilis are so inexpressive or barely noticeable that patients do not know about their disease for many years. In such people, the disease is detected during the examination. Latent syphilis is divided into early latent (lasting more than 2 years after infection) in people who are examined as partners of patients with infectious forms or identified during wassermanization, and late latent, which is accidentally determined in seroreactions, especially in women with stillbirths and miscarriages.
Author: Elena Stoyanova
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