Why is syphilis so easy to miss?
The first manifestation - chancre - is an ulcer with a dense base and smooth edges. Its key feature: it does not hurt. That is why people often do not attach any importance to it, especially since after a few weeks it heals on its own.
But healing of an ulcer does not mean recovery. By this time, treponema has already spread throughout the body, and after some time, rashes of the secondary period appear, which also go away on their own. Then comes the latent period, which can last for years.
That is why there is an ironclad rule regarding syphilis: any painless ulcer on the genitals, mouth or anus requires examination, even if it has already begun to heal.
Stages and manifestations
- Primary period: chancre - a painless ulcer with a dense bottom, appears a few weeks after infection at the site of penetration of the pathogen; nearby lymph nodes enlarge, also painlessly
- Chancre can be located not only on the genitals, but also in the mouth, on the lips, in the anus - and then its connection with infection does not come to mind
- Secondary period: rash all over the body, often not accompanied by itching; characterized by damage to the palms and soles - a sign rare for other diseases
- Condylomas lata in skin folds, rashes on mucous membranes, focal hair loss
- General symptoms: low-grade fever, weakness, swollen lymph nodes
- Latent period: no manifestations, diagnosis is possible only by blood tests
- Tertiary period: severe damage to the skin, bones, cardiovascular system, nervous system; rare today due to treatment and testing
- Neurosyphilis: can develop at any stage - headaches, visual and hearing impairment, mental and neurological disorders
How is it transmitted?
- Sexual contact with any type of contact is the main route
- Through microdamage to the skin and mucous membranes during close household contact with rashes - rare, but possible
- From mother to fetus during pregnancy - congenital syphilis
- With blood transfusion - today practically excluded due to mandatory testing
- The greatest contagiousness occurs in the primary and secondary periods, when there are active rashes
Diagnostics
- Non-treponemal tests (RPR, RW) - reflect the activity of the infection; used for screening and, importantly, to monitor the effectiveness of treatment
- Treponemal tests (TPGA, ELISA, RPGA) - confirm the fact of infection; remain positive for life even after successful treatment
- PCR or dark-field microscopy of discharge from an ulcer - in the presence of an active lesion
- Examination of cerebrospinal fluid for suspected neurosyphilis
- Testing for HIV, hepatitis, and other STIs is mandatory
- Examination by a dermatovenerologist
- Examination of all sexual partners and contacts
- Pregnancy examination - included in mandatory screening
Understanding the difference between the two types of tests relieves a lot of anxiety: a positive treponemal test in a person treated many years ago is an expected occurrence, and not a sign of a new infection. The activity of the infection is determined by non-treponemal tests over time.
Treatment
- Penicillin antibiotics are the basis of treatment; Treponema pallidum remains sensitive to them, resistance has not developed
- The scheme and duration depend on the stage of the disease and are determined strictly according to standards
- Alternative drugs for allergies to penicillins - according to the doctor's decision
- Mandatory examination and treatment of all sexual partners for a certain period
- Sexual rest during treatment
- Monitoring the effectiveness of non-treponemal tests over time over a long period of time after treatment
- Special regimens for pregnancy and neurosyphilis
- Observation and deregistration based on the results of control tests
Syphilis and pregnancy
- The infection is transmitted to the fetus and can lead to miscarriage, stillbirth, premature birth and congenital syphilis
- Screening for syphilis is included in mandatory examination during pregnancy and is repeated several times
- Timely treatment of a pregnant woman virtually eliminates damage to the child
- Treatment is carried out with penicillin drugs, which are safe during pregnancy.
- Special preparation is required for allergies because alternatives are less effective in protecting the fetus
- The newborn is examined and observed after birth
Prevention
- A condom for any contact with a new or non-regular partner reduces the risk, but does not completely eliminate it, since the rash may be located outside its coverage area
- Examination when changing partners
- Immediate treatment if any ulcer appears on the genitals, mouth or anus
- Testing for any other STI
- Mandatory information to partners upon confirmed diagnosis
- Examination when planning pregnancy
- Refusal to self-medicate with antibiotics: an incomplete course blurs the picture, complicates diagnosis, but does not cure the infection
Where to get examined in Tashkent
Diagnosis requires blood tests - non-treponemal and treponemal tests, and in the presence of an ulcer - examination of the discharge from the lesion.
In Tashkent, you can take tests and get advice if you suspect syphilis at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic; Specific treatment and clinical observation are carried out by the dermatovenerological service.
The main thing to remember is that a painless ulcer that has healed on its own is not a reason to calm down, but a reason to get tested. Syphilis is completely curable, and the earlier treatment is started, the fewer the consequences. Clinic contacts are below.
