Syphilis – symptoms, early signs in adults,incubation period, causes, diagnosis and treatment

Syphilis (Lues) is a long-term, infectious disease
undulating course. In terms of lesions of the body syphilis
refers to systemic diseases, and the main route of transmission –
to venereal. It affects the entire body: skin and
mucous membranes, cardiovascular, central nervous,
пищеварительную, опорно-двигательную system.

What is this disease, the first signs and causes of development, and
as well as a rash of syphilis on the skin of an adult, and
what is prescribed as a treatment – we will consider further in the article.

What is syphilis?


Syphilis is the worst venereal disease
characterized by a multiyear course and affecting all organs

In the environment, the causative agent of syphilis can live in the presence of
moisture within a few hours, but almost immediately dies when
drying, high temperature, disinfectant.
It retains its vitality when frozen for
a few days.

The disease is very contagious even during the incubation period.

Symptoms of syphilis are so varied that to understand them
it is quite difficult to go. As the disease develops
change fundamentally: from a painless ulcer in the first stage
to severe mental disorders in neglected form. The same
the sign is different in different patients depending on the immunity,
места возникновения или даже пола person


The course of syphilis – a long wavy, alternating
periods of active and latent manifestations of the disease. In development
syphilis distinguish periods that differ in the set of syphilides –
various forms of skin rashes and erosions appearing in response to
introduction to the body of pale spirochetes.

В зависимости от отрезка времени, прошедшего с момента
infections distinguish:

  • early syphilis – up to 5 years,
  • more than 5 years late.

По типичным симптомам сифилис разделяют на:

  • первичный (твёрдый chancre, склераденит и лимфаденит),
  • вторичный (папулёзная и пустулёзная сыпь, распространение
    diseases on all internal organs, early neurosyphilis)
  • третичный (гуммы, поражение внутренних органов, костной и
    articular systems, late neurosyphilis).

Find out what syphilis looks like, you can only after
incubation period. In total, the disease has four stages, for each
of which has its own symptoms. Long incubation
the period lasts 2-6 weeks, but sometimes the disease may not
develop over the years, especially if the patient took antibiotics,
was treated for infectious colds. At this time, laboratory tests are not
will give a reliable result.

Primary syphilis

Lasts 6-8 weeks, characterized by the appearance on the spot
penetration of pale spirochetes of primary syphiloma or solid
chancre and subsequent enlargement of nearby lymphatic

Secondary stage

This stage of the disease lasts about 2 to 5 years. For her
characteristic wave-like course – symptoms of syphilis appear,
then disappear. The main features at this stage include
the appearance of a rash. Rashes can form on various
areas of the skin, including the body, legs, arms, and even the face.

Secondary syphilis can often be diagnosed.
сифилитическую розеолу — это своеобразные округлые
бледно-розовые пятна, которые в диаметре могут достигать
10 мм. Soие пятна могут быть на любом участке тела
the patient.

Отличительная особенность сифилитической розеолы — это
ее постепенно проявление по 10-12 пятен в сутки
в течение семи дней. If a на розеолу надавить,
то она исчезает.

It should be noted that secondary syphilis can be several

Fresh this species is a consequence of the primary
forms. Симптомы — мелкая полиморфная сыпь и твердый
Hidden даже инкубационный период сифилиса никак не проявляется
externally, however, can be detected through serological
Recurrent при данной форме рецидивы чередуются, во время каждого
рецидива на теле появляется сыпь.Но в отличие
от свежего сифилиса сыпь при рецидивах менее обильна, пятна
larger, it is possible to reveal the centers of rashes.

Третичная стадия

Tertiary syphilis is manifested by focal destruction of mucous membranes and
skin, any parenchymal or hollow organs, large
суставов, нервной system. Основные признаки – папулёзные
rashes and gumma, degrading with severe scarring. Determined by
rarely develops within 5–15 years if no treatment
was carried out.

Congenital form

Congenital syphilis can be divided into several types:

  1. The early form of the disease, as a rule, manifests itself in the first
    two months of life baby. The first signs of syphilis are education.
    papular rash, as well as the defeat of the nasal mucosa. K more
    partial or complete destruction can be attributed to serious complications.
    nasal septum, hydrocephalus, hepatosplenomegaly, lag
    in mental and physical development.
  2. For the late form of congenital syphilis is characteristic
    called triad Getchinson. These children have lesions.
    corneas, dental pathology, and labyrinth deafness.

Incubation period

During the entire incubation period, regardless of
how long he was, man is contagious. Therefore after
the patient is diagnosed, he should inform about it
their sexual partners.

The duration of the incubation period is influenced by
many factors. It is shortened for several reasons:

  • Secondary infection after a full cure syphilitic
    infections (superinfection).
  • Genital infections (especially gonorrhea).
  • Severe comorbidities (cirrhosis, tuberculosis,
  • Drug and alcohol abuse.
  • The presence of more than two foci of penetration of pale treponema.

It is lengthened due to the following factors:

  • Elderly age (55-60 years). it связано с увяданием обменных
    processes in the body.
  • Long-term diseases that are accompanied
    immunocompromised. Surgeries.
  • Individually reduced susceptibility to spirochete bacteria.
    The reason for this phenomenon has not been established.
  • Use of antibiotics (for pneumonia, sore throat, flu,
    genital infections). it маскирует недуг и замедляет развитие

How does syphilis manifest: first signs

сифилитическая сыпь

The appearance of syphilitic rash on his hands

The time between infection and the first signs of syphilis
depends on the person’s immunity and the way in which
bacteria. As a rule, this occurs a month later, but manifestations
may be designated earlier or later, or absent altogether.

The first signs that need to pay attention:

  1. The first visible symptom of syphilis is an ulcer, which
    manifests itself in the place where syphilitic
  2. In parallel, the lymph node is inflamed, located
    next, and behind him – the lymphatic vessel. Doctors have this stage
    stands out in the primary period.
  3. After 6-7 weeks the ulcer passes, but the inflammation
    it spreads to all lymph nodes, and a rash appears. So
    the secondary period begins. It lasts from 2 to 4 years.


Один из признаков, возникновение твердого chancreа на лице

In men, this is the appearance of a painless ulcer called
твердый chancre. Its location in almost all cases.
accounted for genitals. Chancres may appear on the head, on
foreskin, on the penis itself, and may even appear on

Сам chancre круглый и твердый на ощупь, сверху покрыт белым
greasy bloom. According to its consistency it is cartilaginous. Almost in
In all cases he is alone, only occasionally
small ulcers close to each other.

In women, skin manifestations are characterized by the occurrence of
твердого chancreа на половых органах. Soже зафиксированы случаи
появления первых признаков заражения в виде chancreа на губах либо
near the nipple on the chest. Sometimes there are several small ulcers,
sometimes it is single.


The causative agent of the disease is a bacterial microorganism,
Treponemapallidum (pale treponema). Enters the human body
through microcracks, abrasions, wounds, ulcerations, from lymphatic
nodes enters the bloodstream, affects the mucous surfaces,
integuments, internal organs, nervous system, skeleton.

The likelihood of infection depends on the amount ingested
bacteria, that is, regular contact with the patient increases the risks.

Getting from a sick person to the skin or mucous membranes
healthy person, the pathogen is introduced through microscopic
surface injuries and spreads through the body. Wherein
complex immune processes occur. However, after treatment
strong immunity is not formed, therefore, to become infected with syphilis
can be repeatedly.


External ulcers, erosion, papules are very contagious. If a у
a healthy person there are microtrauma of the mucous membrane, then
when in contact with a patient, he risks getting infected.

The blood of a person with syphilis is contagious from the first to
the last day of illness, so transmission can
to occur not only during transfusion, but also during injury
mucous and skin integuments.

How is syphilis transmitted?

Syphilis is transmitted in the following ways:

  • sexual (95%) after contact with a sick partner;
  • it is very rare to get sick with syphilis in a household way (this
    due to the fact that the bacterium dies without the necessary conditions for it when
    drying out);
  • intrauterine – so children are infected in the womb
  • through breast milk from a sick mother to a baby;
  • during childbirth during the passage of the child by birth
  • through the blood that is used for transfusion.

The most contagious patients are patients with primary and secondary
periods of illness. During the tertiary period, the concentration of pale
treponema in the discharge of the patient is sharply reduced.

Symptoms of syphilis

Сифилис довольно разнообразен в своих проявлениях. it
зависит от ряда факторов, начиная от состояния иммунитета
человека, которого поражает трепонема, и заканчивая
количеством возбудителей, проникающих в тело.

The first symptoms of syphilis are in most cases sufficient.
characteristic so that they can was to see and recognize. If a
contact a venereologist at the first suspicion, you can avoid
masses of trouble and really quickly get rid of it

Allocate skin manifestations of syphilis and internal lesions.
Characteristic symptoms are:

  • the emergence of hard chancre – smooth painless ulcers with
    rounded, slightly raised edges with a diameter of up to a centimeter,
    bluish-red color, can sometimes hurt;
  • swollen lymph nodes;
  • headaches, malaise, pain in muscles and joints;
  • high temperature;
  • пониженный гемоглобин, увеличение лейкоцитов в крови;
  • indurative edema;
  • felon – an inflammation of the nail bed, not healing a few
  • amygdalite – solid swollen reddened tonsils,
    difficulty swallowing.

What does syphilis look like on human skin: photo

фото твердого chancreа при сифилисе

сифилитическая сыпь на руке

It looks like a rash on the palms

Symptoms of Primary Syphilis

  • The initial symptoms of the disease appear in that place, through
    which treponema infiltrated the human body. There is formed
    painless ulcer with tight edges – hard chancre. More often
    it occurs in the genital area – on the skin or mucous membrane
  • One week after the formation of skin damage
    first inguinal enlarged, and then all groups of lymph nodes.
    The duration of this period is one and a half months.

5-6 weeks after the onset of primary chancroid
heals spontaneously, even without treatment. This is one of the main
the dangers of syphilis – a person believes that everything is in order, but
major clinical symptoms appear later.

Симптомы вторичного сифилиса

The first rash (papules or roseola) often occurs with
residual effects of hard chancre and scleradenitis. 1-2 after
months they pass without a trace, and there comes a period of early hidden
syphilis. After a few weeks (months) comes comes
wave of generalized rash (secondary syphilis), which
Lasts about 1-3 months.

More often сыпь бывает:

  • roseolous – in the form of rounded pink spots;
  • papular – pink, and then bluish-red nodules, in shape
    and sizes reminiscent of lentils or peas;
  • pustular – pustules located on a solid base,
    which may ulcerate and become covered with a dense crust, and when
    healing often leaves a scar.

Different elements of the rash may appear at the same time, for example
papules and pustules, but any kind of rash contains a large
the amount of spirochetes and very contagious.

  1. The first wave of rash (secondary fresh syphilis) is usually
    the brightest, abundant, accompanied by generalized
  2. Later rash (secondary recurrent syphilis) is paler,
    often asymmetrical, arranged in arcs, garlands in places,
    subject to irritation (inguinal folds, mucous membranes of the mouth
    and genitals).

Despite the fact that during this period there is a purely skin
symptoms, pale treponema, disseminated all tissues and organs,
can cause various forms:

  • meningitis
  • liver pathologies (icteric or anicteric hepatitis),
  • lipoid nephrosis or other kidney disease,
  • syphilitic gastritis,
  • uveitis
  • as well as various lesions of bones and joints.

Symptoms at the tertiary stage

If a больной сифилисом не лечился или лечение было
defective, then a few years after infection
появляются симптомы третичного syphilis. Serious happen
violations of organs and systems, the patient’s appearance is disfigured, he
becomes disabled, in severe cases, fatal

For the tertiary form characteristic gummas are round, large,
painless syphilides. They may appear on the surface.
skin, and on internal organs. It breaks the heart,
kidney, digestive system.

One of the typical symptoms of late syphilis is destruction.
the saddle of the nose, because of what the profile becomes characteristic

After some time, an infection of the nervous
system. Neurosyphilis leads to gradual degeneration of the entire
nervous system:

  • sensitivity impairment
  • altered reflexes
  • sense organs errors,
  • paralysis
  • character change
  • weakening of memory
  • dementia.

The secondary and tertiary periods are almost identical.
symptoms. Differences in symptoms for men and for women present
only in the primary period when the genital organs appear

  • chancre on the cervix. Symptoms of syphilis, at location
    hard chancre on the uterus in women are practically absent and can
    be detected only during a gynecological examination;
  • gangrenous chancre on the penis – there is a chance
    self-amputation of the distal part of the penis;
  • the chancre in the urethra is the first sign of syphilis in the male sex,
    which is manifested by secretions from the urethra,
    tight penis and inguinal bubo.


The most serious consequences of syphilis are:

  • прежде всего, поражение центральной нервной system. it
    чревато проявлением meningitis невритов, гидроцефалии.
  • Very often in patients with neurosyphilis violated
    the functioning of the organs of hearing and vision.
  • Often enough as consequences syphilis is manifested
  • The cardiovascular system is also subject to complications:
    sometimes manifested syphilitic myocarditis, later violated
    functioning of the aortic valves, periodically having seizures
    angina pectoris Due to impaired blood circulation in a patient
    myocardial infarction occurs.


If a skin rash or sore occurs, refer to
dermatologist. Patients often get an appointment with a urologist or
gynecologist. Doctors of all these specialties after the relevant
tests and detection of syphilis guide the patient to the venereologist.

Laboratory diagnostic methods include:

  • Analysis for syphilis. In the taken biomaterial (blood,
    cerebrospinal fluid, discharge from skin elements) under
    microscopic detect pale treponema.
  • Wasserman reaction, testing for fast plasma reacts.
    The patient donates blood for syphilis, where the patient is found
    antibodies that are produced against certain parts
    treponema and tissue, destroying the pathogen.
  • ПЦР – полимеразная цепная реакция – метод лабораторной
    diagnosis, which also allows you to identify treponema in a
    patient material.
  • Different kinds of serological reactions: PHA, RIBT, REEF, ELISA.


The main method of treating syphilis is antibacterial
therapy. Currently, as before, antibiotics are used.
penicillin (short and prolonged penicillins or
durant penicillin drugs).

In the event that this type of treatment is ineffective,
or the patient has an individual intolerance to this
group of drugs, he is assigned drugs of the reserve group
(macrolides, fluoroquinolones, azithromycins, tetracyclines, streptomycin
and so on.)

It should be noted that in the early stages of syphilis
antibacterial treatment is most effective and leads
to complete cure.

Apply two main methods of treatment.
сифилиса: непрерывный (перманентный)
и перемежающийся (курсовой). In the process required
control tests of urine and blood, the state of health is traced
patients and organ systems work. Preference is given to the complex
therapy, which includes:

  • Антибиотики (специфическое лечение сифилиса);
  • Общеукрепляющие (иммуномодуляторы, протеолитические
    enzymes, vitamin and mineral complexes);
  • Симптоматические средства (обезболивающие,
    anti-inflammatory, hepatoprotectors).

Drugs in pills used most often:

  • Rovamycin. The dose is determined by the doctor. Cannot be used when
    complications of the liver and during pregnancy. Overdose can
    manifest as vomiting or nausea.
  • Sumamed. It has a negative effect on the liver and kidneys. Treatment проводится
    early in syphilis, often used as an extra
    remedy for stronger drugs.
  • Cefotaxime. Dosage varies by stage
    sexually transmitted diseases and the patient’s response to medication.
    Banned for penicillin allergies.
  • Amoxicillin. Poorly effective compared to penicillin and
    its derivatives. It is forbidden to take with antibacterial


Prevent syphilis impossible. Against this disease is not
There is no vaccine or other methods of active prevention. Important
follow the rules of safe sex, abandon random

Public prevention should be carried out in accordance with
general rules to combat sexually transmitted diseases. Components
such prophylaxis:

  • mandatory registration of all patients
  • examination of his family members and persons who were with him in
    close contact,
  • hospitalization of infected and observation of them for
    next few months
  • constant dispensary follow-up treatment
    sick patients.

If a вы вынуждены близко контактировать с человеком, который
sick with syphilis, it is important to take all measures to ensure that the disease is not
has spread. For this it is sufficient to strictly observe all
rules of hygiene, as well as avoid close physical contact with
contagious sick. If a соблюдать все эти правила, то риск заражения
noticeably decreases.

Syphilis is a very dangerous infectious disease, like
for the man himself and the people around him. Important при
the first signs, contact a dermatologist or
to the venereologist for making an accurate diagnosis, testing and
start correct treatment with medications.

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