Syphilis – symptoms in women and men, stage, treatment

Syphilis – this is one of the most common diseases transmitted predominantly sexually (STDs). The causative agent of the disease is the bacterium pale treponema. Modern medicine can easily cope with this disease, but if the patient is not treated, then he is waiting for a slow and painful death with a large spectrum of symptoms.

According to 2014, 26 people per 100 000 of the population of European countries are sick with syphilis. The incidence of sexually transmitted diseases is declining slowly, so the state often is engaged in informing the population about STDs. Awareness of STD prevention helps to avoid serious health problems for both young people and adults.

Syphilis Symptoms

Once in the human body, the bacterium Pale Treponema, the causative agent of syphilis, goes through an incubation period that lasts from 1 to 6 weeks. At this time, the person does not know about the infection, as he has no signs of the disease. Even the majority of tests can not reveal the disease at this stage. There is a high probability that the patient will infect several sexual partners with syphilis, unaware of the consequences of their actions.

The first signs of the disease appear at the end of the incubation period with the onset of primary syphilis. They can be located on the skin in the form of hard chancre, multiple chancre, syphilitic rash, baldness (skin syphilides) and mucous membranes – chancres in the mouth, genitals, rashes on mucous membranes (mucous membranes syphilides).

Signs of syphilis in women

The end of the asymptomatic period is marked by the appearance of the first sign of infection (3-4 weeks after infection). In places of hit of a bacterium, a chancre forms. Its appearance gives the countdown of the primary stage of syphilis. Hard chancre is formed as an immune response to the introduction of pale treponema. It is localized in the mouth, in the area of ​​the external and internal genital organs, in the area of ​​the anus.

Hard chancre is an inflammatory growth of a rounded shape with a flat base. At the initial stages of its appearance almost does not hurt. Appears in the field of infection. If treatment is not carried out, a syphilitic rash is added to the chancre on visible areas of the body and on the mucous membranes.

Signs of Syphilis in Men

In men, as in women, the first noticeable sign of infection appears as a solid chancre. An ulcer forms more frequently on the penis, at its base and on the head. However, it can also appear in the mouth, on the scrotum, in the anus area. Symptoms and the course of the disease do not differ in the male and female part of the population. Further description of syphilis will be given without separation by gender.

Symptoms of Primary Syphilis

  • The primary stage of syphilis begins with the discovery of a hard chancre on the skin or mucous membranes of a person. At the initial stage, this does not cause serious discomfort. Then there is a gradual inflammation of chancre, it takes on a red or bluish color, characteristic of a strong inflammatory process.
  • During the first week after the onset of the first symptoms, inflammation of the lymph nodes and blood vessels begins next to chancre (regional scleradenitis). Lymph nodes inflame in the form of tangles, forming significant edema and swelling around hard chancre. With the localization of sores in the mouth, it threatens the inflammation of one tonsil and throat swelling, making it difficult to swallow and breathing. Symptoms cause considerable distress in verbal communication and eating. Scleradenitis in the genital area complicates the process of walking and the act of defecation.
Symptoms of Primary Syphilis
Photo: Jarun Ontakrai /

The end of the primary and the onset of secondary syphilis is considered to be the appearance of a specific rash on the patient’s body. Modern methods of diagnosis can detect syphilis immediately after the onset of the first symptoms. The most commonly used enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). These tests are prescribed by the therapist in the clinic or by the venereologist in the skin and venereal clinic. The average cost of analysis is 500 rubles. It should be remembered that the analysis will be timely only at the stage of primary syphilis. Earlier tests will not show anything except the seronegative reaction, indicating a lack of pale treponema in the body.

Symptoms of secondary syphilis

  • The skin around the chancre is covered with spots and ulcers with a diameter of up to 15 mm. The rash can grow and form in large areas on the skin and mucous surfaces, causing the patient severe discomfort. Syphilitic rashes are of three kinds.
    Roseolary rash – pink or red spots with clear or blurred borders 5-50 mm in diameter. No cavities. Do not protrude over the skin.
    Papular rash – small conical growths of pink color. Can peel off on top of the cone. Such raw materials look extremely unpleasant.
    Pustular rash – growths with purulent cavities.
  • Along with the appearance of a rash, damage to the nervous system can begin. The degradation of the nervous tissue negatively affects vision, memory, attention, coordination of movements. Unfortunately, the treatment of the disease will not lead to the restoration of the lost functions of the central nervous system, but will only stop the process of further damage to the nervous tissue.
  • Signs of partial or complete baldness appear. Hair fall out, usually on the head. At first, the quality of the hairline deteriorates: hair splits, thin, thin. Then the thinning of the hair is enhanced, extensive bald areas of skin appear. After recovery from syphilis, the hairline does not resume.

Syphilis Stages

In our time, every person who has become infected with a pale treponema can quickly and efficiently receive adequate and effective treatment. Only a few pass through all stages of syphilis. Without treatment, a person lives in terrible agony for 10 or even 20 years, after which he dies.

A brief description of the stages of syphilis follows.

Stage of incubation period

Stage Name Time Limits Description of symptoms
Incubation Period From infection to 189 days. During this period, there are objectively no manifestations in the patient’s body.
If the infection gets into several places in the body at once, then this shortens the incubation period to 1-2 weeks. If an infected person takes antibiotics, for example, from the flu or from a sore throat, then the incubation period can be delayed even for half a year. The end of this period occurs with the appearance of the first symptom – a hard chancre and inflammation of the lymph nodes. If the pathogen enters the bloodstream directly, then the stage of primary syphilis does not manifest itself and the disease proceeds immediately to the secondary stage.

Primary syphilis stage

Stage Name Time Limits Description of symptoms
Primary syphilis stage From the onset of solid chancre to the appearance of rashes and inflammation of the lymph nodes in the chancre area Hard chancre is a single solid formation that penetrates a little, but does not grow into tissue, caused by an immune response to pale treponema. It has a rounded shape and distinct edges. Localized in the area of ​​infection (Genitalia, oral cavity, anus, fingers).
It does not cause pain, but it should cause serious concerns and motivate the patient to stop any sexual contact and immediately consult a doctor in order to begin treatment before a syphilitic rash appears.
Multiple scans may appear at the end of the primary stage.
The second symptom is the appearance of swollen lymph nodes near hard chancre.
At the end of the stage of primary syphilis, malaise, dizziness, body temperature rise.
Atypical symptoms sometimes occur at this stage, which will be described below in the appropriate section of the article.
Headed Syphilis Borders are hard to determine Observed when infected through blood. There are no symptoms, the disease goes immediately to the secondary or latent stage, bypassing the primary one.

Secondary syphilis stage. It is divided into four stages of the disease. In the absence of adequate treatment, the order will be approximately as follows:

Secondary syphilis Time Limits symptoms of secondary syphilis
Early (Lues secundaria recens) From 60-70 days after infection. From 40-50 days after the appearance of chancre. Lasts from several days to 1-2 weeks Three types of rash caused by an active immune response and the production of endotoxins that fight infection.
The nervous system, internal organs, bones suffer.
The temperature rises to 37-37,5 ° C, accompanied by malaise, cough, runny nose, conjunctivitis.
Extensive inflammation of the lymph nodes without pain and discomfort, which are hard and cool to the touch.
Often hair falls out, perhaps complete baldness.
Hidden From 60 days after the appearance of chancres or later At some point, the immune system blocks the effect of an infection that destroys the body. The rash stops. Of course, the infection does not leave the organs and tissues, the patient lives in anxiously awaiting recurrence.
Return (recurrent) After the hidden phase With any weakening of the immune system (stress, cold, skipping meals, injury), a relapse may occur. It manifests itself in the appearance of a new rash, more extensive, with foci of skin hemorrhages. All symptoms characteristic of early syphilis recur. Often, multiple chancre of the genitals is formed.
Early Neurosyphilis Since 2 years from the moment of illness Associated with inflammation and damage to the blood vessels and neurons of the brain, internal organs (almost always the heart and liver), and bones and joints. Manifested in the form of chronic meningitis, impaired ability of pupils to narrow when exposed to light. Miliary gummas are formed inside the brain vessels, which increase intracranial pressure, worsening general well-being and causing headaches. Many symptoms violate higher mental functions, such as attention, memory, coordination of movements. The changes are irreversible.

Stage of tertiary syphilis. It is divided into three stages of the disease. In the absence of adequate treatment, the order will be as follows:

Name of the stage of tertiary syphilis Time Limits Description of symptoms
Hidden chronic stage Lasts from 1 year to 20 years About 70% of patients in the absence of treatment live as carriers of the infection, moving from the latent phase of tertiary syphilis to the recurrent phase. However, sooner or later the immune system does not stand. A person moves to the next stage with a high probability of becoming disabled or fatal.
Tertiary Syphilis With the onset of the relevant symptoms Extensive damage occurs to all organs and tissues, bones and nervous system. Gummas are formed in the most merciless manner in many places. Gums are characteristic purulent tumors, often bleeding and moist from lymph and pus. Often appear on the face. Heal very hard, forming ugly scars. Often, gummas become infected with other bacteria, leading to serious complications: an abscess and gangrene.
Late neurosyphilis The final stage leading to disability and inevitable death. 10-15 years from the onset of the disease. Extensive damage to the central nervous system, leading to loss of vision, paralysis, impaired mental cognitive functions.
Infectious diseases of the brain develop – meningitis, brain and bone gum.

Neurosyphilis begins at the end of secondary syphilis. Usually manifested as the following diagnoses:

  • Asymptomatic neurosyphilis – in which there are still no painful manifestations, but tests already show inflammation and infection of the liquor. This stage of neurosyphilis usually begins a year and a half after infection.
  • Gummous neurosyphilis – accompanied by the formation of gum inside the brain and spinal cord. This is a painful symptom that feels like a large tumor, causes permanent pain, causes an increase in pressure inside the patient’s skull.
  • Syphilitic meningitis is a lesion of the lining of the brain at the base and in the region of the cranial vault. Accompanied by severe symptoms, including impaired attention, thinking, memory, emotional person.
  • Meningovascular form of neurosyphilis – destroys the vessels of the brain, accompanied by chronic meningitis. In the absence of therapy leads to headaches, personality changes, behavior, sleep disturbed, convulsions begin. This ultimately leads to strokes.
  • Spinal troughs – a violation of the nerve fibers of the spinal cord, their thinning and dysfunction. This leads to an irreversible disruption of the ability to move in space: the gait is bent, the patient can fall, losing the sensation of the earth under their feet. When you close your eyes, orientation in space is lost.
  • Progressive paralysis – causes a violation of the functions of the central nervous system, accompanied by personality disorder, dangerous behavior for society, degrade all higher mental functions. A person becomes obsessed and can easily go to a psychiatric clinic if he is not diagnosed with syphilis. Ultimately, progressive paralysis leads to complete paralysis of the body.
  • Atrophy of the optic nerve – degradation of the visual function. At first, the vision of only one eye deteriorates, but the infection gradually approaches the second optic nerve. Causes total blindness if not treated. Changes in the visual apparatus are irreversible.
  • Late visceral syphilis is a degradation of the tissues of internal organs. Basically, the cardiovascular system and the liver are affected. The remaining organs are rarely affected. Patients complain of deterioration of health at the slightest load, they have systolic murmurs in the heart due to aortic dilation. With the localization of late visceral syphilis, a heart attack can occur in the heart.
  • Late syphilis of bones and joints – causes local expansion of bones and large joints. Accompanied by the formation of gum on the bones.

Atypical Syphilis

In addition to hard chancre, others may also appear at the stage of primary syphilis. atypical chancre. That is why this variant of the disease is called atypical syphilis. Atypical chancres are of the following types:

  • Inductive edema.
    It looks like a change in the color of the scrotum in men, the clitoris and labia in women. Color varies from scarlet to bluish in the center, pales at the edges of the edema. Women are more prone to this symptom than men. Usually the patient perceives indurative syphilitic edema as an infectious-inflammatory disease of a different kind, since a blood test at this stage of syphilis does not provide information about the true cause of the edema. You can distinguish it from another infection by the absence of an inflammatory process in the blood and by the presence of inflammation of the lymph nodes.
  • Chancre felon.
    It may appear in people who care for patients with syphilis: medical personnel, relatives. The large, index and middle fingers of the hand are affected. This is a very painful attack. The skin lags behind the fingers, exposing the vast bleeding areas, as with second-degree burns. Also panaritium is accompanied by swelling and inflammation of the fingers, preventing the normal functioning of the person. It often appears with hard chancre of the genitals.
  • Chancre-amygdalite.
    Manifested in the form of inflammation of one tonsil, and its surface is not disturbed, remains smooth. The oral cavity is subjected to severe pain, difficult swallowing process. The patient is experiencing a fever, as with angina. The difference from sore throat is that only one tonsil becomes inflamed during amygdalite.

Congenital syphilis

Maternal illness during pregnancy is highly undesirable. The fetus is exposed to pale treponema, which leads to irreversible morphological consequences, impaired intrauterine development.
Medicine has three main symptoms:

    • Parenchymal keratitis is a pathology of the external epithelium of the internal organs and the eyeball. Manifested in the form of severe redness and inflammation of the organ outside. Sometimes inflammation penetrates slightly into the surface. After the treatment, scars remain, there may be a thorn in the eyes. The most frequent effect on the eye is reduced visual acuity. Keratitis is accompanied by blurred vision, acute pain, tearing.
    • Deafness from birth. The causative agent of syphilis actively destroys the nervous tissue of the fetus during pregnancy. Pathology of the auditory nerve may be one of the options, resulting in irreversible deafness.
    • Congenital anomalies of teeth. Occur due to underdevelopment of tooth tissues during fetal development. This pathology is called Getchinson’s teeth. Teeth grow in the form of a screwdriver with a rounded groove on the cutting edge, rarely planted. Sometimes the teeth are not completely covered with enamel. Which leads to their early destruction and impartial appearance.

A child who has had intrauterine syphilis has poor health, even if the mother has successfully completed the course of treatment. If adequate treatment is not followed, then the child will have pronounced deformities and will remain disabled for life. When a mother becomes infected with syphilis, breastfeeding should be stopped immediately, since syphilis is transmitted through mother’s milk.

If a woman who has previously had syphilis wants to become pregnant, she should be tested for pale treponema (ELISA or PCR). After receiving confirmation of the absence of the disease, you can safely decide on pregnancy.

Syphilis pathogen

Treponema pallidum (Treponema pallidum) is a bacterium that causes syphilis. German scientists in 1905 discovered the cause of one of the most common sexually transmitted diseases. Having discovered the bacterial nature of the disease, microbiologists and pharmacists have found the key to the rapid cure of syphilis, and also opened the way for the invention of methods for the early diagnosis of the disease.

Properties of the pathogen

The bacterium was called pale in view of the fact that for a long time scientists could not see it through a microscope. The transparent color of treponema is difficult to turn into other colors for further investigation. For staining using the methods of Romanovsky-Gizma and silver impregnation, allowing under a dark-field microscope to detect bacteria for further study.
It was found that in favorable conditions (it should be only the human or animal body) pale treponema is divided every 30 hours. The weak point of treponema is that it lives and multiplies only at 37 ° C. This explains the effectiveness of archaic methods of treating syphilis, when, artificially raising the patient’s body temperature to 41 ° C with the help of malaria, there was some relief of the symptoms of the underlying disease.
The length of the bacteria is 8-20 microns with a thickness of 0.25-0.35 microns. Relatively long, her body forms curls in the form of a coil. At the same time, he constantly changes the shape and number of curls due to the ability to reduce the cells of the pale treponema.

Incubation Period

Once in the body through micro-damage to the skin and mucous membranes, the causative agent of syphilis begins an incubation period. Sharing at a rate of about once every 30 hours, it accumulates at the site of infection. No visible symptoms are observed. About a month later, a solid chancre forms on the body in combination with inflammation of the lymph nodes next to it. This means a transition from incubation to the stage of primary syphilis. The strength of immunity in different patients is different, which makes a large variation in the length of the initial period of infection. It can last from 1-2 weeks to six months.

How the disease is transmitted

The process of transmitting the pathogen occurs in most cases sexually. Infection is guaranteed during traditional, anal and oral sexual contact, even with a patient in the incubation stage. Hard chancre is formed at the sites of bacteria.

When caring for the sick, infection is likely through contact with the patient’s clothing, his personal belongings, and his body. In this case, chancre-felon appears, affecting the fingers and toes. It is one of the most painful symptoms in the primary syphilis stage. Then a hard head of the genitals can appear.
Syphilis can also be transmitted through blood. When transfusing contaminated blood, when reusing a patient’s syringe, his razor, scissors, dishes.

How to treat syphilis

Treatment should begin at the first sign of syphilis. So the healing process will be as fast as possible. Since the 50s of the 20th century, antibiotics have been used in the treatment of syphilis. Penicillin-based drugs were used. Nowadays, preparations based on it are also used, since pale treponema does not know how to adapt to this type of antibiotics. Sufficient doses of penicillin effectively fight the disease. For the treatment of syphilis in patients with allergic reactions to penicillin, use erythromycin or tetracycline.
If the course of the disease has reached neurosyphilis, the treatment is complicated. Pyrotherapy (artificial increase in body temperature) and intramuscular administration of antibacterial drugs are added.

In the case of tertiary syphilis, along with antibiotics, highly toxic preparations based on bismuth are used. Treatment takes place strictly in the hospital with multi-level maintenance therapy.

If a patient is diagnosed with primary syphilis, it is necessary to forcibly treat all of his sexual partners who have been in contact during the last trimester.
If secondary syphilis is diagnosed, it is necessary to forcibly treat all of its sexual partners who have been in contact during the past year.

It is necessary to disinfect all items in the house with which the patient had direct contact: plumbing, dishes, bedding and underwear, clothes, etc.
Hospitalization in the initial stages of syphilis is not required, rather ambulatory treatment. Only in severe forms, starting from the secondary stage, the patient is placed in the hospital. Treatment for syphilis under the OMS policy is free and anonymous.

Cope with the disease of folk remedies is not recommended. Only a well-designed treatment can defeat pale treponema. Otherwise, there is a high probability of the disease going to more severe stages.

Which doctor treats syphilis

Since syphilis is a sexually transmitted disease, the venereologist is involved in treatment. The patient can turn to the therapist and get a referral to a venereologist. There is a possibility of direct treatment in the skin and venereal clinic.

After examining and receiving the test results, the patient is treated by either the venereologist himself, who specializes in all STDs, or the patient is referred to a specialized specialist, a syphilidologist.

Syphilidologist is in every major city with skin and venereal clinics. He can choose the most effective dosage of drugs and develop a treatment program that must be strictly followed. With complications in men (when the head of the penis is injured), syphilis is treated together with a urologist.
With complications in women (hard chancre in the vagina, on the cervix), you must go to the gynecologist.

How long it takes to treat syphilis

The duration of treatment of the disease is determined solely by the doctor. Depending on the stage of the disease, complications and the general condition of the body, it may take from two weeks to six months to cure.

It is very important to know that in no case should the treatment be interrupted. With incomplete treatment, the patient will soon have a relapse. Therefore, treatment must be taken very seriously.

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