The etiology and route of infectionThe causative agent of syphilis TPHA, it is called so because it remains invisible through the light microscope when stained by conventional dyes.
In most cases, infection occurs through sexual contact with an open hearth infection (chancre, syphiloma). The transfer agent is also possible by household (for example, using the same glass), through blood products, and from mother to fetus (in this case we speak of congenital syphilis). After atrium (microtrauma on the skin, trunk, oral mucosa, genital) pathogen enters the lymph nodes, and then the systemic circulation.
SymptomsThe incubation period averages about 3-6 weeks. The first sign of the disease is the formation at the site of contact painless chancre sores dense spherical with a diameter of 0.5-2 cm, with a sleek, shiny bottom. These sores usually do not bleed and do not tend to merge. During the first week after the appearance of the chancre swollen lymph nodes affected area (there is a regional lymphadenitis). This period of the disease is called primary syphilis. Sometimes, the primary lesions may not be, or they are on the internal reproductive organs (such as the wall of the vagina in women), which greatly complicates diagnosis. Syphilitic ulcer can become infected again. This process is accompanied by severe swelling, redness in the chancre, with the surface of the ulcer can be separated pus. In the analysis of discharge from the ulcer area is not always possible to distinguish the pale treponemu, because of what may be wrong conclusion about the absence of syphilis.
After about 2-3 months after infection when the skin and mucous generalized rash appears, we can speak of the disease in the second period. By this time, the primary foci tend to disappear, leaving behind scars. Cutaneous manifestations of secondary syphilis are due to vascular changes in the deeper layers of the skin. Localized rash on the trunk, extremities, face, as well as on the palms and soles. The rash may be mottled, or pustular bubble and have a dark red color that fades over time. Pockets of rash formed on an unmodified background, the individual elements are not inclined to merge. Very rarely a rash accompanied by itching. In the analysis of scrapings from secondary syphilides TPHA detected, indicating that their infectiousness. In 10% of cases there is overgrowth of the elements in the mucous membranes, under the breasts, in the armpits, the anus followed by their weeping. This is the so-called broad warts, which are highly contagious.
Rash is sometimes accompanied by a slight malaise, sore throat, slight fever. Duration of the secondary period of the disease is several days. Without treatment, the disease becomes latent (asymptomatic) form.
Patient latent syphilis is contagious, it is also possible transmission of infection from mother to fetus. During this period, which can last for several years or even a lifetime in the blood have antibodies to the causative agent of the disease. Approximately 30% of patients the disease progresses to the Tertiary period, which is characterized by severe destructive lesions of the internal organs and systems. Tertiary syphilides (gummas) on the skin are single painless bumps tight, exciting the deepest layers of the skin and subcutaneous fat layer. In the center of gummas often forms a portion of necrosis and the subsequent formation of rough retracted scar. Exactly the same gummas can appear in any internal organ. More often than not involved in the process of bone-cartilage and the nervous system. In the former case, holes are formed in the hard and soft palate, the cartilage of the nose and throat. Infection of the nervous system (neurosyphilis) leads to symptoms of lesions of the meninges, the development of paresis and paralysis, as well as violations of the psyche. Education gummas in the cardiovascular system is fraught with development of aneurysms, an inflammation of the wall of the aorta, narrowing of the blood vessels of the heart.
DiagnosticsThere is a lot of blood tests that identify syphilis. All are based on the detection of specific antibodies and are divided into two groups of non-treponemal and treponemal. For the screening used the so-called quality netreponemnye Wasserman (RW) with cardiolipin antigen. Under certain conditions, the result of this analysis may be false positives. This requires confirmation with a treponemal research (RW with treponemal antigen RIBT), the results of which remain positive after the disease for life.
To evaluate the effectiveness of treatment using quantitative Wasserman with treponemal antigen.