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How to identify the symptoms and treat primary syphilis

Primary syphilis (hereinafter – PS) is the period of the disease, which continues from the end of the incubation period before generalization process. In other words, primary syphilis is characterized by a local infectious process, the maximum of which occurs before the lymph node of any one region.

What characterizes the given period and which has complications and pitfalls?

Main symptoms of the disease

After a certain period of time from contact with the sick person, during which the Treponema "settling" in a new organism develops from the first stages of syphilis. Typically, the duration of the incubation period is several weeks to a month. There are two possible scenario:

  1. The first version of the current initial stage – of an infected person are no external symptoms, implicitly develops the latent form. The disease is detected by chance during clinical examination or pregnancy.
  2. From an infected person to the skin or mucosa appears ulcerative defect, usually round or oval, painless. In the absence of pain can be seen immediately. The bottom of this "canker smooth and shiny, bright pink, there may be a small amount of discharge, usually slimy, light. On palpation you can feel the density of the edges and bottom, so this ulcerative defect is called a "hard chancre".

Localization of the ulcer may be different:

  • the mucous membrane of the vagina, vulva, cervix in women; penis, scrotum in men;
  • the tonsils and the bottom in the oral cavity, soft palate, lip, tongue;
  • perianal area and rectum;
  • somewhat atypical, but could be a possible localization on the finger, hand, belly, thighs.

The frequency of occurrence of ulcer in different areas is reflected in the table below.

Topical arrangement of "hard chancre" The frequency of occurrence
Penis head, foreskin 90-95% of all cases
Vulva, the area of the labia, vagina
Tonsils, lip 75% of all extragenital localizations
Fingers 7%
Perianal region, rectum 6,8%
Soft and hard palate, tongue, floor of the mouth Extremely rare, less than 1%
Belly, inner thighs, Breasts Up to 5%

It always occurs ulcerative defect? No, sometimes instead of it develops dense (almostsolid) edema in the above areas (usually the scrotum and labia, tonsils), with pressure which does not appear the hole. Such swelling also painless or virtually painless, the color of her dark-red, sometimes with cyanosis.

In the presence of congenital or acquired immunodeficiency on the background of chronic comorbidity in the place of specific formation of the ulcer may join other bacterial flora. While you may experience pyoderma, gangrene, candidiasis, inflammation of the glans penis and foreskin.

Primary syphilis is always accompanied by an increase in regional lymph nodes – they get a smooth rounded shape and dense texture, with the surrounding tissues such nodes are not soldered.

Methods of diagnosis of the primary infection

Features of diagnosis the first stage of the disease is such that it can be divided into two halves: about a month all reactions would be negative. So the first half is called primary seronegative syphilis. In the second half (once a month) specific reactions are positive. This part is called seropositive.

Способы лабораторной диагностики первичного сифилиса

When choosing an antibacterial drug the doctor evaluates:

  1. The circulation period from the time of infection.
  2. The presence of concomitant infection and these survey results for other STIs.
  3. The presence of comorbidity, especially diabetes mellitus and other endocrine diseases, alcoholism, drug addiction, intake of immunosuppressants for any reason.
  4. The severity of clinical symptoms and size of the ulcer.
  5. The presence of allergic reactions to medicines.

Criteria of recovery

To positively say that the man is completely cured, you must meet the following requirements:

  1. To achieve the disappearance of any symptoms.
  2. To perform laboratory monitoring after treatment, and then several times during the year.
  3. Optimally, if the results of studies are negative or titers will decrease by 4 and more times in comparison with the previous study.
  4. In any case, by the end of the first year of the clinical examination and laboratory tests should be negative.
  5. To continue the examination in the subsequent 5 years after clinical recovery, the results are stored in the clinic and a duplicate on hand.

In conclusion I want to note that timely treatment for medical help in the first stage almost always contributes to a complete cure. We should not think that the above symptoms will be yourself or try to treat themself. The worst thing in syphilis, inadequate treatment or its absence.


  1. The order of Ministry of health of the Russian Federation dated 26.03.2001 № 87 "On improving the serological diagnosis of syphilis".
  2. The order of Ministry of health of the Russian Federation dated 25.06.2003 № 327 "On approval of Protocol of management of patients with syphilis.
  3. Clinical manifestations of primary and secondary syphilis. Males A.V. – Russian medical journal.