Symptoms, signs, manifestations and treatment of secondary syphilis
In the secondary period of syphilis the patient is extremely contagious to a greater extent than in other periods. Through vivid clinical picture it is, as a rule, turns to the doctor and learns about his diagnosis. But even if the patient does not enter into sexual relations, he can transmit the infection through everyday life. Through contact with dishes, Cutlery, towels, toothbrush and other personal items there is a risk of infecting family members. Therefore, the rational treatment carried out in hospital conditions.
The first episode of a generalized rash are called secondary fresh syphilis. It is associated with the penetration of Treponema in the blood and lymph vessels and spread it throughout the body. This rash may persist for 2-3 months, after which it fades and disappears due to the resistance of the immune system even without treatment. There comes a latent period, but through time the rash again.
Re-flashes are secondary recurrent syphilis. They alternate with latent phase and can occur with different frequency within a few years.
A week before the rash appears, the patient noted a temperature increase and a General malaise that passes without treatment. Then increase all of the lymph nodes and rash. In addition, patients report the symptoms of secondary syphilis:
- alopecia areata: diffuse alopecia caused by malnutrition of the hair follicles;
- vitiligo: white spots on the back of the neck, arranged in the shape of necklace (necklace of Venus);
- aphonia: impaired voice due to lesions of the vocal cords.
The rash of secondary syphilis consists of three possible elements that are constantly in different phases of maturation:
- roseola (spot);
- papules (nodules);
Roseola represent a pink or red circular spots turn pale with pressure. Normally their size in diameter of not more than 5 mm. Papules, unlike spots, towering above the skin surface, also have a red hue and can peel off.
Pustules are rarely seen, mostly in debilitated elderly patients or in patients with immunodeficiency. This blisters filled with yellow purulent contents.
All syphiliticspotted elements is absolutely painless and not itchy, unlike the rash in other infections. They heal without a scar, even if untreated, but can leave pockets of hyperpigmentation.
The difference between fresh and recurrent syphilis
Fresh and re-rash in secondary syphilis are a number of differences:
- When fresh, dominated by roseola, and when re papules.
- Fresh rash has a bright red color, whereas for the relapses characteristic copper colour of the spotted elements.
- Fresh eruptions smaller recurrent.
- Fresh rashes are symmetrical and diffuse, and in return she is single-ended and forms the typical figures: circles, garlands, chains, etc
- Repeated rashes with the formation of flakes on the periphery of the rim (Vorotnikova).
Symptoms of the disease in the oral cavity
In the secondary period of syphilis the characteristic symptoms are observed in mouth:
- erythematous angina: drainage rosealine painless rash on the tonsils, soft palate and Palatine arches;
- "plaque mown meadows": the presence in the language of the patient papules that coalesce into plaques with a smooth surface due to the shedding of the epithelium;
- syphilitic binding: weeping painless erosion at the corners of the mouth.
Diagnosis and treatment
Only one of the rash and accompanying symptoms insufficient for diagnosis and appointment drugs antisyphyllitic treatment. Therefore, the surface of the spotted elements on the skin the doctor takes a scraping. It examined in the laboratory under the microscope for the detection of Treponema pallidum. In addition, throughout the period of diagnostic value has Wasserman. It is positive as when fresh secondary and recurrent syphilis.
At the time of treatment must not only avoid sexual relations, but also to adhere to a special regime, so as not to transmit the infection at home.
If a patient is treated at home, he has to eat from separate utensils, to have their own towel, washcloth, soap, and other hygiene items. Also, it is desirable to sleep separately from my spouse, since all elements of the lesions contain numerous treponemes.
Since compliance is difficult, most patients with syphilis receive treatment in a hospital. Moreover, injections of antibiotics are required to conduct every 3-4 hours, which makes therapy in a hospital setting more convenient and productive.
Antibiotics show the greatest efficiency penicillins. Used injection water soluble penicillin with a frequency of eight times per day, salts of penicillin two times a day. For outpatient therapy prolonged usedrugs (Bitsillin"), which is administered every few days.
If you are allergic to penicillin is used "Doxycycline", "Tetracycline" or macrolides (Erythromycin," "Azithromycin"). Except for antibiotic injections, used an immunostimulating drug ("Pirogenal", "Methyluracil", etc.). Inside patients take a multivitamin.
Local treatment consists in treating the lesions with chlorhexidine and lubrication the heparin ointment to accelerate resorption.
All family members are infected, regardless of symptoms, should be screened. And sexual partners of the patient over the past year, receive preventive treatment.