Syphilis treatment

Syphilis is perhaps the disease most feared. It is caused by a bacterial pathogen, the spirochaete. Syphilis is sexually transmitted from person to person. Can be contracted through shaking hands, contact with a towel, doorknob, etc. – is practically zero.

• History

Syphilis is thought to have come to Europe from America. It was brought by the sailors of Christopher Columbus, and at the turn of the 15th and 16th centuries, the first pandemic of the disease broke out in Europe, you can read more about it in this historical essay. Today, when everyone has access to personal protection, and everyone knows about the dangers of STDs, syphilis still affects 3-4 people out of 1000 population.

• First Stage

About 3 to 4 weeks after unprotected intercourse, a man has an ulcer on his penis. It’s called a hard chancre – if you touch it, it’s hard at the base. Sometimes it looks like a pimple, sometimes like a cratered ulcer. It is painless, not bothersome. Usually a person thinks it’s a chafing, or a bite, or an allergy. Classically, sexual intercourse is considered vaginal. But in addition to it, there can also be anal contact and oral. With oral infection, the chancre forms on the lip or palate. Patients often confuse schankre in the anus with an acute form of hemorrhoids and do not always think twice about getting tested. Following the appearance of the chancre, the lymph nodes enlarge, but the person might not feel it. If the patient found a chancre and went to the doctor – syphilis can be cured at the first stage.

• Second stage

After a while the hard chancre goes away on its own, the lymph nodes shrink. But after about six months – and it can be as much as a year or a year and a half, given the extensive use of antibiotics – a person develops a nonspecific rash on his skin. Even doctors sometimes mistake them for an allergic reaction, but by that time the patient has already forgotten about the ulcer (chancre) that did not bother him at all. Papules, or red nodules, appear on the palms of the hands. Leucoderma appears around the neck, what was formerly called the “Venus necklace. Today there are many erased forms of secondary syphilis, instead of the classic “Venus necklaces” there are 2-3 incomprehensible spots that even a doctor can’t always identify. If not diagnosed, syphilis develops further.

• Stage III

Tertiary syphilis is characterized by gummotic changes in the tissues. A gumma (syphilitic granuloma) is a nodule in the tissue in which, concentrated spirochaetes. More often, gummae occur in the liver, soft tissues, and the aortic wall. Tissues are irreversibly destroyed, rough knots form. If the spirochaete enters the trunks of the nervous system – an extremely dangerous condition develops – neurophysilis. However, spinal sinusitis (a form of late-onset neurosyphilis, characterized by lesions of the central nervous system) is almost never encountered today. The painter Mikhail Vrubel suffered from spinal dehydrosis, hence his demons. More about Vrubel’s tragedy and his doctors can be read in this article.

• Broad-pointed condylomas

Broad-pointed condylomas should not be confused with acute condylomas, which occur with the human papilloma virus. In the past, widespread condylomas occurred in stages 2 and 3 of syphilis. But nowadays, whether because of the wide use of antibiotics or for other reasons, condylomas can also occur in the first stage. Because of the difference in the anatomy of the genitals, men detect condylomas more easily than women. If you see or feel that a condyloma has appeared on the genitals, do not try to determine on the Internet whether it is a broad-sided or not, go straight to the doctor.

• Syphilis test

Three weeks after having unprotected sexual intercourse (including oral and anal sex) you have to take a specific RW test (Wasserman test, or simply “syphilis test”). It makes no sense to take the test earlier, because the body’s immune response has not yet developed, and the test can give a false-negative result. Syphilis test can be done in any private lab, but it is best done at the local health center.

It is important to understand that if syphilis infection has occurred, the RW test will always be positive. Only 1 out of 10 patients will have a syphilis marker that goes away after treatment. The presence of the marker (positive RW test) can cause unnecessary questions during hospitalization, childbirth, professional examinations at work. A person who has fallen ill must therefore only undergo legal treatment at a public health institution licensed to treat syphilis. Such institution will issue a certificate to the patient that syphilis occurred, the patient underwent treatment, was registered and disregistered, and is healthy. No private hospital has the right to treat syphilis and issue such certificates! A private clinic can only diagnose and refer a patient to a public medical institution.

• Syphilis treatment

Today all over the world syphilis is easily treated with prolonged penicillin antibiotics. Treatment of syphilis with prolonged antibiotics is only 4 injections of extincillin. Bicillin or penicillin are used in the treatment of syphilis – 6 injections daily for 10 days, the treatment is complicated. The task of the state is to make the patient not contagious for the society. Everywhere in the world, if syphilis is diagnosed, the patient gets the first injection of a prolonged-action antibiotic extincillin – after that he is no longer infectious. Treatment with bicillin or penicillin does not work as quickly, and the person continues to pose a risk to their sexual partners until treatment with bicillin is complete. Allergies to penicillin can be treated with second-line drugs, such as tetracyclines.

• What to do if unprotected intercourse occurs by accident

Specific antibodies for syphilis and HIV appear in the blood three to four weeks after infection. But it is necessary to see a doctor 1 week after the suspected sexual intercourse. Do not take any medications before seeing a doctor. Your doctor will prescribe a special laboratory test called an immunoblot. This is a highly specific and highly sensitive method to detect traces of emerging antibodies to the syphilis pathogen.

For patients who have had syphilis in the past, it is important to understand the difference between testing for M and G levels on a total basis and testing for these levels one at a time. Their cumulative test will always be positive because immunoglobulin G is preserved in the blood of those who have had syphilis in the past. Only the M globulin will tell us about the new infection. This is a rather complicated issue, which you should not try to solve by yourself with the help of the Internet.

After a suspicious unprotected sexual intercourse a blood test for syphilis, a blood test for HIV (this is also taken not earlier than 3-4 weeks after the contact) and a blood test for hepatitis C, which is easily transmitted sexually. At the same time, a sample is taken from the urethra or from the vagina and cervix for markers of sexually transmitted diseases. Their pathogens include gonococcus, trichomonas, ureaplasma, metaplasma, chlamydia, candida, gardnerella. If you suspect unprotected intercourse, the only way to be sure is to get a full battery of tests.

• How to protect yourself from sexually transmitted diseases

A good condom guarantees protection from STDs, provided that it is worn correctly, that it has not burst, that extragenital contacts – oral and anal – have also been carried out with a condom. Today, there is no better protection against STDs than the condom. Genital preparation with drugs like MIRAMISTIN is not effective!