I. Clinical staging.
Early syphilis: infection time within 2 years, including stage I syphilis, stage II syphilis and early latent syphilis.
Late syphilis: the infection time is more than 2 years, also known as stage three syphilis.
Latent syphilis: no clinical symptoms, but abnormal blood tests.
Congenital syphilis: early, occurring within 2 years of age, similar to stage II syphilis; late, occurring after 2 years of age, similar to stage III syphilis; congenital latent syphilis (<2 years of age for early congenital latent syphilis, ≥2 years of age for late congenital latent syphilis)
Second, the symptoms of each stage.
Syphilis is the most clinically complex venereal disease, but its treatment is relatively easy.
The typical clinical manifestation of syphilis is the appearance of hard chancre after 2-4 weeks of infection: it appears as a dark red hard lump and shallow ulcer on the external genital area, painless (no pain), with cartilage-like hardness, 1-2 cm in diameter, with a peripheral elevation and depression in the middle, with a very clean, non-staining surface and no exuding secretions, and swollen surrounding lymph nodes, which heals itself in 2-6 weeks.
Characteristics of stage II syphilis rash: Syphilis rash usually occurs 3-4 weeks after the hard chancre subsides, equivalent to 9-12 weeks after infection. Stage II syphilis is the entry of the syphilis spirochete into the bloodstream via the lymph nodes causing widespread systemic damage. In addition to causing skin damage, it can also invade the internal organs and the nervous system.
Stage II syphilis can be preceded by flu-like syndrome (headache, low-grade fever, sore limbs), and these prodromal symptoms, which last about 3-5 days, subside after the rash is out.
The skin damage of second-stage syphilis can be divided into a symmetrical generalized rash, macules, papules, pustules, etc., occurring on the skin and mucous membranes of the body. Mucous membrane can occur mucosal spots, flat warts, highly infectious.
Stage III syphilis. It occurs 2 to 3 years or even 10 years after infection, the skin is gum-like swelling, but can also involve bones, joints, heart and blood vessels, manifesting as aortitis, aortic valve atresia and aortic aneurysm, etc., invading the nerves as spinal consumption and general paralysis (paralytic dementia). Congenital syphilis has early congenital syphilis, which is equivalent to acquired stage II, but is heavier. Late congenital syphilis is similar to acquired, but rarely occurs with cardiac, vascular and neurological lesions. They are mainly substantial keratitis, neurogenic deafness, Hutchinson’s teeth (central incision of upper incisors, small lower and large upper, equal in width and thickness), and peyote shaped tibiae.
The characteristics of stage III syphilis are as follows.
① late onset (2-15 years after infection), long duration of disease, if left untreated, can be up to 10-30 years, or even lifelong ;
②Symptoms are complex and can involve any tissues and organs, including skin, mucous membranes, bones, joints and internal organs, more likely to invade the nervous system, easily confused with other diseases and difficult to diagnose;
③The syphilis spirochetes in the body and skin lesions are few, the infectious power is weak, but the destructive power of the tissue is strong, often causing tissue defects and organ destruction, which can lead to disability and even endanger life;
④Anti-syphilis treatment is effective, but the damaged tissues and organs cannot be repaired.
⑤ Syphilis seropositivity is unstable, with a negative rate of 30% or more, and the cerebrospinal fluid is often altered.
Latent syphilis (latent syphilis): according to the duration of the disease is divided into early (less than 2 years of disease) and late (more than 2 years of disease), both without clinical symptoms, but the serological test is positive.
Congenital syphilis (definitely the mother has syphilis).