What is latent syphilis (latent syphilis)?
Patients with untreated syphilis, or inadequate doses of medication, no clinical symptoms, positive seropositivity, no other diseases present that can cause positive seropositivity, and normal cerebrospinal fluid are called latent syphilis. Patients who have been infected for less than 2 years are considered to have early latent syphilis, and such patients may have second stage recurrent damage and should be considered infectious.
Patients who have been infected for more than 2 years are called late latent syphilis, and recurrent damage in these patients is rare and generally considered non-infectious (note: in the past, the boundary between stage II syphilis and stage III syphilis was 4 years, so it was called late latent syphilis only after 4 years, and recurrence is even less likely). However, a female patient can transmit syphilis to her fetus for at least 5 years after infection, so a patient with syphilis more than 2 years old is still infectious. If latent syphilis is left untreated, late syphilis can occur in some patients, and late latent syphilis can also occur in cardiovascular syphilis or neurosyphilis.
What is congenital syphilis?
Congenital syphilis, also known as fetal syphilis, is syphilis that is transmitted from the mother to the fetus through the placenta by blood. The risk of transmission to the fetus is greatest in mothers with untreated early syphilis, and the likelihood of transmission decreases as the duration of syphilis increases, but mothers infected with syphilis can transmit it to the fetus for at least 5 years. In recent studies, spirochetes have been detected in fetuses aborted at 9-10 weeks, but in general, it is possible to prevent clinical symptoms in the newborn after adequate anti-syphilis treatment of the mother before 16 weeks of gestation.
What is early congenital syphilis?
Early congenital syphilis develops within 2 years of age. The child is often premature, malnourished, with little subcutaneous fat, loose skin, wrinkles, and an elderly appearance. They often have enlarged liver and spleen, enlarged lymph nodes, hemolytic anemia, thrombocytopenia or leukocytosis.
Syphilitic rhinitis The most common manifestations are runny, purulent discharge, nasal congestion, breathing through the mouth when crying, difficulty breathing, and often a strong cough caused by sucking milk and choking into the trachea.
The skin lesions are multilinear, similar to the acquired syphilis rash of stage II syphilis, and include syphilis rash, papular syphilis rash, blistering syphilis rash, and pustular syphilis rash. The specific “syphilitic aspergillosis” is a blistering and maculopapular lesion, up to 3 cm in diameter; it occurs on the palmoplantar area, is plagioid or purulent, and contains a large number of syphilis spirochetes. Chancroid lesions are often around body openings, especially around the mouth, but also in the nostrils and perianal area, with radiolucent chancroid that heals to form firing scars. In the perianal and moist areas of the external genitalia, flat wart lesions may form, containing large numbers of syphilis spirochetes. Others may include nail fungus, nail bed inflammation, baldness, and mucosal plaques.
Bone lesions such as osteochondritis, periostitis, chondritis enough, and osteomyelitis can occur, and the affected limb may seem to be paralyzed due to limb pain, which is called pseudoparalysis of Paro. Syphilitic dactylitis is also seen, where one or several fingers are diffusely swollen, pyknotic in shape, and may break down.
Syphilitic meningitis, cerebrovascular thrombosis, diffuse interstitial pneumonia (white pneumonia), optic nerve atrophy, syphilitic meningitis, laryngitis, pharyngitis, syphilitic nephritis, and orchitis may also occur in early congenital syphilis.
What is late-onset congenital syphilis?
Late congenital syphilis occurs after the age of 2 years and continues until around puberty, but it is rare to occur after the age of 30 years. Skin and mucous membrane lesions, mainly dendritic swelling, are seen on the face, trunk and extremities.
Substantial keratitis starts around puberty and accounts for 60% of cases between the ages of 5 and 15. According to statistics, 95% of substantial keratitis in the eye is syphilitic and 5% is tuberculous. It starts on one side and tends to spread to both sides later. Acute attacks, corneal congestion, clouding, photophobia, lacrimation, vision loss. There may also be iridocyclitis, corneal leukoplakia, or blindness. The disease often occurs in conjunction with neurological deafness.
Nerve deafness Due to damage to the 8th pair of cranial nerves, the onset of the disease is between 4 and 25 years of age, mostly around 10 years of age, with sudden onset and involvement of both sides, which can lead to deafness. Sometimes there is tinnitus and dizziness. Anti-syphilis treatment or other treatments are poorly effective.
Hodgson’s teeth manifest as poorly developed incisors, sparsely arranged (comb-like teeth), misshapen (narrow at both ends and thick girdle-shaped in the middle), notched in the middle of the occlusal margin (semilunar notch or wedge-shaped notch), and molars may be mulberry-shaped.
Patients presenting with substantial keratoconus, neurogenic deafness, and Hodgson’s teeth are referred to as Hodgson’s syndrome or Hodgson’s triad. Although the triad is characteristic, only about 25% of patients have all three signs, with parenchymal keratitis being the most common.
Bone damage Peyronie’s tibia (or Saber’s tibia) is a thickening of the middle of the tibia, which bulges forward in an arch-like bend and is painful. Croton’s joint is a swelling and fluid accumulation in the elbow and knee joints, while the skin does not show redness, swelling and heat, and occurs symmetrically. Saddle nose is caused by dendritic swelling, perforation, and destruction of the nasal septum and epiglottis, which are formed after healing, or congenital nasal bridge bone dysplasia. Higoumennakis’ sign is a unilateral hypertrophy of the inner 1/3 of the clavicle, which occurs on the right side in right force and on the left side in left force.
Neurological damage of stage III syphilis may also occur: optic atrophy, juvenile paralytic dementia, and juvenile spinal cord consumption. Although rare, cardiovascular damage has been reported.
How is syphilis diagnosed?
First of all, early detection, early diagnosis and early treatment should be achieved. If treatment is timely and adequate, clinical and serological recovery can be fully achieved and the impact on their families and society can be prevented. The medical history is very important for the diagnosis of syphilis. Syphilis infection has no racial or population differences. Except for congenital syphilis, syphilis is almost always transmitted by intimate contact with stage I or II syphilis damage (hard chancre, mucosal spots, flat warts).
The possibility of indirect infection is extremely small, therefore, prostitution, promiscuity, extramarital intercourse or spouse with syphilis infection is an important cause of infection; in recent years the proportion of homosexuals infected with syphilis has increased. Those who have been clearly infected with syphilis, on the one hand, to understand the first, second and third stage, on the other hand, to check whether the combination of other sexually transmitted diseases, and should pay attention to whether the past treatment of syphilis is adequate and thorough; whether married women have premature birth, stillbirth or birth process fetal transmission of syphilis fetus. Patients with congenital syphilis should be examined for their parents’ STD status.
How to check the body when diagnosing syphilis?
1. Stage I syphilis Focus on the pubic area, including the common external genital chancre and its nearby lymph nodes.
2. Stage II syphilis involves the whole body, including skin and mucous membrane rash, bone lesions, eye lesions, neuropathy, and lymph node enlargement. There are three stages of recurrent damage.
3.Stage III syphilis Progresses to all organs and organs of the body, focusing on skin, mucous membrane, bone, eye, cardiovascular and neurological examinations, which include common routine examinations, liver and kidney functions, X-rays, immune functions, ECG, CT, MRI, etc.
What is the importance of blood sampling for syphilis?
The syphilis spirochete enters the body and stimulates the body to produce two types of antibodies: non-specific antibodies, or reactin, and specific antibodies, or special antibodies against the syphilis spirochete. For these two types of antibodies, there are more testing methods, most of which are already in clinical use in China. Non-specific tests such as VDRL, USR, RPR and other methods are simple and easy to perform, with high sensitivity, but may appear false positive, and are often used for census or screening. Specific tests are more complicated, long and expensive, and require certain skills and experience, but are highly specific and have great diagnostic significance.
Is syphilis treatment complicated? Is the cost high?
The actual fact is that you can find a lot of people who have been in the market for a long time. The clinical applications for STD treatment
Antibiotics are also gradually increasing. As a result of the proliferation of illegal medical advertising, some lucrative practitioners in the pursuit of profits, in the treatment of venereal disease on the patient alarmist, a lot of scavenging, often a simple venereal disease to spend thousands, tens of thousands of dollars, to the patient caused a serious economic burden, physical and mental extreme pain, to the community increased the burden. As most of the strains of syphilis spirochetes found in the clinic are sensitive to penicillin, the treatment of syphilis is extremely simple and low cost. Some people who are allergic to penicillin can be treated with tetracycline, doxycycline, etc., and the cost is not very high. Therefore, patients are advised not to be fooled.
How is early syphilis treated?
Early syphilis includes stage I, stage II and early latent syphilis. Patients who are allergic to penicillin department can be treated by applying penicillin intramuscular injection. Benzathine penicillin G 2.4 million units, 1.2 million units per side of the buttock intramuscular injection, once a week for 2-3 weeks, can be cured. Procaine penicillin G 800,000 units can also be applied. Inject intramuscularly into the buttocks once a day for up to 10-15 days. Penicillin allergy can be treated with oral tetracycline, 500mg 4 times a day for 15 days. Or doxycycline 100mg twice daily for 15 days. You can also take erythromycin orally in the same way as tetracycline.
How to treat advanced syphilis?
Late syphilis includes three stages of syphilis in skin, mucous membrane and bone, late latent syphilis, latent syphilis in which the stage of disease cannot be determined, and second stage recurrent syphilis. Its treatment is also based on penicillin. Benzathine penicillin G 2.4 million units, 1.2 million units intramuscularly on each side of the buttocks, once a week for 3 weeks. You can also apply procaine penicillin G 800,000 units, injected intramuscularly in the buttocks once a day for 20 days. The second course of treatment can be administered after 2 weeks of discontinuation as the condition changes. Penicillin allergy can be treated with oral tetracycline, 500mg 4 times a day for 30 days. Or doxycycline 100mg twice daily for 30 days. You can also take erythromycin orally, the usage is the same as tetracycline.
Is it all right for syphilis patients to be treated with injections, and do they need to be reviewed for a long time?
No. After intramuscular injection of penicillin, most of the skin lesions disappear and the serum test is low, but the patient should not think that the treatment is over and everything is fine. In fact, after adequate treatment, patients should be followed up for 2-3 years to observe changes, both clinical and laboratory. The labs are performed 4 times a quarter in the first year, 2 times a quarter in the second year, and once every 6 months. If there is very little decrease in serum assay titers within 6 months of treatment, or if there is a decrease ear less than 4 times, all should be considered treatment failure.
Can I get pregnant with syphilis?
Syphilis is one of the common venereal diseases. Many young women with early syphilis do not have obvious clinical symptoms, some have very small damage to the chancre, mistaking it for boils and infections that heal after some days; some have chancre in the vagina or cervix, which is not detected; some also really do not have the chancre process of pubic ulcers, and some suffer from occult syphilis, but once you have syphilis, if it is early syphilis (also known as stage 1 syphilis, stage 2 syphilis). If untreated, 100% will affect the fetus and cause congenital syphilis in the fetus.
Another 50% of young women with syphilis will have a miscarriage, premature birth, or the fetus will die in the womb and not survive at all; the other 50% (that is, half) even if the child is born alive, it will be a baby with congenital syphilis. The other 50% (or half), even if born alive, will be a congenital syphilis baby. 10% of babies born to young women with untreated latent syphilis will have symptoms of congenital syphilis. In addition, young women with syphilis can transmit it to each other through sexual contact for two years, and after two years there is less chance of transmission, but untreated young women with syphilis can transmit it to their fetus for many years, which also shows that the more years you have syphilis, the less chance of transmission to the fetus, unfortunately the vast majority of pregnant women are young people who have not had the disease for very long.
How can a woman with syphilis have a child without the disease?
The occurrence of congenital syphilis can be completely prevented if adequate systematic treatment is received before 16 weeks of gestation (four months). Adequate treatment starting at 5-6 months of gestation may also lead to fetal cure. Now we take regular treatment measures for pregnant women with syphilis, one course of treatment before and one course of treatment after 3 months of gestation to ensure that no child with congenital syphilis is born, so young women with syphilis, or with other venereal diseases, should be tested for syphilis serum when they want to get pregnant to prevent syphilis combined with pregnancy.