Hidden syphilis: symptoms, diagnosis and treatment of all forms
Jul 03, 2018
Hidden syphilis is diagnosed in the absence of signs of disease, and serological reactions in the blood are positive.This form arises in patients who have been active in the past with diseases that have resolved themselves, or due to specific treatment.Table of contents:
Forms and periods of latent syphilis
A latent form of syphilis is a situation where the disease occurs without symptoms, but specific seroreactions are positive.In most cases, latent syphilis is detected accidentally during the examination.
In some cases, the specialist can determine the period of the disease:
- , with the latent period of primary syphilis, the patient previously had a hard chancre, but no secondary syphilis occurred;
- for the latent secondary period include the latency period after the emergence of secondary syphilis and recurrent syphilis;
- latent tertiary syphilis.
In venerology, three periods of latent syphilis are distinguished:
- Early latent syphilis - infection occurred no more than two years ago.This category of patients in the epidemiological plan is most dangerous.
- Late hidden syphilis - more than two years have passed since the infection.
- Hidden unspecified syphilis is diagnosed if there are no symptoms of the disease, and positive serological responses are found in the blood of a patient who has not been treated before.
How is latent syphilis transmitted
It is believed that if the patient does not have clinical manifestations, then it is impossible to get infected from it.But this is an erroneous opinion.
If the patient's body does not have skin rashes of the early period, then with normal contact, it is almost impossible to get infected from it.
But there are other ways of infection:
- any kind of sexual contacts;
- through blood, breast milk or saliva.
Caution should be used if your partner has been diagnosed with latent syphilis.Especially dangerous is the disease, which occurs in the first two years.Then the risk of contracting is significantly reduced.
If syphilis is diagnosed in social workers( educators, sellers, doctors, teachers, etc.), but for the period of treatment, it is suspended from work and sent to the sick leave.Recovering, a person is no longer dangerous to society.
Early latent syphilis
The period of early latent syphilis lasts from the moment of infection until the second relapse period.Infectious diseases can appear in patients.
Anti-epidemiological measures to be taken against them:
- hospitalization of the patient;
- examination of sexual partners and patients living with sick family members;
- compulsory treatment.
Early latent syphilis is mainly diagnosed in people under the age of 40 years.Most of them can not control sexual attraction and are prone to frequent changes in sexual partners, which in the epidemic inevitably leads to infection and development of the disease.
Diagnosing an active form of the disease in a sexual partner is an absolute proof of latent syphilis.
A specialist carefully collecting an anamnesis examines the patient, during which he pays attention to eruptive-ulcerative eruptions on the skin, mouth, lips and genitals, the appearance of pigment spots in the neck, and hair loss during the lastTwo years.The doctor also finds out whether the patient has taken antibiotics or not, and whether he has been treated for gonorrhea.
Symptoms of early latent syphilis
- Primary syphilis transferred can be indicated by seals or scar on the genitals and an increase in regional lymph nodes.
- In 75% of cases serological reactions are sharply positive.In 20% of patients there is a low titer.A positive RIF is noted in 100% of cases.Serologic response titers decrease with the treatment of concomitant diseases with antibiotics.
- In patients with penicillin, a third of patients experience an increase in body temperature, headaches and muscle pains, tachycardia and vomiting.This is due to the mass death of the pathogen.Side effects are quickly eliminated by aspirin.
- With the development of latent syphilitic meningitis in the cerebrospinal fluid, an increase in protein is observed, positive reactions to globulin fractions and cytosis.Cerebrospinal fluid is quickly sanitized with specific therapy.
Treatment for early latent syphilis
Therapy is performed according to the approved schemes.Its goal is to rapidly destroy the pathogen in the patient's body.Negative seroreaction occurs quite quickly with specific treatment.Fading or total negation of sero-reactions is the only confirmation of the effectiveness of treatment.
Timely diagnosis during early latent syphilis and effective treatment provide a favorable prognosis.
Late concealed syphilis
Patients who have been infected more than two years ago and who have no symptoms of the disease, and serological reactions are positive, diagnose late latent syphilis. Basically, it is detected during a preventive examination.
These patients are less dangerous in epidemiological terms, since tertiary syphilis are not so contagious.They contain a minimum number of pathogens.
The disease is mainly detected in patients older than 40 years.About 65% of them are married.
When a patient is questioned, the time of probable infection and the presence of symptoms indicating the manifestation of infectious syphilis in the past are determined.
Signs of late latent syphilis
- During the examination, traces of previously resolved syphilis are not determined.At inspection signs of a specific lesion of the nervous system and internal organs are absent.
- For the diagnosis of late latent syphilis, the following serological reactions are used: RIF, RIBT, RPGA and ELISA. RIBT and RIF are always positive.
In some cases, serological tests are repeated several months later.
Treatment of late latent syphilis
The therapy of this form is carried out according to the approved schemes of .The purpose of treatment is the prevention of the development of a specific lesion of internal organs and the nervous system.Patients need consultation of a therapist and neurologist.Negative seroreaction in the period of treatment is extremely slow. In some cases, after treatment, seroreactions remain positive.
Hidden unspecified syphilis
Hidden unspecified syphilis is diagnosed in the absence of information on the timing and circumstances of infection, and if there is a positive serological test.These patients need a thorough clinical and serological examination.Obligatory are RPGA, RIF, RIF-abs, IFA, RIBT.
In patients with unspecified and late syphilis, false positive nonspecific serological responses are often detected.
In case of timely treatment, external manifestations of the disease disappear quickly enough.In the most neglected cases, it is almost impossible to restore health.
After the disease, it is necessary to take a very responsible approach to the issue of pregnancy planning.It should be borne in mind that for a full recovery of the health of future parents it will take a year.Therefore, it is very important to observe precautions to exclude the possibility of infection.
Radevich Igor Tadeushevich, a first-line sexologist andrologist