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Syphilis of the nose

Syphilitic lesions of the nose are currently extremely rare.

Primary syphilis of the nose develops when pale treponema penetrates through microscopic lesions of the skin or mucous membrane of the nose (the so-called extragenital route of infection). This is possible as a result of infection by poorly disinfected instruments used in the examination of patients with syphilis, or by any other infected objects. After the end of the incubation period (on average 3 weeks), a solid chancre (primary syphilis) appears at the site of infection. The latter is surface erosion, the color of meat, with smooth, well-defined edges, with a smooth, glossy, as if varnished surface, based on a dense infiltrate. After 5 - 7 days after the appearance of chancre, regional lymph nodes increase.

The development of secondary syphilis of the nose coincides with the appearance of specific syphilitic rashes (usually 6 to 7 weeks after the development of hard chancre). On the skin of the external nose and the mucous membrane of the nasal cavity, various rashes (secondary syphilis) occur in the form of rose-colored, papular and pustular formations. They are accompanied by the appearance of catarrhal changes in the nasal cavity, redness and swelling of the mucous membrane, rhinorrhea in the form of serous-bloody or mucopurulent discharge. Due to the disintegration of papules, usually located at the entrance to the nose, and the secretion of secretions irritating the skin, painful cracks form on the threshold of the nose. Patients also complain of an unpleasant smell from the nose, which, however, people around do not feel (kakosmia subjectiva).

The appearance of a persistent runny nose in infants and young children, accompanied by dense discharge, which tends to form crusts, should cause a suspicion of congenital syphilis.

Tertiary syphilis is the most common syphilitic lesion of the nose.
It manifests itself in the form of syphilitic gum. Gummous infiltrate is a specific infectious granuloma. The cell mass of gumma is made up of cells of the mononuclear phagocyte system. Epithelioid and giant cells are not a constant finding, which distinguishes syphilitic gum from tuberculous tubercles. The borders of the gum are often vague. Gummas undergo necrosis and decay, reminiscent of cheesy necrosis in tuberculosis. The breakdown of gummas leads to destructive changes in the organ where they are located (Davydovsky IV, 1963). In the nose, syphilitic gum is most often localized on the nasal septum, capturing, in contrast to tuberculous infiltrate, not only cartilaginous, but also bone sections. The gummosis process can spread to the bottom of the nose. As a result, a hard palate defect may form, communicating the nasal cavity with the oral cavity. Propagating along the bone wall of the external nose, gumma causes its deformation in the form of retraction of the bone part with the formation of a saddle-shaped or lornet-shaped nose (Fig. 2.10.4).

Bone sequestration, atrophy of the mucous membrane with the accumulation of a large number of fetid crusts, dried mucus can be found in the nasal cavity. The patient’s speech takes on a nasal tone (hence the old name for such patients is “gundosy”).

Diagnosis of nasal syphilis is based on an anamnesis, assessment of the described clinical symptoms, and serodiagnosis. It must be remembered that in the initial period of primary syphilis, serological reactions are negative, as a result of which it is called seronegative.

The treatment of syphilis in our country is regulated by special instructions approved by the Ministry of Health. Deformations of the external nose can be eliminated through plastic surgery, which is carried out after the complete cure of syphilis.
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Syphilis of the nose

  1. Syphilis of the nose
    Syphilis of the nose manifests itself in the form of primary sclerosis, secondary and tertiary symptoms. Hard chancre (ulcus durum) is very rare. It can be localized at the entrance to the nose, on its wings and the skin of the nasal septum. Infection of these sections of the nose more often occurs by injuring the skin with a finger. With the development of a syphilitic process in the nose, a reaction occurs
  2. Deformations of the nasal septum, synechia and atresia of the nasal cavity
    The etiologic deformation of the nasal septum may be due to physiological, traumatic, and compensatory factors. Physiological curvature occurs when there is a mismatch in the growth of the nasal septum and the bone frame into which it is inserted. The growth of the septum is slightly ahead of the growth of the facial skeleton, so its curvature occurs. In childhood, physiological
    The fact of transmission of syphilis to offspring was established in the late 15th - early 16th centuries. For several centuries, the question of the mechanism of transmission of syphilitic infection remained unclear. For centuries, the germinative hypothesis was dominant, according to which syphilis is transmitted to the fetus only by the father through a sperm that directly infects the egg cell. According to this view, a child with syphilis
  4. Congenital syphilis. Fetal syphilis
    Under the influence of treponem, changes that occur in the placenta make it functionally inferior, as a result of which its intrauterine death occurs at the 6-7th month of pregnancy. The dead fruit is pushed out on the 3-4th day, usually in a macerated state. The macerated fruit, compared with a normally developing fruit of the same age, has significantly smaller sizes and weights. Leather
    Currently, there is a large group of sexually transmitted infections (STIs). Classification of STIs (WHO, 1982) Bacterial nature 1. Syphilis and other treponematoses (pint, frambesia, bezhel) 2. Gonorrhea 3. Chancroid 4. Venereal lymphogranulomatosis 5. Donovanosis 6. Urogenital chlamydia and Reiter’s disease 7. Urogenital mycoplasmosis (in t .h.
  6. The course of the secondary and tertiary periods of syphilis. Malignant course of syphilis
    Secondary period. This period begins with the onset of the first generalized rashes (on average 2.5 months after infection) and lasts in most cases for 2–4 years. The duration of the secondary period is individual and is determined by the characteristics of the patient's immune system. In the secondary period, the most pronounced wave-like course of syphilis, i.e., alternation
  7. Tertiary syphilis. Congenital syphilis.
    Tertiary syphilis. Congenital
  8. Treatment of patients with syphilis. Cure criterion. Clinical examination of patients with syphilis
  9. Tuberculosis of the nose
    Mycobacterium tuberculosis, spreading along the lymphatic and circulatory pathways, enter the nose from the focus, which may be in the lungs, joints or larynx. In rare cases, the infection enters the nasal mucosa by contact. The pathomorphological substrate of the disease is infiltration - an accumulation of specific tubercles in the submucosal layer. Tuberculous tubercle
  10. Nose injuries
    Clinical picture Damage to the external nose is very common. The degree of damage to soft tissues, bone and cartilage skeleton depends on the nature of the injury, the direction and strength of the impact. The nasal bones and septum are most often damaged, and fractures of the frontal processes of the upper jaw and the walls of the paranasal sinuses are less common. Sometimes there is damage to the nose with a break in its tip or edge. Injuries
  11. Anatomy of the nose
    In clinical and anatomical terms, the nose is divided into external and internal departments. The external nose, nasus externus, is an important anatomical component of the face, largely determining its individual characteristics. The external shape of the nose is compared with a trihedral pyramid. In the outer nose, there are: 1) the root located between both eye sockets, 2) the tip (tip) of the nose, 3) the back
  12. Nose injuries
    Damage to the external nose and walls of the nasal cavity are more often observed in men and in children. Injuries to the skin of the nose are found in the form of a bruise, bruising, abrasion, and injury. During the examination, it must be borne in mind that damage often only appears to be superficial in appearance, but actually penetrates more deeply; in such a wound there may be a hardly detectable foreign body;
    The nasal cavity (cavitas nasi) is the initial section of the respiratory tract and, at the same time, the organ of smell. Passing through the nasal cavity, the air either cools, or warms up, moisturizes and purifies. The nasal cavity is formed by the outer nose and bones of the facial skull, divided by a septum into two symmetrical halves. The nostrils are the front openings in the nasal cavity, and through the choanas are the back openings
  14. Polyps of the nose
    Polyps of the nose is one of the complications of year-round allergic rhinitis. Usually they are localized on the middle nasal concha, around the openings of the maxillary sinuses and the ethmoid labyrinth. Polyps are observed in both allergic and infectious rhinitis. Polyps that occur with allergic rhinitis look like whitish or gray, shiny, gelatinous formations. Polyps in chronic
  15. Diseases of the external nose and nasal cavity
    Congenital anomalies of the external nose in the form of its complete absence, splitting of the tip of the nose, double nose, etc. are extremely rare and do not have such practical significance as congenital and acquired changes in the nasal cavity, leading to impaired patency of the nasal cavity for inhaled and exhaled air. Narrowing and overgrowing of the nasal cavity. Congenital narrowness is sometimes observed.
  16. Tuberculosis of the nose
    Tuberculosis of the nose, according to the clinical classification of tuberculosis (1973), is included in the group of tuberculosis of the respiratory system and a subgroup of tuberculosis of the upper respiratory tract. It usually develops in the presence of a tuberculous focus (most often in the lungs). Mycobacterium tuberculosis (Koch's bacillus) penetrate the nasal cavity and its external integument endogenously through the blood and lymph vessels.
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