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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., the alternation of manifest and latent periods of the disease.

The tension of humoral immunity at this time is also maximum, which determines the formation of immune complexes, the development of inflammation and the mass death of tissue treponemas. The death of some pathogens under the influence of antibodies is accompanied by a gradual cure of secondary syphilides within 1.5–2 months. The disease goes into a latent stage, the duration of which can be different, but on average is 2.5–3 months.

The first relapse occurs approximately 6 months after infection. The immune system again responds to the next multiplication of pathogens by enhancing the synthesis of antibodies, which leads to the cure of syphilis and the transition of the disease to a latent stage. The undulating course of syphilis is due to the characteristics of the relationship between the treponema pallidum and the patient’s immune system.

Tertiary period. This period develops in patients who have not received treatment at all or have not been sufficiently treated, usually 2–4 years after infection.

In the late stages of syphilis, the leading role in the pathogenesis of the disease begins to play the reaction of cellular immunity.
These processes proceed without a sufficiently pronounced humoral background, since the tension of the humoral response decreases as the amount of treponem in the body decreases.

Malignant course of syphilis. Malignant syphilis in each period has its own characteristics.

In the initial period, there are ulcerative chancres, prone to necrosis (gangrenization) and peripheral growth (phagedenism), there is no reaction of the lymphatic system, the entire period can be shortened to 3-4 weeks.

In the secondary period, rashes are prone to ulceration, papulopustular syphilis is observed. The general condition of patients is disturbed, fever, symptoms of intoxication are expressed. Often there are manifest lesions of the nervous system and internal organs. Continuous recurrence is sometimes noted, without latent periods.

Tertiary syphilis with malignant syphilis can appear early: a year after infection (galloping course of the disease). Serological reactions in patients with malignant syphilis are often negative, but can become positive after the start of treatment.
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The course of the secondary and tertiary periods of syphilis. Malignant course of syphilis

  1. The course of the incubation and primary periods of syphilis
    The incubation period. This period begins from the moment of infection and lasts until the appearance of primary syphiloma - an average of 30–32 days. It is possible to shorten and lengthen the incubation period compared to the indicated average duration. The early stages of syphilis are characterized by partial inhibition of cellular immunity, which contributes to the reproduction and spread of pathogens in
  2. The general course of syphilis
  3. Tertiary period of syphilis. Clinical manifestations
    Lumpy syphilis. Typical places of its localization are the extensor surface of the upper limbs, trunk, face. The lesion focus occupies a small area of ​​the skin, is located asymmetrically. The main morphological element of tubercular syphilide is a tubercle (dense, hemispherical, cavityless formation of a rounded shape, dense-elastic consistency). Grouped
  4. Serodiagnosis of the secondary period of syphilis
    With Lues II recens, a sharply positive result for all standard serological reactions is observed in almost 100% of cases; The titer of reagins is the highest (1: 160; 1: 240; 1: 320), RIF 4+; RIBT gives a positive result in more than half of patients, but the percentage of treponemal immobilization is low (40-60%). With Lues II recidiva, a positive result for standard serological reactions
    Secondary Lues begins 9-12 weeks after the introduction of pale treponema or 6-8 weeks after the onset of primary syphiloma due to generalization of the infection, when blood CSB becomes sharply positive in almost 98-100% of patients. It lasts from 2 to 5 years, divided into: secondary fresh (Lues II recens); secondary hidden (Lues II latens); secondary
  6. Damage to bones and joints in the secondary period of syphilis
    Damage to bones and joints with Lues II confirms the systemic course of the infectious process. As a result of the penetration of pale treponemas and sensitization to them in the bones and joints, specific inflammatory changes occur with a benign course. In bones according to the type of periostitis or ostioperiostitis with pain intensifying at night or at rest at rest. Unlike rheumatic
  7. Tertiary syphilis. Congenital syphilis.
    Tertiary syphilis. Congenital
    Analysis of the HIV epidemic gives reason to fully consider it as a sexually transmitted disease, the epidemiological and clinical features of which are very similar to syphilis. HIV infection has a number of characteristic STI pathogens, in particular pale treponema, biological properties, and in the spread of HIV infection, as well as other STIs, a decisive role is played
  9. Tertiary syphilis.
    It appears after the last relapse of secondary syphilis, in particular secondary recurrent syphilis, after a certain period of time, usually after 3-5 years (cases of earlier manifestations of 2-3 years, and later 10-15 years and even 30-40 years are described ) Manifestations of tertiary syphilis, in contrast to syphilis of the primary and secondary periods, are characterized by a more significant depth of damage
  10. tertiary syphilis
    It develops approximately 3-5 years after infection. It occurs: - in 64% of cases in those who have not been treated for early forms of syphilis; - in 35% - in poorly treated for early forms of syphilis; - in 1% of cases - in persons who received full treatment. Thus, Lues III is not the inevitable end of the disease, despite the fact that the patient did not receive full treatment or
  11. Tertiary syphilis
    tubercular syphus develops in approximately 40% of patients at the 3-4th year of the disease, lasts indefinitely and is manifested by the development of a specific inflammation - an infectious granuloma. Manifestations of the tertiary period are accompanied by the most pronounced, often indelible disfigurement of the patient’s appearance, severe violations in different organs and systems, lead to disability, and often
    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.
  13. Tertiary syphilis
    Lesions of the oral mucosa in tertiary syphilis can manifest as tubercles, gum and diffuse gummous infiltration. Tertiary syphilis are more common in the nose, soft and hard palate, palatine curtain; less often - in the tongue, behind the pharyngeal wall and lips. Localization of lesions significantly affects the clinical picture. Common clinical signs
  14. Secondary Fresh Syphilis
    ROSEOLS secondary syphilis is characterized by generalization. In addition to the skin, mucous membranes and lymph nodes, the central nervous system, bones, joints, hemopoietic, hearing, vision, etc. organs can be involved in the pathological process. The main manifestation of this period is generalized rashes on the skin and mucous membranes (secondary syphilides). With early secondary syphilis
  15. Tertiary syphilis
  16. Bone damage in tertiary syphilis
    Forms of bone lesions in syphilis: periostitis, osteitis and osteomyelitis. They are limited or diffuse, widespread. Periostitis in the form of only bone changes is rare; they are combined with osteitis in those rare cases when only the periosteum is affected, the process occurs simultaneously in many bones and is characterized by the duration of existence. Distributed periostitis
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