Tertiary syphilis - Causes, Symptoms, Diagnosis and Treatment

Tertiary syphilis - Third period syphilis develops in insufficiently treated patients or patients are not treated at all. Manifested form syphilitic infiltrations (granulomas) in the skin, mucous membranes, bones and internal organs. Granulomas with tertiary syphilis compress and destroy the tissue in which there are, which can lead to fatal diseases. Diagnosis of tertiary syphilis include clinical examination of the patient, the formulation of serological and immunological responses, the survey of affected systems and organs. Therapy tertiary syphilis is carried out courses of penicillin-bismuth treatment with the additional use of symptomatic and bracing means.

  • Symptoms of tertiary syphilis
  • Complications of tertiary syphilis
  • Diagnosis
  • tertiary syphilis.
  • Treatment
  • tertiary syphilis.
  • Tertiary syphilis - treatment

  • Tertiary syphilis


    syphilis, as in modern Venereology detection and treatment of the majority of cases it is at the stage of primary or secondary syphilis. Tertiary syphilis may occur in patients who had an incomplete course of treatment or treated with drugs in insufficient dosage. If untreated, syphilis (eg, due to undiagnosed latent syphilis), about a third of cases develop tertiary syphilis. Contributing to the emergence of tertiary syphilis factors are associated chronic diseases and intoxication, alcoholism, senile and child.

    The patient with tertiary syphilis practically not contagious, as being in his body a few treponemes are located deep inside the granuloma and die in their decay.

    scarring. By the manifestations of tertiary syphilis include papulose and gummy syphiloderm.

    Bugorkova syphiloderm - formed in the dermis infiltrative knot, slightly protruding above the surface of the skin, having a size of 5-7 mm, red-brown color and firm texture. Usually tertiary syphilis rash nodules occur in waves and asymmetrically on the local area of ​​skin, while the individual elements are in different stages of development and do not merge with each other. Eventually papulose syphiloderm undergoes necrosis with the formation of ulcers round with smooth edges, infiltrated the base and smooth clean bottom. The healing of the ulcer Tertiary syphilis occurs weeks or months, after which the skin remains land atrophy or scar hyperpigmentation on the edge. The scars that appear as a result of a resolution of several grouped Bugorkova syphilides form a single mosaic picture of the scar. Repeated eruptions of tertiary syphilis never occur in scars.

    Gummy syphiloderm (syphiloma) more often single, rarer formation of several gummas one patient. Gumma is located in the subcutaneous tissue painless knot. The most frequent localization gummas tertiary syphilis - a forehead, the front of the leg and arm, the knee and elbow joints. First, the node is mobile and not soldered to the adjacent tissues. He gradually grows in size and lose mobility because of the fusion with its surrounding tissues. Then it appears in the middle of assembly opening through which the liquid is separated gelatinous. The slow increase in the hole leading to the formation of an ulcer crater with edges is cut off. At the bottom of the ulcer is visible necrotic core, after which the discharge of the ulcer heals with scar formation retracted the stellate. Sometimes when there is tertiary syphilis gumma resolution without going to an ulcer. In such cases, there is a reduction unit and its replacement by dense connective tissue.

    In tertiary syphilis sores gummy can capture not only the skin and subcutaneous tissue, but also to be cartilage, bone, vascular, muscle tissue, which leads to their destruction. Gummy syphilides may be placed on the mucous membranes. Most often it is the nasal mucosa, tongue, soft palate and pharynx. The defeat of tertiary syphilis nasal mucosa leads to the development of rhinitis with purulent discharge and a violation of nasal breathing, then there is a destruction of the nasal cartilage to form the characteristic saddle deformation possible nosebleeds. With the defeat of tertiary syphilis develops mucosal tongue glossitis with speech and difficulty chewing food. Defeat of the soft palate and pharynx lead to nasal voice and enters the food during chewing to the nose.

    Violations of the physical organs and systems caused by tertiary syphilis, observed in an average of 10-12 years after infection. In 90% of cases of tertiary syphilis infection with lesions of the cardiovascular system as myocarditis or aortitis. Lesions of the skeletal system with tertiary syphilis can manifest osteoporosis or osteomyelitis, liver disease - chronic hepatitis, stomach - gastritis or gastric ulcer. In rare cases, there are destruction of the kidneys, intestines, lungs, nervous system (neurosyphilis).

    cardiac insufficiency, coronary spasm with myocardial infarction. Against the background of tertiary syphilis complications possible patient death, which is observed in about 25% of cases.

    RPR-test gives a negative result, so the basic meaning have blood tests using a RIF and RIBT that are positive in the majority of cases of tertiary syphilis (92-100%).

    To identify the degree of damage to physical systems and organs on the testimony of conduct ECG, ultrasound of the heart, aortography, X-rays of bones, rhinoscopy and pharyngoscope, gastroscopy and liver ultrasound investigation of liver function tests, chest X-ray, lumbar puncture to study the cerebrospinal fluid and so on. The patient may require additional consultation of the cardiologist, neurologist, otolaryngologist, gastroenterologist, ophthalmologist.

    The differential diagnosis is carried out with tertiary syphilis skrofulodermoy, induratum erythema, ulcerative manifestations of skin cancer, miliary tuberculosis, actinomycosis, leprosy, decaying lipoma.

    coagulation, ECG and others. According to the testimony appoint fortifying agents, and symptomatic treatment.