Syphilis in the tongue: symptoms and treatment

Syphilis walks the planet for more than one century, and has already been well studied. To date, innovative methods of diagnosis and treatment have been developed, but still the number of its victims is growing. Only in Russia in the last quarter century their number has increased by 7 times.

Syphilis in the tongue and in the mouth is less common than on the genitals, but is no less dangerous. The main feature of this form is that in the mouth on mucous membranes and in its tongue it is easy to confuse with completely harmless diseases, because of what many patients do not rush to the doctor, and are engaged in self-medication and miss the time. But with syphilis, the prognosis of healing depends entirely on the timeliness of the treatment started.

Consider how syphilis manifests itself in the language, how it can get infected, how dangerous it is for others, and what methods of its treatment have been developed.

Portrait of the pathogen

Syphilis causes a microscopic microbe - anaerobic, whose name is "pale treponema". Pale it is called because in the reactions of Romanovsky-Giemsa it becomes pale pink. Its microscopic body looks like a thin spiral with pointed tips and a 12th or 14th, less often 8 curls. These parasites are very mobile, but not very tenacious. They are able to withstand a medium with t = 55 ° C for only 15 minutes, and at boiling, that is, at t = 100 ° C and above, perish instantly. Also, they easily destroy any disinfectants, even ordinary household soap. Therefore, in order not to pick up syphilis in the language of everyday life, one should only observe hygiene. A distinctive feature of treponem is that they feel great only in a warm and humid environment. In the cold, and under the influence of some medications, they can form cysts and wait for their hour for years. In the heat, especially without a drop of moisture, they die as the wet substrate dries out. Propagation of treponema by simple division, and, quite slowly. Usually the process of producing a new bacterium lasts 32 hours. This feature affects the duration of the incubation period.

Ways of infection

Erroneous is he who believes that syphilis in the language can be picked up only with oral sex with an unreliable partner. According to WHO statistics, about half of the patients get infected with this ailment. The rest are infected with pale treponema in the mouth in other ways:

• A kiss with sick syphilis (traumatic, deep);
• Transfusion of untested donor blood;
• Visit a dishonest dentist working with non-sterile tools;
• Injecting several people with a single syringe (mainly for drug addicts);
• Using a toothbrush, a spoon, a glass after a patient with syphilis;
• Transmission by treponem from mother to fetus (congenital syphilis);
• Infection of infants during breastfeeding;
• Infection of health workers.

The mechanism of infection

Manifestation of syphilis in the tongue is possible if pale treponema managed to penetrate into the mucous membranes of the oral cavity. With oral sex, the mechanism of transmission is uncomplicated. Treponema is always massively present in the sperm of the patient, even if visually his genitals have no signs of disease.

Once in the mouth of a new victim, the bacteria try to penetrate into the mucous tissues. Especially beneficial for the parasite, if they have wounds. In this case, infection occurs with 100% probability. In the saliva of a patient with syphilis, treponema is found only if he has characteristic rashes in his mouth. This determines the percentage probability of infection with a kiss.

Intruded into the intercellular space of tissues, bacteria are assisted by the spiral shape of their body, due to which they are "screwed in" like a corkscrew, and when they get inside, they start to multiply. The immune system of the victim sends antibodies, macrophages, and lymphocytes to the aggressors. If the person's immunity is very strong, and contact with the patient was one-time and short-term, it is possible to stop the disease. But more often agents of the immune system can not cope with the army of parasites penetrated into the body, which in addition to protecting the body are covered with capsule-like mucus. Treponema multiply, initially filling the lymphatic fissures, since in the lymph of oxygen only 0.1%. Then they penetrate into the blood and begin to travel through the body, affecting other organs.

Classification

In the world practice, the following classification of syphilis is used:

• primary;
• Secondary (early and late);
• congenital.

Each of these forms has its own syphilis symptoms of the tongue.

More often, a simpler classification is used:

• Syphilis early (easier to diagnose, more contagious, symptoms may disappear without leaving traces);
• Syphilis late (common on all organs, although it could start in the mouth).

In medicine, there is a slightly different classification of syphilis:

• Primary (seronegative and seropositive);
• Secondary (fresh, hidden, recurrent);
• Tertiary (open, hidden);
• Congenital (early and late);
• visceral.

The process of the disease is divided into four stages:

• Incubation;
• primary;
• secondary;
• tertiary.

Let us consider them in more detail.

The incubation period

Signs of syphilis in the language at the very beginning of the disease are absent. This is a hidden stage, lasting from the moment of penetration into the mucous microbe and before the appearance of the first visual symptom.

At this time, treponema increases its number and gradually spread with a current of lymph on the body. The immune system is still able to wage an active struggle with them, significantly reducing their number. A person does not yet feel that he has become infected, although for others he is already becoming dangerous. The incubation period can last from 15 to 60 days. The average time is 20-21 days. Faster symptoms appear in people weakened by other diseases (tuberculosis, AIDS, alcoholism). Delay symptomatology is observed if the patient during the period of infection with syphilis takes antibiotics, treating the angina, gonorrhea and other related ailments.

Primary Period

It comes with the appearance of a solid chancre, and ends with its disappearance and the appearance of a rash. The word "chancre" in translation from Old French means "sore". This formation, as a rule, is painless, dense, appearing at the place of introduction of treponem into the tissue. On the surface of the chancre can be located not delivering painful sensations of erosion. Similarly, in the primary period, syphilis appears in the tongue. The photo shows a solid chancre on the surface of the tongue. It goes through several stages of development, starting with a small red speck. Within two or three days in its center appears a seal, which gradually increases in diameter. Parallel to this, in the center of the chancre, the tissue is necrotic and acquires a red (meat) color.

If you take a scrap from such a place, thousands of treponemes will appear in it. Sometimes ulcers in the center of the chancre cover a whitish coating. With its location in the folds of the tongue, some people experience crevice erosion. When placed on the back of the tongue, it usually protrudes above its surface.

Another important feature is regional lymphadenitis (enlarged lymph nodes). If syphilis occurs in the mouth, lymph nodes increase under the jaws and chin, and sometimes in the neck.

Features of the primary period

Ulcers in the tongue with syphilis, if there are no other symptoms of infection (malaise, fever, headache, etc.), many patients take for anything (for example, for stomatitis), but not for a venereal disease. This especially applies to people who have not entered into questionable sexual relations and have become infected with the domestic way. Therefore, they begin to treat their sores with rinses, cauterize them with iodine. Treponem such methods do not kill, but a person who has chancre on the tongue or on other parts of the mouth (on the gums, lips) becomes very contagious, because bacteria from the sores constantly fall into the saliva. However, when coughing and sneezing syphilis is not transmitted, only through a kiss, a cigarette, dishes.

The analysis on RW (Wasserman reaction) at the first stage can be both negative (seronegative form), and sharply positive with four pluses (seropositive form).

Secondary period

It is marked by the disappearance of chancre, which many people perceive as a "cure for stomatitis." With classic syphilis at this stage, there is a rash on the palms, feet, throughout the body. In addition, there is a lesion of the nervous system. Approximately the same symptoms characterize syphilis in the language. The photo shows how the roseola spots look, which can appear together with papules (plaques). If they occur in the area where the papillae are well expressed, then they protrude above the surrounding tissues in the form of grayish foci with clearly outlined or vice versa, uneven edges. But more often in the place of lesion papillae absent, and then the papule becomes, as it were, shiny, pinkish-cyanotic, located below the neighboring sites. The tongue begins to resemble a meadow cut by separate pieces.

At some patients at the beginning of the secondary period there is weakness, a headache, the temperature rises, which is perceived as an easy cold. This "diagnosis" patients put themselves particularly confidently, if they merge red spots spread to the tonsils and throat, which is very similar to trivial angina. The main difference is that with syphilis there is no pain when swallowing.

The secondary period occurs approximately on 9-10th week after infection and on 6-7th - after occurrence of the first chancre, and lasts from two years and more. At this stage there is a systemic lesion of all internal organs, and the rash and stains in the tongue with syphilis can then completely disappear, then reappear.

Tertiary period

In the neglected state of the disease, many internal organs (bones, liver, heart, spleen) are affected. Immunity of the patient is weakened and can not significantly affect the course of the disease. Nevertheless, exacerbations and remissions at the tertiary stage are traced. They cause their injuries, stress, poor nutrition, other diseases, for example, an elementary cold.

Classically, the Tertiary period begins 4.5-5.0 years after infection, but there are many cases when it began in 10 years or more. The main sign of its beginning is the appearance of gumm - nodes in tissues, significantly deforming the organs. The tongue looks quite typical when syphilis of the tertiary period, therefore it is already impossible to confuse this venereal disease with a cold or with sore throat.

Gunma in the tongue can cause a nodular or diffuse glossitis. The latter is considered the most serious complication of syphilis in the mouth. The patient's tongue thickens due to diffuse infiltration, becomes denser, which causes inconvenience when pronouncing sounds. Later on, the scar tissue appears on the site of the infiltration, the tongue becomes even denser, the papillae flatten, the surface becomes bumpy, painful cracks and ulcers appear on it, which can give rise to malignant tumors. Despite such unpleasant symptoms, a patient for others is not very dangerous, since there is almost no treponem in the gammons.

Diagnostics

Syphilis in the language of an experienced doctor can determine by external manifestations, but most often the patient is assigned a series of tests. The most common, but also the most inaccurate - is RW. At the serological stage, he can give a negative result in a sick person, and in a healthy person, a positive one under such conditions as:

• pregnancy;
• tuberculosis;
• malaria;
• Blood diseases;
• After anesthesia;
• During menstruation.

More precise is the analysis of PCR, but it gives the right answer only at the primary and secondary stages of syphilis development. In addition, such reactions are used to detect treponema: RIBT, RIF, RPGA, RIT, RPR, DAC.

None of these methods is 100% accurate, so two analyzes are usually performed to obtain the correct result. For their conduct, the patient gives an empty stomach blood from the vein. The second kind of tests for syphilis is scraping from hard chancre, papules and nodules of the rash, but it is effective only at the primary and secondary stages of the disease.

A positive result is indicated by "++++" or "+++". This requires one more confirmatory analysis.

A doubtful result is indicated by "++" or "+". In this case, the diagnosis is repeated after 10-12 days.

Treatment of syphilis in the tongue

Since treponema is very sensitive to mercury, it was previously removed from syphilis with drugs based on it. With the discovery of penicillin, to which treponema is also very sensitive, this practice is a thing of the past. For several decades, penicillin preparations have been used to treat syphilis. Only if the patient has an allergy on them, they are replaced with "Erythromycin", "Cephalosporin", "Tetracycline". Sometimes used and aminoglycosites, which are also able to suppress growth treponem, but they need to take in too high doses, which is unsafe for the patient.

In addition to treating a person who has syphilis diagnosed, undergo a diagnosis and, if necessary, a course of therapy should all who have been in contact with him.

Forecast

Primary and secondary stages of syphilis of the tongue, with proper therapy, are cured by almost 100%, but it must be taken into account that treponema is able to protect itself from the effects of drugs. If the situation for them develops unfavorably, they stop the violent activity, form cysts and begin to wait. As soon as the treated person has a decrease in immunity, they again form ordinary spiral forms and begin to multiply. Therefore, after completing the course of therapy every 3 months, patients take control tests. This lasts for 2 years. Then another year the tests are given once every 6 months. After this, a complete examination of the patient is carried out, with good results it is taken off the register.

The tertiary stage of syphilis is also being treated, but the deformations of the language that have already begun are not being restored. Also, the deep stellate scars that remain after gumma do not disappear.