Syphilis in the mouth: symptoms at each stage of the development of the disease. Why papules appear in the mouth and how to distinguish them from syphilis Chancre in the sky in the mouth

Syphilis- This is a dangerous sexually transmitted disease that has become widespread.

The causative agent of the pathological process is pale treponema.

There is an opinion that the disease is now completely eliminated, however, this is not so.

You can still get syphilis today.

What does syphilis look like, and what are the symptoms of pathology in the mouth?

What to do if there are signs of infection and who is better to contact?

What happens if the process is left to chance?

The most common places for the introduction of pale treponema into the body are the mucous membranes.

Therefore, the first signs of syphilis may appear in the genital area and in the mouth.

The disease may be congenital.

Those. when syphilis is transmitted from a sick mother to a child at birth and acquired (infection occurs during sex, through everyday life, through blood, etc.).

As you know, the main method of transmission of infection is the sexual route of infection.

But doctors do not exclude the possibility of infection and contact-household way.

• Most often, syphilis in the mouth manifests itself after engaging in non-traditional forms of sex, including during oral-genital caresses.
• Another way for the pathogen to enter the oral mucosa is possible if non-sterile instruments contaminated with spirochetes from a previous patient were used when visiting the dentist.
• Congenital syphilis is a problem that appears in a child at birth. Moving along the birth canal of the mother, the mucous membranes of the newborn are at great risk of infection. Syphilis can affect the mucous membranes of a child, as a result of which signs of the manifestation of the disease may appear, both on the genitals and in the mouth.
• Another way of infection is through blood transfusion and organ transplantation. This also includes the use of non-sterile syringes for injection.

Symptoms of syphilis in the mouth

The first symptoms of the disease do not appear immediately, but only after the incubation period is over.

Therefore, an attempt to diagnose the disease immediately after accidental oral contact is practically useless and blood serological tests will be negative.

This is due to the fact that the symptoms of oral syphilis will first appear only after a certain time, after about one to a couple of months.

During this time, the pathogen will multiply and begin to destroy the body, and an active process of antibody formation will begin in the blood.

The timing of the incubation period may be shifted and depends on:

• A quantitative indicator of microbes that have entered the body through contact.
• state of the immune system. With a strong immune response and a small amount of treponemas entering the body, they can be destroyed and the disease can be forgotten. But more often the opposite happens.

The development of the disease goes through several subsequent stages.

This is the incubation period, primary syphilis, secondary and late (tertiary).

Each of them has specific manifestations.

The features of the disease are that periodically there is an alternation of the active and passive phases, in which there are no signs of syphilis.

At each stage of the inflammatory process, new symptoms of syphilis damage appear.

How does primary syphilis appear in the mouth

In the first stage, the symptoms of oral syphilis are reduced to the appearance of a hard chancre, which is called amygdalitis, due to the specific localization.

The difference between a hard chancre from herpes aphthous stomatitis and candidiasis is that a syphilitic ulcer is a painless formation with a hard bottom with convex smooth edges.

It does not contain plaque, which, when you try to separate, begins to bleed.

If mouth ulcers with syphilis form in an inconspicuous place, then the patient may not even suspect that he has an infection and therefore do not consult a doctor.

Depending on the site of infection, signs of syphilis can form on the lips, tongue, throat, and tonsils.

The size of the ulcer can be very small (from 1 to 2 mm) and reach gigantic sizes (from 15 to 20 mm in diameter).

The number of formations - no more than three pieces.

Subjective sensations may be absent.

But there may be symptoms of soreness, dry throat, hoarseness.

Another characteristic feature is an increase in regional (parotid, cervical, submandibular) lymph nodes.

As a rule, they are painless when touched, mobile, elastic without involving the surrounding tissues in the process.

The development of syphiloma begins with a small point of redness, which gradually becomes dense and begins to become inflamed.

In special cases, jams or cracks appear instead of ulcers.

Manifestations of chancre in the mouth with syphilis may look like this:

• On the edge of the lips- the chancre has some resemblance to a mushroom cap. The diameter of the formation can reach three centimeters. The surface of the syphiloma is clean, shiny. Sometimes exudate may occur.
• On the tongue. An outgrowth in the form of an inverted saucer. The chancre can take on a gap configuration.
• On the tonsils. The shape of the ulcer is oval with a hint of meat, the formation of a rather dense structure. Due to the reddening of the mucosa, the chancre acquires a copper tint.
• On the gum formation has the shape of a crescent adjacent to the teeth.

If the chancre accompanies the addition of a secondary infection, more often staphylococcal, then the process is exacerbated, and the symptoms may be masked.

Secondary infection with syphilis is manifested by an increase in the size of the chancre, the bottom of which is covered with a purulent coating.

The stage of manifestation of primary syphiloma is considered the most dangerous in terms of infection for others.

If you do not start treatment at the stage of development of primary syphilis, then the disease will move into the second stage.

Secondary syphilis: signs in the mouth

Symptoms of pathology are not limited to the formation of syphiloma.

The duration of primary syphilis is approximately six months.

After that, the next stage of the development of the disease begins, if the patient does not go to the doctor.

Secondary syphilis in the mouth is manifested not only by changes in the mucous membrane, but also by formations in the form of a rash on the skin.

When examining the oral cavity, in addition to a hard chancre, macular syphilides (red spots with clear contours) appear on the mucosa.

Such a picture may suggest that the patient has stomatitis, in which there is a burning sensation in the mouth.

The elements of the rash can be in the form of papules and roseola.

• In the area of ​​the soft palate and tonsils, bright red, roseolous rashes capable of merging appear. As a result, large foci of hyperemic mucosa are formed.
• A papular rash is characterized by the presence of a dense base and clear boundaries. When they are injured, erosion is formed. Frequent places of localization - gums, inner surface of the cheeks, tongue.
• When pustular rashes (which contain fluid) are damaged, purulent ulcers form.

At this stage of the process, the pathogen spreads with the blood to all organs of the body.

The formations in the mouth may become inflamed.

The disease may be accompanied by headache, blurred vision, hearing, and other symptoms indicating complications from organ systems.

Body temperature may rise.

It is important to know that the rash in the oral cavity in the second stage of the disease is contagious.

In the absence or ineffective therapy, the last stage of syphilis begins to develop.

Manifestations of the late stage of syphilis

Tertiary syphilis is the last final stage in the development of pathology.

And it no longer matters where the pathogen has entered in the mouth or in the genital area.

In the tertiary form of the process, papules and chancres are replaced by tubercles and gums, which are localized not only on the mucous membranes, but also on the skin.

They are easy to identify when examining the patient.

The sizes of gums are up to one and a half centimeters.

They are able to break through with the release of a huge amount of treponema.

At the site of the breakthrough of the formation, a deep painful ulcer remains, which heals for a very long time, leaving behind a scar.

A sign of syphilis of the tongue at a late stage of the process is oral glossitis, in which there is an increase in the size of the tongue, and the papillae completely disappear on it.

The body is unable to perform its functions.

This negatively affects the patient's speech and the lack of the possibility of a full meal.

Holes form in the sky, caused by the destruction of the periosteum and bone tissue as a result of necrosis.

Late syphilis is a pathology that is characterized by damage to all organs and systems with the development of irreversible changes in them.

Damage to the central nervous system (neurosyphilis) is especially dangerous.

Tubercular syphilides are localized in the region of the lips, palate and upper gum.

They have a rich red color with a bluish tint.

Outwardly, they resemble mounds with a flat surface.

They tend to break up into separate sores with dense edges.

After healing, scars form in their place.

The duration of the process is approximately three months.

The lymph nodes do not react in any way.

What is the difference between syphilis and other infections

The features of the course of the disease include the following:

• painless rashes, if there is no secondary infection
• no pain on palpation of enlarged lymph nodes
• body temperature remains within normal limits

With secondary infection, the following complaints are added:

• soreness of the tonsils against the background of their enlargement
• the formation of purulent deposits in the lacunae of the tonsils
• redness and swelling of the throat
• rise in temperature

Diagnosis for suspected syphilis in the mouth

Examination of patients with subsequent treatment takes place in a specialized institution.

To undergo a diagnosis, you need to contact a venereologist.

The specialist will order an examination.

If the tests are positive, he will refer the patient to a highly specialized syphilidologist who treats syphilis.

In some cases, an infection in the oral cavity may require the help of an ENT or dentist.

Additionally, immunologists and other specialists whose specific activities are related to certain types of damage to the body can be involved.

If the patient additionally has other infections, for example, with HIV, the symptoms of the disease may have some features. In this case, you will need to involve an infectious disease specialist.

Signs of damage to the tonsils with syphilis

There are several forms of infection of the tonsils with an infection:

• Anginal, which is manifested by hyperemia of the tonsils and an increase in nearby lymph nodes.
• Ulcerative. Chancre has even outlines, the bottom of which is covered with a gray film. With the defeat of the ulcerative form, salivation increases, pain radiating to the ear joins, the temperature may rise.
• erosive. Oval ulcer with exudate inside. The bottom of the erosion is cartilaginous.
• Pseudophlegmonous.
• Gangrenous.

Any of these forms is very contagious and causes the patient a lot of inconvenience.

Symptoms of damage to the pharynx with syphilis

In the primary form of syphilis, the formation is localized, as a rule, on one side.

Since the pharynx takes part in the formation of the voice, the patient complains of hoarseness, coughing is possible.

In the secondary form of syphilitic lesions, the larynx is involved in the process.

What to take tests for syphilis

If you suspect a syphilis lesion of the oral cavity, you should consult a doctor.

After the examination, the doctor will decide which tests should be taken to confirm or refute the diagnosis.

First of all, it will be necessary to donate blood for RW (Wasserman reaction).

The assay is highly sensitive, and yet may give false positive reactions.

If a positive result comes in, then a PCR test is performed to clarify.

For research, a scraping from chancres is performed.

It is very difficult to diagnose the latent and late forms of the disease.

Since serological reactions can show the absence of the pathogen in the body against the background of pronounced symptoms.

Currently, it is PCR scraping for treponema that is becoming the main method.

Compared to other methods, this is the most reliable way to confirm the presence of the disease.

It is necessary to regularly examine persons who are at risk.

These include the following types of personalities: drug addicts, prostitutes, homosexuals.

Principles of treatment of syphilis

At the first manifestations of the oral form of the disease, therapy should be started immediately.

The disease can cause serious complications that are practically beyond the control of the doctor.

The primary goal of therapy is the destruction of pale treponema.

For this, a course of antibiotic therapy is carried out.

Antibiotic treatment regimens include:

• Preparations of the penicillin group. If the patient has an intolerance to this drug group, then treatment with other drugs is carried out;
• Immunomodulators. These funds contribute to the activation of immunity in order to increase the protective forces. In addition, it will help to guard against other infections that may be activated against the background of a decrease in the protective function of the body.
• local therapy. Be sure to treat ulcerative rashes in the mouth with antiseptics. Due to the lack of sterility in the oral cavity, against the background of ulcerative lesions, the rapid development of a secondary infection is possible. For rinsing, you can use Chlorhexidine and Miramistin.

Prevention of syphilis

Patients after completing the full course of treatment will need to monitor the effectiveness of drugs.

This is necessary in order to be sure that the drugs were correctly selected and the patient recovered.

To confirm that the patient no longer has an infection in the body, various types of examinations will be required.

Only after laboratory confirmation that the patient does not pose a danger to others, it is possible to deregister in the dermatovenerological dispensary.

In addition, in order to exclude re-infection, it is also necessary to adhere to the rules of personal hygiene.

They are simple:

• rejection of casual relationships without the use of protective equipment
• with an active sexual life, it is necessary to regularly visit a doctor for a preventive examination
• when using the services of a dentist or other specialists whose activities are associated with a violation of the integrity of the mucous membranes and skin, you should carefully choose a clinic

If you suspect syphilis in your mouth, contact the author of this article - a venereologist, syphilidologist in Moscow with many years of experience.

Sexually transmitted diseases do not always affect the surface of the genitals - sometimes clinical manifestations are diagnosed in the oral cavity. Pale treponema, after attaching to the surface of the mucosa, leads to the fact that syphilis in the mouth develops rapidly.

Despite the local lesion, the threat to health is high to the same extent as when a rash occurs in the inguinal zone.

Features of infection

The defeat of the oral cavity occurs after unprotected oral contact with a partner who is a carrier of a sexually transmitted infection. There is a high risk of transmission of the pathogen through a kiss, as well as common dishes.

The appearance of an insidious disease is permissible even after a visit to a medical facility where sanitary standards for disinfecting instruments are violated.

Treponema pallidum transmission methods:

• visit to the dentist's office;
• examination by an otolaryngologist;
• treatment of patients with venereal disease;
• opening of an abscess.

Syphilis appears on the tongue and other parts of the mouth is also likely after injections, blood transfusions and surgical intervention in this area. During the incubation period, the patient feels depressed, weak, depressed and observes a relapse of chronic diseases.

primary stage

As with lesions of the genital organs, the development of the disease includes 3 stages. The first stage is characterized by a long wait for the first signs to appear, which develop a month after pale treponema attaches to the body. In the second month (in 95% of those infected), although after a 1-week period it is observed - a sign that is rarely given special importance.

However, gross pathological changes are more often diagnosed, leading to lymphadenitis, in which red swollen bumps form in the localization of the lymphatic system (more often in the cervical, occipital and ear regions).

Clinical manifestations:

• the presence of 1 or more chancres;
• frequent projection - on the lips, tonsils and tongue;
• rare location - on the gum;
• sizes - from 5 to 20 mm;
• absence of soreness of the ulcer.

The chancre is red in color with hard edges and a soft center that often dies off. If treponema is attached to a wound located at the entrance to the mouth opening, then syphilis on the lips is diagnosed, which differs from a cold on the lips in the absence of small bubbles with wet contents, as well as a dense crust.

From purulent tonsillitis, the lesion is differentiated according to the side of the lesion - with a venereal disease, only one side of the tonsil is damaged. Another important marker is the appearance and development of the sore, which on the tonsils often becomes white rather than red. It does not cause pain, but during the period of increase, itching may occur. The development of pain syndrome is observed only after the progression of the disease.

Unlike other types of rashes: the chancre has a rounded shape. Occasionally, it takes the form of a furrow hidden in the tongue fold.

secondary stage

Effective ways to prevent infection remain protected sex and visits to medical organizations with a high reputation, which guarantees protection against the transmission of pale treponema through the household.

26.10.2018

In the oral cavity syphilis manifests itself at the beginning, when the causative agent of the disease enters the mucous membranes of the gums, skin of the lips, the delicate surface of the pharynx, larynx and tonsils.

The cause of infection is a kiss or oral sex with a sick person. Another variant of infection is the infection at the dentist's office.

Incubation period syphilis in the mouth lasts from a week to six months, the infection develops in stages, at each stage the clinical picture changes:

• a month after infection, the first manifestations - on the mucous membrane in the oral cavity you can find a primary syphiloma, as it's called, a hard chancre. After about 6-7 weeks, the chancre will disappear. 5 weeks after infection, the size of the lymph nodes adjacent to the chancre increase. These are lymph nodes in the neck and under the jaw;
• after about 2-3 months from the moment of infection and after 6-7 weeks from the moment of formation of syphiloma, the pathogen enters the bloodstream, causing skin rashes - syphilides. Soon thesesigns of syphilisdisappear, sometimes there are relapses;
• syphilis symptomsin stage 3 appear after 3-6 years from the moment of infection. Mucous membranes affected in the oral cavity , skin, as well as internal organs and parts of the nervous system. At this stage of development syphilis in the mouth makes itself felt by formations in the form of tubercles and gums. Such a stage is rarely detected today, because you need to lead a completely asocial lifestyle in order to rot alive and not go to the doctor.

How can you get syphilis

Syphilis in the mouthdoes not appear on its own, infection is preceded by certain circumstances. Often these are medical procedures, when poorly sterilized medical instruments serve as a source of infection that is transmitted from one patient to another.

oral syphiliscan only settle if there is definitely damage in the form of scratches, abrasions, scuffs. Some doctors believe that throat syphilis , lips and tongue can occur even on mucous membranes that are not damaged.

Another option for potential infection is through the blood. I.e, throat syphilis can be obtained from blood transfusions, injections, surgery and various procedures. Given the mode, healthcare workers are most at risk, especially those who deal with events:

• gynecological examination;
• dental treatment;
• surgical intervention;
• treatment of patients with syphilis;
• opening of abscesses;
• careless handling of tools.

Patients who have syphilis on the lips , in the mouth or on the genitals.

primary stage

In the first stage of syphilis in the throat manifests itself a month after the date of infection - it will be a hard chancre, which will disappear after 6 weeks.

The presence of a chancre indicatesoral syphilis, a week later, inflammation of the lymph nodes is added to the symptoms, in which the causative agent of the disease multiplies.

The occipital, cervical and mandibular lymph nodes are most often inflamed. There is usually no pain. In the oral cavity there may be one chancre or a cluster of sores. Chancre in most cases affects lips , tonsils, mucous membrane of the tongue. Less commonly, syphilomas are detected in the sky, cheeks from the inside, gums. The diameter of the chancre is approximately 5-10 mm, sometimes up to 20 mm. This is an ulcer, in the middle of which the tissue dies, a dense infiltrate is formed.

Secondary stage: new symptoms

Not everyone is concerned mouth ulcers with syphilisthat appear in the primary stage. But whensyphilis on the lipssupplemented by significant skin rashes, this is alarming.

For the secondary stage of infection, which occurs approximately 3 months from the day of infection, several symptoms are characteristic, including lesions of the mouth in the form of macular syphilis. These are red spots with a diameter of about 10 mm, which can affect the tongue, palate, tonsils, palatine arches. According to outward appearancessyphilis on the tonguesimilar to catarrhal stomatitis, only the latter is distinguished by a burning sensation and pain.

tongue with syphilispapular syphilides are affected - rashes that do not have such clear outlines as a chancre, but can be combined into a large plaque. If the patient does not fully exercise oral hygiene, then this is fraught with complications - papules turn into fusospirochetosis - this is the name of ulcers that are covered with a coating of a mixture of pus and blood.

More often, papules affect the tongue on the sides, under the influence of saliva, they turn into ulcers, erosions with a white coating. Through time syphilis of the tongue subsides, larynx and other surfaces are cleaned and the disease seems to be gone.

Tertiary stage - dangerous complications

When the disease is started and passed into the tertiary stage, then throat syphilis and the tongue is no longer manifested by chancre and papules, as in stages 1 and 2, they are replaced by tubercles and gummas. Often a single gumma is found in the mouth - a small nodule that grows up to 15 mm or more. After a while, this gumma opens up, turning into a painful abscess. Such an abscess heals for about 4 months, in its place there is a scar in the form of an asterisk or a snowflake.

The most dangerous symptom of tertiary syphilis in the mouth is diffuse sclerotic glossitis, when the tongue enlarges, its papillae smooth out, and the surface becomes dense.

An infiltrate appears on the surface of the deformed tongue, which will eventually be replaced by scar tissue. The tongue shrinks, decreases in size and becomes less mobile, becomes covered with cracks, as a result, a person’s speech is disturbed. In 3 stages syphilis on the lips and in the mouth does not cause inflammation of the lymph nodes, as it was at first.

Diagnosis of syphilis in the mouth

If a patient goes to the doctor with complaints of some kind of rash in the mouth, this should definitely make the specialist suspect syphilis. If the suspicions are correct, then the doctor can make sure that they are correct even with a visual examination of the oral cavity - usually the affected areas are limited from tissues.

Another point that helps to detect syphilis at the stage of visual examination is a change in the color and structure of the mucosa, the appearance of erosions and ulcers of various sizes. Such symptoms often indicate syphilis, the first thing to do is to lean towards this version, check it with the help of tests. The patient needs to discuss his problems with a dermatovenereologist.

Erosions and ulcers are examined several times under a microscope in the area of ​​dark vision, which makes it possible to identify pale treponema in discharge from ulcers, or to exclude its presence in biological material.

The results of specific serological tests will be ready in about 2-3 weeks. If pale treponema is not detected in the discharge from the hard chancre, it should be checked for its presence in the local lymph nodes.

Most often, a dermatovenereologist can make a confident diagnosis based on the picture of the disease, but it is necessary to confirm suspicions with serological studies. This applies to both primary and secondary syphilis.

Another thing is the diagnosis of the late stage of the disease or its latent form, in which case it is serological tests that can confirm suspicions. A specialist in venereology uses all available diagnostic and laboratory methods to make an accurate diagnosis and prescribe adequate therapy.

For microscopic examination, it is necessary to take material from a hard chancre in the mouth and send it for examination under a microscope. Mobile pale treponemas may be found in the specimen. Doctors consider the study of biomaterial under a microscope to be an insufficiently effective technique, since the microflora in the mouth consists of a large number of different bacteria, among which it is difficult to distinguish treponema.

The serological method involves the use of the Wassermann reaction to detect antibody titers associated with syphilis. Diagnosis is highly sensitive, but does not give accurate results, since the reaction will be positive in other diseases.

This means that this method allows, in general, to make sure that there is a problem, but what exactly - you will have to find out using other methods. Doctors should be aware that pregnant women and patients with autoimmune diseases will have a false positive reaction.

To diagnose a sexually transmitted disease, a puncture of fluid from the spinal cord can be taken for analysis. Blood for syphilis must be donated with a certain regularity to everyone who is at risk, and these are:

• medical workers;
• drug addicts;
• homosexuals;
• pregnant women;
• donors;
• sexually active youth leading promiscuous sex life.

Before donating blood for syphilis, it is advisable not to eat food 12 hours before the material is taken, you can drink water. If the result turned out to be false positive, after a couple of days the analysis is done again.

Treatment of syphilis of the throat and complications

The goal of the treatment regimen is to suppress the vital activity of pale treponema. In addition, the patient needs to eliminate negative symptoms. The therapy is carried out with antibacterial agents from different groups, supplementing the course with immunomodulators.

A complete treatment regimen includes several courses, between which a good break is made. To relieve negative symptoms, the doctor prescribes antipyretics, medicines for wound healing and tissue regeneration (ointments, applications, rinses, lotions) to the patient. After the end of the course of therapy, control blood tests are taken for several months in a row.

If we talk about the consequences of syphilis, most of them will be with untimely treatment. Because of this, the infection can affect not only the soft tissues in the mouth, but also spread to the internal organs, worsening the patient's condition.

As for the course of the disease, sometimes patients rejoice in the disappearance of symptoms, believing that the disease has passed by itself, this is not so. Over time, the following complications can be noticed:

• damage to bones and internal organs;
• soft tissue necrosis in the affected area;
• local bleeding, malfunction of the vascular, circulatory system;
• asymmetry of the face due to damage to the soft tissues on it and the neck;
• destruction of brain cells.

Patients should be aware that stages 2 and 3 of syphilis are practically incurable. Therefore, you need to regularly visit a doctor, take tests so as not to miss the moment of infection, if there is such a risk. By the way, immunity to this venereal disease is not produced in the body, so you can get infected several times.

Summing up, it can be noted that syphilis is a dangerous disease that, if not diagnosed and treated in time, gives complications. In case of lesions of the mucous membrane in the mouth for no particular reason, you should immediately consult a doctor. It is better to be safe than to miss the onset of such a disease.

In order not to get sick, you need to avoid casual sex, exclude drugs, lead a reasonable and healthy lifestyle.

Oral syphilis is an infectious disease caused by the bacterium Trepomena pallida. At all stages of the disease, rashes are localized on the oral mucosa.

Syphilis can be congenital or acquired. With congenital bacteria enters the fetus through the placenta of an infected woman.

Acquired is characterized by infection through the dermis, mucous membranes, due to direct contact, usually sexual, as well as through household contact through objects that contain the pathogen.

Reasons: know to avoid

Infection with syphilis can be provoked by the following factors:

Localization of the lesion

Manifestations of syphilis, regardless of the stage and form, will always be localized in the oral cavity, the disease will affect:

• tonsils;
• sky;
• language;
• gum;
• buccal mucosa;
• lips.

Stages and forms of development of syphilis

There are several stages of the course of the disease, at each of which certain symptoms will be observed.

The incubation period - how it all begins

The incubation period lasts from three weeks to a month from the moment of infection to the appearance of the first symptom - a hard chancre.

In some cases, the period may last longer, for example, in people who use antibiotics to treat acute infectious diseases, in the presence of a pathological process in the body, in older people.

Stage One - Chancres Everywhere

In the photo, syphilitic chancres

The primary stage begins with painless. It lasts one and a half to two months. Hard chancre begins with the appearance of redness on the mucous membrane, which then progresses to induration due to the formation of an inflammatory infiltrate.

This redness increases in diameter and reaches several centimeters. In the center of the infiltrate, an erosion of a bright scarlet hue is formed.

At the final stage of development, the chancre looks like a small dense erosive elevation above the level of the mucosa. When injured and in the presence of a secondary infection, the infection turns into a painless ulcer of a round shape with clear boundaries. The chancre can be located on the mucous membrane of the lips, cheeks, soft and hard palate, and differs in forms:

• rounded shape - on the tongue and lips;
• elongated shape - on the gum;
• in the form of cracks - in the corners of the lips.
• on the tonsils is located unilaterally.

Stage two - the appearance of roseola

The secondary stage begins two months after infection, if treatment has not been carried out. At this stage, roseola and papules appear in the mouth. At this stage, syphilis is most contagious..

Roseolas appear on the palate or tonsils and look like bright red spots that stand out clearly against the background of the mucosa. Without treatment, roseola lasts for more than a month without changes in shape and color.

Papular syphilis is the most characteristic manifestation of the secondary stage in the mouth. May occur in case of recurrence of the disease.

Rashes are observed on the entire surface of the oral mucosa. Papules are rounded, dense, of different sizes, covered with plaque, which, when scraped off, reveals red erosion underneath.

When papules appear on the tongue, the papillae disappear, the skin becomes smooth with bright red plaques. Papules can be concentrated in one place and form large foci. Erosion of papules and the occurrence of syphilitic cause very painful sensations.

In the photo, manifestations of secondary syphilis on the lips

Stage three - massive impact

The tertiary stage is characterized by the formation of gums and bumpy rashes. Gummas at this stage of syphilis are formed over the entire surface of the oral mucosa, but most often on the tongue, lip or hard palate.

They begin painlessly and imperceptibly in the form of a deep node in the mucosa, which gradually increases in size and acquires a brown tint.

The central part of the gumma is destroyed during the formation of an ulcer. Surrounded by a dense formation rising above the level of the mucosa. When the zones of the tongue and lips are affected, pain is not observed, as, for example, with tuberculous ulcers in the mouth.

There are also no acute inflammatory processes. After the ulcer heals, an inverted scar forms. This process takes several months.

Tubercular syphilis often focuses on the lips. Tubercles brown, dense, not causing pain. Localized in groups without an acute inflammatory process. These bumps quickly collapse, forming small deep ulcers.

If left untreated, this type of syphilis can last for a very long time from several months to several years. After healing, characteristic scars remain forever.

How to correctly diagnose a violation?

Confirmation of the diagnosis will be the detection of the pathogen on the surface of the primary syphiloma or in the regional lymph nodes. An important factor in diagnosing primary syphilis with a negative result will be the identification of the pathogen in the hard chancre.

Serological tests will show a positive result a few weeks after the onset of the chancre. By the end of the fourth week, these reactions will show a stable positive result.

Diagnostic methods

Diagnostics will be based on the following methods:

• immune fluorescence reaction;
• reaction of an immobilization of pale treponemas;
• test for the presence of pale treponema.

This is how the Wasserman reaction is done

Identification of the primary stage

The end of the primary period is characterized by such symptoms: weakness, aching bones, headache, fever, leukocytosis. Chancre at the primary stage must be differentiated from a traumatic ulcer, which, unlike syphilis, is not characterized by seals.

A chancre on the tonsils will differ from a sore throat in a unilateral lesion with no inflammation and pain.

The chancre on the lips is differentiated from, which is characterized by swelling, soreness, reactive flow and blistering formations.

A chancre may be similar to pyoderma, which is characterized by inflammation, purulent discharge, pain, and duration.

It is also necessary to diagnose chancre and severe form, which is characterized by painful ulcers and inflammation of the mucosa.

Chancre may be similar to a decaying cancerous tumor, but its infiltrate will be much deeper than primary stage syphiloma. The edges of the ulcer are uneven, compacted and bleeding.

In the diagnosis, the detection of the pathogen or mutating cells in a cancerous tumor will be decisive.

Syphilitic chancre on the lips

Diagnosis of a secondary disorder

Diagnosing secondary syphilis can be difficult. Important signs will be the absence of pain, long-term resistance to drugs, as well as the stability of the pathological picture of the disease.

When diagnosing syphilis at this stage, the main role will be played by the identification of the pathogen in the scraping from the surface of the papules, as well as a positive result during serological tests.

Differentiate syphilis in this case from such diseases:

Also, papular syphilis is differentiated from leukoplakia in HIV.

Tertiary form

With tertiary syphilis, it is very difficult to make a diagnosis, since it is rather difficult to identify pale treponema in the discharged contents of tubercles and gums.

The indicators of RIF and RIBT will be important, which, in the presence of a pathogen, will show a positive result.

Syphilitic gummas are differentiated from: tuberculous ulcer, traumatic ulcer, tumor ulceration,.

Tuberculous syphilis is diagnosed with lupus erythematosus, which develops much more slowly, in some cases for years, and also has a different structure of ulcers and scarring from syphilis.

Therapy of the disease

Treatment of syphilis in the oral cavity will be aimed at destroying the pathogen in the body, as well as eliminating symptoms and complications. Therapy should begin as soon as possible.

The treatment is based on the appointment of bactericidal drugs of various groups, as well as an increase in the level of resistance to infection.

Therapy is carried out in courses with long intervals between them. Of great importance for the effectiveness of treatment will be the general condition of the human body. To achieve a positive result, drugs are prescribed that activate the protective functions of the body.

After the end of complex treatment, clinical and serological blood control should be carried out for a long time.

Complications and consequences

In the event that treatment is not carried out on time, the disease will affect not only tissues, but also internal organs of a person, worsening the general condition of the body.

Over time, the symptoms become less and less pronounced, and it will look like an improvement, but this is just a manifestation of the course of the disease, and further deterioration will occur with such signs:

• tissue necrosis at the site of the chancre;
• deep lesions of tissues, bones and organs;
• destruction of the vascular system, which is fraught with bleeding;
• damage to the cervical and facial tissues;
• brain damage.

Prevention is more important than ever!

The following preventive measures will be of great importance:

• use contraceptive methods during sexual intercourse;
• avoid engaging in promiscuity;
• use only personal household items and hygiene items;
• undergo a clinical examination every year.

A disappointing prognosis is the prerogative of all syphilitic patients

There are no criteria for an absolute cure for syphilis in the mouth, but modern medicine has proven that timely treatment in the early stages provides a positive result, but it is almost impossible to cure the disease at the last stage.

The quality of life of the patient will directly depend on the nature of the complications.

It must be remembered that the human body is not immune to this disease, so a person who has had syphilis is not immune from re-infection.

Syphilis in the mouth is an infectious disease caused by Treponema pallidum. The mucous membranes of the oral cavity and larynx are affected at any stage of the disease. Syphilis is congenital, when infection of the fetus occurs during fetal development, or acquired - the bacterium enters the body through wounds on the skin or mucous membranes upon contact with sick people or contaminated objects.

Causes

Pale treponema can enter the body through the use of non-sterile medical instruments, during injections or surgical interventions. The main way of transmission of syphilis is sexual. Localization of rashes depends on the stage and form of the disease. Mouth ulcers occur anywhere, it can be:

• language;
• cheeks;
• gums;
• tonsils;
• sky.

Syphilis in the oral cavity develops in several stages, and each of them has certain symptoms. usually lasts 21–30 days, after which a hard chancre forms on the tongue. In certain cases, more time passes from the moment of infection to the appearance. For example, in the treatment of other infections with antibacterial drugs.

Primary and secondary syphilis

At the first stage, the syphilitic rash looks like ulcers that are present for 1-2 months. Before the appearance of a hard chancre, the mucous membranes turn red and swell. In the future, a seal appears and begins to increase, which is an inflammatory infiltrate (see photo). Red erosion is formed in the center. A fully formed chancre looks like a dense ulcerated elevation of a rounded shape with pronounced borders. It can be found on the tonsils, mucous membranes of the lips and cheeks.

At the last stage of development, the chancre looks like a small seal that rises above the level of the mucosa. When damaged or in the presence of a secondary infection, the seal turns into a painless oval ulcer with clear boundaries. Chancre can be found on the mucous membrane of the lips, cheeks, soft and hard palate, the formation has various types: rounded ones affect the tongue and lips; oblong - gums; cracks - corners of the mouth.

The pharynx develops 2 months after infection. At this stage, spots and papules appear in the mouth. Such syphilitic rashes are considered the most contagious. affects the sky or tonsils and has a bright red color. If untreated, the rash disappears after a month.

Papular syphilis on the mucous membranes of the larynx is a characteristic symptom of the secondary stage. Rashes affect the entire oral cavity, the elements have a round shape and a dense base, most often covered with plaque, after the removal of which erosion remains. Syphilis on the tongue contributes to the disappearance of papillae and smoothing of the skin. Papules on the gums can merge and form continuous foci. The appearance of a specific seizure in the corners of the mouth is accompanied by severe pain.

How is tertiary syphilis manifested?

This period begins with and tubercular syphilides. What does such a rash look like? Gumma has the appearance of a deep-seated nodule, which gradually grows and becomes dark in color. With the collapse of the central part of the seal, an ulcer is formed, surrounded by a dark rim.

With a syphilitic lesion of the oral cavity, unpleasant sensations are not observed, a sore throat may appear when the disease passes into the form of a sore throat. After the healing of the gumma, a retracted scar remains.

Tubercular syphilides appear in the lips. They are brown in color and dense in texture. Differ in multiple character and absence of inflammatory process. Syphilomas quickly disintegrate, after which small erosions remain. This period of the disease in the absence of treatment can last for years. Scars after healing of ulcers remain forever.

Diagnosis and signs

The diagnosis of syphilis of the throat is made when a pale treponema is found in the tissues of syphilis or in nearby lymph nodes. Serological tests give positive results only a few weeks after infection. The first signs of syphilis are found when examining the patient's oral cavity and skin. Further applied:

• Wasserman reaction;
• Treponema pallidum DNA test.

Symptoms of syphilis in the first stage will be as follows:

• general weakness;
• pain in muscles and joints;
• leukocytosis.

Primary chancre should be able to distinguish from a traumatic wound that does not have a solid base. From the usual angina, syphilitic differs in one-sided lesion and the absence of unpleasant sensations in the early stages. Chancre on the lips can be confused with herpetic eruptions, which are accompanied by swelling. Differential diagnosis is carried out with a severe form of aphthous stomatitis, in which ulcers form.

The chancre in the mouth is similar to the manifestations of a malignant tumor at the decay stage, but it affects deeper tissues than syphilis. Cancer ulcer has uneven bleeding edges. It is quite difficult to identify secondary syphilis of the oral cavity. An important sign is the absence of pain, the inability to eliminate the rash with the help of drugs. Confirm the diagnosis by performing serological tests.

Papular syphilitic eruptions must be able to distinguish from leukoplakia and candidiasis. With syphilis, pale treponemas are found on the surface of the ulcers. The disease can be confused with allergic stomatitis and erythema, in which the general condition significantly worsens. Syphilis of the tongue is distinguished from nonspecific glossitis, in which there are no seals and there are red spots. In the tertiary period, pale treponema is not found on the surface of the ulcers.

Diagnosis involves conducting serological studies. Gummous infiltrates must be able to distinguish from tuberculous and traumatic ulcers, cancerous tumors, aphthous stomatitis. Tubercular syphilis is similar to lupus, which is characterized by a slower development.

Methods of therapy

Treatment of a syphilitic ulcer in the mouth is aimed at eliminating pale treponema in the body, relieving discomfort and preventing complications. Antibacterial drugs should be started as early as possible:

If left untreated, pale treponema affects the internal organs, contributing to the development of dangerous complications. Over time, the symptoms of the disease may become less pronounced, and the patient may take this for recovery. In the future, there is necrosis of the tissues surrounding the chancre, bone damage, destruction of large vessels, and the development of neurosyphilis.

Prevention of infection involves the use of barrier methods of contraception. During the period of treatment, a patient with syphilis should have separate dishes, towels, hygiene items. Each person is shown an annual examination. The early stages of the disease are treatable, but the tertiary form has a poor prognosis. The patient's quality of life depends on the type of complications.