The incubation period of syphilis is about 9 to 90 days. When the patient is infected with syphilis, the clinical serum reaction at this time is positive and the symptoms temporarily subside. This stage is called syphilis incubation period.
Some patients take antibiotics when they are infected, so the onset will be delayed. Of course, patients have strong resistance and the onset will be later.
It is also rare for patients to have latent symptoms of secondary syphilis and tertiary syphilis until half a year or even many years later. Primary syphilis: Hard chancre appears 2-4 weeks after infection, mostly in the genital area, and in the coronal sulcus, penis and foreskin in men. Women are in the labia majora or cervix. At first, it was a papule, which quickly broke into a small red ulcer, round, with a small amount of serous secretions and a large number of treponema pallidum. Hard chancre is often single, cartilaginous and painless.
Secondary syphilis: As Treponema pallidum enters the blood from lymph nodes, it spreads in the body and then presents systemic symptoms. 7- 10 weeks after infection, mild headache, muscle joint pain and lymph node enlargement may occur. Systemic rash, such as macula, papule, pustule, oyster shell rash, etc. , copper red, with a small amount of scales. Normal symmetrical distribution, dense non-fusion.
Tertiary syphilis: It not only invades the skin and mucous membrane, but also involves all internal organs or tissues of the whole body, which is very destructive.
Principles of treatment
Emphasis on diagnosis, early treatment, regular course of treatment and adequate amount; Clinical and laboratory follow-up were conducted regularly after treatment, and sexual partners received the same treatment. Early syphilis can be completely cured after thorough treatment, and the infectivity can be removed. After 6 months, USR, RPR or VDRL test turned negative or the titer decreased significantly. If the antibody titer rises again, it should be serum recurrence. The treatment of advanced syphilis can eliminate the inflammation in the tissue, but the damaged tissue will not repair naturally, which is a sequela.
Penicillin is preferred, such as penicillin aqua, procaine penicillin, benzathine penicillin, etc. Those who are allergic to penicillin can choose tetracycline and erythromycin. Jarish-Herxheimer reaction (J-HR) may occur in some patients at the initial stage of penicillin treatment, which can be prevented with a small dose. Serum should be rechecked every 3 months in the first year after syphilis treatment, and every 6 months for the next 3 years. The last review includes cerebrospinal fluid examination. Neurosyphilis and cardiovascular syphilis should be followed up for life.