Syphilis is a sexually transmitted disease caused by Treponema pallidum. Microorganisms are small, their length is not more than 20 microns. Outwardly, it seems that this is a small spiral, it moves around its axis. There are several ways to transmit the disease.

Treponema pallidum is a tenacious bacteria that can survive for several days in a humid environment. They are not sensitive to cold, they do not die even at a temperature of minus 75. Syphilis in children is dangerous because it can lead to the development of many complications.

Acquired syphilis

Parents suffering from the development of the disease often ask the question “can their children get sick?”. Unfortunately, the answer in this case is unequivocal - yes, children get sick.

The body of children is especially vulnerable to the causative agent of pathology, stronger than the body of an adult. The situation is complicated by the fact that bacteria can be transmitted not only through sexual contact. A child can catch syphilis from relatives who are sick.

If the baby is constantly surrounded by people suffering from syphilis, then the risk of infection increases several times. However, this probability will depend on several important factors. Below we consider the main ways of infection.

household route of infection

Pale treponema can enter the body of a child if he comes into contact with people with a primary or secondary form of the disease. Contacts can be of several types.

Through a rash in primary or secondary syphilis. Such rashes contain a large number of bacteria, especially if their surface is weeping. When the damaged skin of the baby comes into contact with the elements of the rash, bacteria easily penetrate into his body.

Important! The elements of tertiary syphilis are not dangerous, the thing is that there are few treponemas in them, this is not enough for infection.

Next possible view infection - by contact with the saliva of a sick person. Bacteria are found in large numbers not only in rashes on the skin, but also in saliva. Any contact with her is dangerous for a child: the disease can be easily transmitted through a kiss.

In addition, the patient's saliva can get on toys, nipples, spoons, and so on. But we must remember that bacteria can only survive if the saliva on the objects is wet, after it dries they will die.

Infection through breast milk. Many nursing mothers are interested in whether they can breastfeed a baby with such a diagnosis? In this case, too, the unequivocal answer is no. If a woman is a carrier of the secondary stage of syphilis, then the disease will be transmitted to the child through milk.

Artificial route of infection

Not only the everyday way of infection is possible, but also artificial, namely, artificial. This includes cases when bacteria enter the child's body through various instruments.

Main ways:

• through an injection in a hospital, if the syringe has been used before;
• in a blood transfusion where the blood does not go through the proper level of processing;
• in a beauty salon, when cutting a baby with non-sterile scissors;
• during any surgical intervention.

Infection by artificial means is rare, main reason- dishonesty. And more often, not even medical institutions, but private organizations are to blame for this.

Other routes of infection

Infection can also occur for other reasons, including the following:

• germinal pathway- father's sperm or mother's egg are infected;
• infection at the time of labor, or with separation of the placenta;
• if the rules of personal hygiene are not observed, then the causative agent of the disease enters the baby's body through the umbilical wound.

In most cases, infection occurs vertically, that is, at birth or while in the womb. If the baby is still healthy in the abdomen, then in order to prevent infection during childbirth, it is recommended to do a caesarean section. The photo below is an example of the development of the disease in children.

How common is syphilis in children?

According to statistics, syphilis is 10 times more common in children than in adults. The disease of early childhood occurs precisely because of bodily contact with infected people.

That is why, if a disease was found in one of the family members, it is necessary to undergo preventive treatment for everyone else. Thus, it is possible to protect the household and the child from possible infection.

Interesting! Acquired syphilis is more common in adolescents and schoolchildren.

Not only family contacts can become a source of infection, there are other reasons:

• sexual life began early;
• ignorance of elementary security measures regarding sexual life, parents should educate on this topic;
• close communication of children with each other: the use of toys, the transfer of chewing gum from mouth to mouth, and so on.

All of the factors listed above increase the risk of infection several times over. The video in this article explains in more detail how the infection occurs.

What to do if the child is sick?

In the event that a child is diagnosed with a similar diagnosis, he is necessarily suspended from attending a kindergarten or school. Treatment is carried out in a dermatovenerological dispensary. That is, those children who are sick with syphilis do not study either in ordinary or in any special institutions.

Parents and close relatives who have been in contact with the child should be examined. Children cured of the disease do not pose any danger to society, they can continue their education.

Acquired syphilis develops in the same way as in an adult. It is also important to remember that there are no distinguishing signs of the disease in boys and girls, they are the same for both sexes.

Primary syphilis

Three to four weeks after infection, the primary stage begins to develop. In the place where the bacteria were introduced, a hard chancre is formed - an ulcer, small in size and dense to the touch. This is the first symptom of the development of syphilis in adults and children.

In addition to the presence of a hard chancre, you can notice that the lymph nodes and lymphatic vessels become inflamed and increase in size. Moreover, it is precisely those that are close to the site of the introduction of treponema that are inflamed.

In those children who are sick with syphilis, a hard chancre is most often localized on the lip or in the oral cavity. The duration of this stage is up to seven weeks.

Secondary syphilis

One and a half to two months after the appearance of hard chancres, the next stage of the disease begins to develop. Symptoms of secondary syphilis are a rash on the skin. Often it is accompanied by an increase in body temperature, which may not subside for several days.

Outwardly, the rash can resemble numerous childhood infections, such as rubella, chickenpox, measles. However, unlike these infections, the rash will not go away for several months.

Its varieties can be as follows:

• roseola - spots no more than 3 millimeters in diameter;
• papules - up to one centimeter in size;
• pustules.

The duration of secondary syphilis is up to three years. Periods of rashes can pass, a remission stage begins.

Tertiary syphilis

This stage is considered the most serious and destructive. Gummas, otherwise bumps, form inside the body and under the skin.

Education may not take place for several years. After this time, purulent processes begin to form. Erupted ulcers can destroy the surrounding tissue.

The most common route of infection is intrauterine.

Bursting ulcers have a negative impact on the area where it happened: areas of the skin, bone and vascular tissue are destroyed. Gummas formed on the internal organs can affect their work.

Forecast

What happens if a child develops syphilis?

The prognosis depends on how exactly the child was infected, as well as how early treatment was started. Only in 11% of cases, healthy children are born in pregnant women. If they completed a course of treatment in a timely manner, then in 80% of cases children are born without pathologies.

Women who become infected before the fifth month of pregnancy, but who have undergone a course of treatment, can give birth to a completely normal baby. If therapy was started late, then most likely a miscarriage will occur, or the child will be born with pathologies.

With acquired syphilis in children, how soon treatment began is also important. In the secondary and primary form, the prognosis is almost always favorable. In a running form, it will be extremely difficult to do something.

Diagnostic methods

If you suspect the development of congenital syphilis in a baby, you should examine him, as well as the mother.

In order to identify pale treponema, the following tests should be taken:

1. Serotological reactions- blood is taken from a vein, always on an empty stomach. In infants, blood is taken from the cranial or jugular vein. The material of an infected baby will contain antibodies to pale treponema. Syphilis can be detected as early as 8 weeks after infection.
2. PCR- DNA of pale treponema is determined. You can start the examination from the first month of life. Diagnosis is essential for detecting congenital syphilis.
3. Linked immunosorbent assay- allows you to determine the presence of antibodies to treponema. You can give an accurate answer based on the color of the samples. The disease can be detected at an early stage of development.
4. The cerebrospinal fluid is taken and sent for examination.

A doctor conducts an examination, based on the results obtained, a final diagnosis is made and appropriate treatment is prescribed.

Treatment Methods

Pale treponema is a microorganism that is still sensitive to penicillin. Children need to be treated comprehensively. If the child was born from a sick woman, then regardless of whether he is sick or not, a course of penicillin will be prescribed.

For the treatment of the primary form, as well as as a prophylaxis, one should undergo a course of treatment with penicillin for two weeks. Treatment of congenital or recurrent syphilis is carried out with the same drug, but longer, not less than one month.

Children with late congenital disease should be treated with drugs called Bismoverol and Bioquinol. Drugs are administered intramuscularly, twice a week. More precise instructions are given by the doctor, the dosage may vary depending on the age of the child.

As a supplement, immunomodulators and vitamin complexes are prescribed. It is extremely rare that arsenic-based medicines are prescribed for the treatment of pathology. The dosage is selected taking into account the age of the child, his weight, the degree of development of the disease, and so on.

For the entire period of treatment, you must do the following:

1. Parents should monitor the personal hygiene of the child. With the development of the disease, the skin is the first to suffer.
2. Nutrition should be given special attention. Those infants who are diagnosed with congenital syphilis should be fed mother's milk, subsequently it is necessary that foods with vitamins and minerals predominate in the diet.
3. Follow the daily routine of the crumbs. It is advisable to feed him and put him to bed at the same time.
4. It is recommended to spend as much time as possible outdoors.
5. Children, at an older age, for the entire period of treatment should be protected from heavy physical exertion.

After undergoing treatment, children must be registered at the dispensary for another five years.

Prevention

In order to prevent the development of syphilis in children during pregnancy, women must undergo all examinations and procedures prescribed by a doctor. If the woman in labor became infected in the later stages, but the child was born healthy, then it is recommended to feed him with expressed milk.

When one of the family members suffers from the disease, the child should be protected from contact with them. Those children who have already been born with syphilis must undergo treatment, after which they constantly visit the hospital until they are 17 years old.

The dermatovenereologist is engaged in the treatment of the disease. In addition, periodically you should be examined by a neurologist, ophthalmologist and pediatrician.

Acquired syphilis is especially dangerous for a child's body. Infection can occur anywhere, both in the circle of close relatives, and somewhere else. Childhood syphilis is treatable, the main thing is that it be started on time and carried out correctly.

Frequently asked questions to the doctor

The likelihood of infection from a sick father

Tell me, if the father of the child has syphilis, what is the probability that the baby will be born sick?

During pregnancy, the child can only become infected from the mother. Therefore, infection is possible only if a man infected a woman, and she, in turn, transmitted the disease to the fetus.

Medicines for treatment

I am pregnant, what medicines can I take to treat syphilis?

Antibiotics from the penicillin series can be used to treat pregnant women for syphilis. But it is worth noting that only specialists can prescribe drugs, self-medication in this position is not permissible.

Antibiotics and pregnancy

I am pregnant, can I take antibiotics for syphilis and how dangerous are they?

Those antibiotics that are prescribed for the treatment of syphilis during pregnancy are generally safe. Occasionally, they can provoke the development of unpleasant allergy symptoms. It is recommended to follow the instructions of the attending physician.

According to foreign authors, the frequency of syphilis in childhood is still 2-4%.

Over the past decades, there has been a decrease in congenital syphilis in children and syphilis in pregnant women.

In the vast majority of cases, the sick mother transmits syphilis to the fetus, while the influence of the father is manifested mainly in the infection of the mother, and the placental mode of transmission must be given priority. Transmission of syphilis by germinal route, through an infected egg cell and through an infected father's seed, is theoretically possible and experimentally proven, but is unlikely to be of practical importance. It has long been known that some women who give birth to children with syphilis do not themselves detect the effects of syphilis and do not become infected with it. From a modern point of view, this immunity of mothers only indicates that this woman is sick with syphilis in a latent form (70-90% of Wasserman's positive reactions). Prophet's position that a mother with syphilis can, without infecting the fetus with syphilis, pass immunity to him, is now shaken: children are simply sick with syphilis in a latent form (Wasserman's reaction is positive in most of these children). But, undoubtedly, there are children of syphilitic mothers who remain free from syphilis for life and with a negative reaction.

In addition to infection during intrauterine life, infection during childbirth is possible: tearing off the placenta, squeezing it out, damage to the chorionic epithelium contribute to the transition of spirochetes from the placenta to the fetal blood. This includes those cases where children are born healthy, but who show signs of syphilis after a few weeks. Infection during childbirth is also possible by infection through the skin, navel, mucous membrane.

The contagiousness of syphilis for the fetus gradually decreases with the duration of the disease. In the father, the first years are sharply contagious, after 3-4 years the strength of the infection falls, while in the presence of syphilis in the mother, syphilis can also affect after 15-20 years. In recent cases, the case ends with syphilitic abortions, stillbirth, then full-term syphilitic children are born; in the future, healthy children can be born.

The treatment of the mother is of great importance. Often, syphilis of parents affects the offspring in some of its low value and dystrophic-degenerative changes. Untreated mothers give birth to healthy-looking children in only 11% of cases, while treated mothers give birth to good offspring in 80%.

Symptoms of congenital syphilis

A child may be born with symptoms of congenital syphilis; in other cases, syphilis manifests itself after some time, after the so-called latent period, lasting several weeks or even months. For the initial period, the most characteristic are lesions of the skin and mucous membranes.

syphilitic runny nose manifested during the next days after childbirth by difficulty in nasal breathing, a kind of sniffling, the release of a sticky bloody-purulent secretion with infiltration of the nasal passages, ulcerations on the septum, shells and cracks in the skin.

Pemphigus happens already at the birth or comes to light within the first week. The vesicles are filled with serous-turbid, sometimes hemorrhagic contents, in which spirochetes are found. In the circumference of the bubbles, an inflammatory corolla is formed. Favorite localization - on the palms, soles and on the flexor surface of the arms and legs, less often on the trunk and face.

Diffuse cellular infiltration of the skin quite characteristic of syphilis. It leads to thickening and thickening of the skin, loss of elasticity. The most typical lesions are the face, soles, palms. The face takes on a numb, mask-like appearance. In the circumference of the nose, mouth, eyelids, cracks, radial scars are observed against the background of inflammatory redness, and later a scab-like eczema-like rash joins. The color of the skin is brownish-pale, the color of coffee with milk. When the infiltration spreads to the scalp, alopecia develops - hair loss in areas of irregular size and shape, as well as hair loss in the eyebrows and eyelashes. On the mucous membrane of the cheeks, hard and soft palate, superficial sores with a slight whitish coating are sometimes observed, sometimes weeping papules near the anus. On the buttocks, in addition to erythema and continuous infiltration, there are superficial erosions, the process often passes to the scrotum, labia.

Infiltrated sole leather, and sometimes the palms appear reddened, with a characteristic peculiar luster (mirror soles), sometimes with the separation of the stratum corneum in large layers.

One of the early forms of disseminated rashes is papular-pustular syphilis with purulent pustules drying into thick crusts. Often there is a polymorphic maculopapular rash, consisting of small infiltrates of bright red or salmon color on the limbs, soles, palms, neck, face. The suction comes from the center and leaves behind a light brown pigmentation.

Occasionally, acne-like syphilis occurs. Roseola congenital syphilis is not very common.

Sometimes ulceration and weeping in the area of ​​the umbilical wound are of a syphilitic nature; this is proved by the presence of spirochetes in the secret.

Lymph nodes in syphilis are usually enlarged, enlargement of the ulnar nodes is especially characteristic.

Bone lesions are quite common and characteristic. Deformities of the nose, snub nose, saddle shape are often noted. The presence of an Olympic forehead is characteristic, due to the deformation of the cranial bones simultaneously with a strong expansion of the cranial veins. Syphilitic osteochondritis is very common (in 77%), periostitis and osteitis are less common. The bones of the forearm, shoulder, and tibia are predominantly affected. Sometimes, as a result of inflammation, the epiphysis separates from the diaphysis, and the diseased limb lies as if paralyzed (Parro's pseudoparalysis). On the radiograph, the epiphyseal line is expanded, curved, next to it, closer to the diaphysis, there is a light strip of granulation tissue; in the area of ​​periostitis, a dark linear tissue surrounding the bone is determined. The phenomena in the area of ​​fingers are less sharply expressed.

Damage to the internal organs play a prominent role. Particularly characteristic is the enlargement and hardening of the liver. Usually we are talking about diffuse hepatitis, liver cirrhosis, often without jaundice and without ascites. But in the presence of scarring processes or with gummy inflammation of the bile ducts, jaundice also develops.

Enlargement of the spleen is the most constant occurrence in syphilis. It is dense, and its increase reaches a significant size.

Often, kidney damage is found with the appearance of protein, cylinders and erythrocytes in the urine.

Of the gastrointestinal symptoms, one can note the presence of habitual vomiting, diarrhea. Sometimes in connection with syphilis there is an increase in the testicles and their dropsy.

On the part of the respiratory apparatus, pneumonia alba, bronchial dilation, and ulceration in the larynx can be put in connection with syphilis. On the part of the heart, murmurs and interstitial inflammation of the myocardium are occasionally encountered.

On the part of the sense organs, the presence of iritis, inflammation of the retina, choroiditis, atrophy of the optic nerve, and deafness can be noted.

On the part of the nervous system, one can note anxiety, transient convulsions, the presence of head dropsy, retarded mental development, and sometimes meningeal and meningo-encephalic convulsions. The autonomic nervous system and endocrine apparatus are often affected ( thyroid, adrenals).

In the blood, the presence of anemia is noted, in severe cases it sometimes proceeds according to the type of pseudoleukemic. The erythrocyte sedimentation reaction is accelerated, the osmotic stability of erythrocytes is increased, coagulability is slowed down, and the viscosity is increased.

Of the general symptoms of untreated syphilis, one can note the poor physical development of children, weight retardation, frailty, predisposition to other diseases. At the same time, general lethargy, apathy, strong screams at night are noted. During the period of occurrence of exanthema or involvement in the process of internal organs, a slight fever is observed.

Symptoms of late syphilis

The so-called late syphilis, which manifests itself most often at the age of 8-14 years, can also be characterized as gummous. Gummas with this form are of various sizes and are located on the soft palate, tonsils, on the sternum, skull, hard palate, and shins. They leave behind ulcers and persistent, bone scars soldered to the skin.

Characteristic of late syphilis is hyperplastic periostitis on the diaphysis of the tibia, leading to the formation of saber-shaped thickenings and bone tumors. So-called nocturnal bone pains are characteristic. Sometimes syphilitic drives develop. The Gutchinson triad is characteristic - keratitis, deafness and Gutchinson's teeth. These latter are characterized by the presence of a lunate recess with a rounded edge on the incisors on the chewing surface. Hummous damage to the liver (with jaundice) and spleen often develops. Damage to the central nervous system gives persistent headaches, epileptiform convulsions, hemiparesis, hemiplegia, mental retardation.

Atypical forms of syphilis and relapses

It should not be thought that every child with syphilis will have the entire symptom complex described above. Quite frequent are cases of congenital syphilis without skin manifestations with an exclusive lesion of the internal organs. Relatively frequent are rudimentary forms with insignificant skin manifestations (slight sniffing through the nose, mild seborrhea of ​​the superciliary arches, slight erythema on the soles, indistinct spots). There are children without any clinical manifestations, but giving a positive Wasserman reaction. Very young children have a septic form with an acute onset, high fever, profuse rash, vomiting, diarrhea, bleeding.

You should always remember about the possibility of recurrence of syphilis. These recurrences represent a repetition of already former skin manifestations. The most common form is condylomas of the skin - weeping papular growths around the anus and genitals. Similar formations can be found on the mucous membranes in the nasal cavity, mouth, pharynx, larynx. Gummy manifestations are less common - gummas of the bones, gummous osteomyelitis, gummas of the liver, kidneys, intestines, testicles, sometimes there are gummas on the skin, in the subcutaneous tissue, in the larynx.

Acquired extrasexual syphilis

Acquired extrasexually, syphilis in children is observed when hygiene rules are violated. Infection occurs through kissing, sucking, through dishes, direct contact. The most common localization of the primary focus is the oral cavity and lower lip. Acquired syphilis in children proceeds as in adults, giving the stage of primary infiltration with buboes, the secondary stage with rash and warts, and the tertiary stage with gummas. The rash is often patchy and roseolous.

Diagnosis and prognosis

Children with syphilis have a slightly lower viability and stamina than healthy ones. For the prognosis, the nature of the syphilis of the parents matters. Cases with pronounced visceral syphilis are not particularly favorable. The earlier treatment is started, the better the prognosis. The prognosis worsens if side infections are mixed with the underlying disease. Relapses of a condylomatous nature proceed favorably. Manifestations in late syphilis are more persistent. Properly treated children with syphilis can remain clinically healthy and develop normally; sometimes a physical or mental retardation develops, sometimes a dystrophic-degenerative condition.

The diagnosis of congenital syphilis is not so easy, since one must be able to make it with mild and unclear clinical manifestations. It is necessary to take into account the entire set of anamnesis data (abortions, stillbirths, etc.). Sometimes an x-ray of the bones solves the problem. The Wasserman reaction is always needed. When evaluating it, it should be remembered that some children without syphilis in the first weeks of life give a positive Wasserman reaction and that in sick children in the first weeks of life, the Wasserman reaction may be negative. It is desirable to supplement this reaction with the Sachs-George, Kahn reaction. Repeated analyzes and systematic observation of the child are necessary. We should not forget the method of finding spirochetes in the products of skin secretions (from blisters of pemphigus, umbilical wound), as well as in conjunctival secretions and in nasal mucus.

Prevention of syphilis

Preventive measures to combat syphilis are determined by the social moments of its spread. Through the properly organized work of women's clinics, it is necessary to establish an accurate record of all pregnant women with syphilis in venereal dispensaries, to conduct treatment and long-term monitoring of them. Family surveys are highly desirable in some cases. To protect children from non-sexual infection, it is necessary to study everyday life, the sanitary and hygienic situation, and sanitary and educational work. Depending on the indications, isolation of children, hospitalization of parents is carried out. It is advisable to hospitalize sick children under one year old with their mother. For ballroom babies, special nurseries are desirable. Older children need to be treated for a long time, leaving them in the usual conditions of the family and school.

As the duration of syphilis increases and the intensity of treatment increases, the harm done to children is greatly mitigated. Although there is no absolute guarantee against infection of children, in practice it is necessary to allow marriage if at least 4 years have passed from infection with syphilis and systematic treatment has been carried out. For the health of the child, timely detection of syphilis in a pregnant woman and timely treatment are extremely important.

A child born to parents with syphilis (in open or latent form) can only be fed by the mother. A mother can feed her child in all cases, regardless of whether she has or does not have symptoms of the disease, and regardless of the presence or absence of signs of lues in the child, but subject to careful monitoring of both and their treatment.

Only if the mother fell ill in the last months of pregnancy and the child was born healthy, is it possible to become infected; therefore, it is desirable to isolate the child from contact with the mother and to feed with expressed milk.

Feeding of children who have lost their mother during the first weeks of life is preferably carried out with expressed milk. Only with a longer observation and repeated negative Wasserman reactions can a child be considered healthy.

Treatment

Children born to mothers with syphilis should be treated if they have, if not pathognomonic, then at least some of the "probable" signs of lues. As for children who look healthy, but born to mothers with syphilis, long-term monitoring, repeated serological tests and treatment according to indications are necessary.

For the treatment of children, mercury and salvarsan were most often used before, as in adults. The dose of novarsenol is calculated for infants at 0.02 per 1 kg of weight, for children 2-4 years old - at 0.01-0.015 and for older children - 0.015 per 1 kg of weight. But it is more advisable to start the first injections in infants with a dose of 0.01-0.015 per 1 kg of weight. For weak children, the first dose should be reduced: 0.005-0.01 per 1 kg of weight. Novarsenol dissolves readily in hot, sterile saline and is administered intravenously.

A good drug for intramuscular injections is miarsenol in the same doses.
The new drug sovarsen is dosed in doses of 0.0025-0.005 up to 1 year, 0.005-0.25 for children 1-3 years old and 0.01-0.03 for children 3-10 years old.

Mercury for injection is used in the form of a 3-5% suspension of calomel or 1% oxycyanic mercury at 0.3-0.5 to 1 year, 0.5-1.0 - 2-5 years and 1.0-1.5 - older children. Sublimate is less commonly used. If mercury injections are poorly tolerated, they are replaced by rubbing a gray mercury ointment at 0.1 per 1 kg of body weight. Sublimate baths are less commonly used (0.75-1.0 sublimate per 20 liters of water).

Good results are obtained by treatment per os. For this purpose, osarsol is used in doses of 0.03 for children under 1 year old 2 times a day, 0.06 for children 1-2 years old, 0.15 for children 2-5 years old 3 times a day.

Instead of calomel injections, treatment with bismuth, the Soviet drug bioquinol, can be used at the rate of 0.5-2.0 ml, depending on age, making injections every other day (8-10 ml for the entire course for infants and 15-25 for older children).

Children also tolerate the so-called one-stage method of treatment: infusion of novarsenol or miarsenol injections and half an hour later on the same day injections of bioquinol or mercury in one and a half dosages. Such treatment can be carried out once a week.

With the phenomena of late syphilis, the use of iodine in the form of potassium iodide 5%, 1 teaspoon (dessert) 3 times a day, is indicated.

Treatment is carried out in series. The child should receive 6 to 8 courses of specific treatment.

When using large doses, they are limited to 12 weeks, during which 12 calomel and 12 neosalvarsan injections are carried out. If the Wasserman reaction remains positive, additional courses of treatment are recommended.

Recently, penicillin has been successfully used to treat congenital syphilis in infants. He is appointed by 200-300 thousand units. per 1 kg of weight per course of treatment. Penicillin is administered at 9-20 thousand units. 5 times a day. On the first day, no more than 30 thousand are administered, in the following days the dose is increased by 30 thousand every day and the dosage is adjusted to 120 thousand. The course of treatment is 10-15 days. In total, about 1.5 million units are needed for the course of treatment. After a break of 2 weeks, another 2 courses of treatment with penicillin are carried out. After a 3-week break, 2-3 courses of combined treatment are carried out.

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Signs of primary syphilis in children in the photo may appear on the lips or in the oral cavity. It has to do with the way the infection is transmitted. With congenital syphilis, the area of ​​​​the face and upper limbs is most often affected in children.

Congenital syphilitic rash

Late congenital syphilis in the photo above can develop in several stages and provoke multiple purulent and ulcerative rashes on the neck or shoulders of the child. It is important to note that with congenital syphilis, treatment is carried out from the very first birthday of the child until complete recovery.

throat syphilis

Given the specificity of the photo of congenital syphilis in children, the primary symptoms of the disease can appear in different areas and affect the soft tissues of the child. One of the rarest types of congenital syphilitic infection is syphilis of the throat and tonsils.

Syphilis on the legs

Syphilis in newborns can appear as ulcerative sores on the legs, toes, and feet. In this case, the rash can develop to and affect large areas of the body.

Inflammation of the tonsils with syphilis

With the development of congenital syphilis in children, the photo in the oral cavity looks like multiple inflammatory processes, cracks or inflammation of the lymph nodes.

Complicated congenital syphilis

If the disease is not detected in time and treatment is not started, then in the photo, syphilis in a child can show symptoms of the secondary stage of the disease, provoke multiple purulent rashes on the back or abdomen.

Syphilis on the gums

Among the most common symptoms of syphilis in children, the photo shows the appearance on the gums or on the tongue. At the same time, congenital chancres can provoke damage to the teeth, caries, jaw deformity and wounds in the corners of the mouth or in the sky.

Chancres on hand

IT'S IMPORTANT TO KNOW!

If a child has been diagnosed with late congenital syphilis in the photo, skin manifestations may become more aggressive, affecting large open areas of the hands or lower extremities.

Syphilis in children photo of an advanced stage

An undiagnosed form of syphilis in newborns can provoke the spread of infection throughout the child's body, cause a multiple rash in the area of ​​\u200b\u200bthe forearms and back, and inflame the lymph nodes.

Congenital syphilis in newborns can manifest itself in the form - lesions of one of the tonsils, due to which it swells, becomes inflamed and can release some pus when pressed.

Syphilis in children photo damage to the skin

In the process of development of the next one, large purulent lesions with jagged edges may occur on the child's skin, from which pus or blood often oozes. Such wounds should be treated with bactericidal agents and the infection should be carefully treated.

Venus necklace in children

Children's syphilis in the photo can sometimes develop rapidly and provoke multiple damage to tissues and skin. As a rule, babies are often diagnosed with a multiple rash around the neck, which is commonly called the necklace of Venus.

Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum (Treponema pallidum). The length of this microorganism is from 6 to 20 microns. Outwardly, it looks like a thin spiral moving around its axis. The disease is quickly transmitted through sexual and domestic contact, as well as through the placenta from a sick mother to a child, which causes childhood syphilis.

Pale treponema is quite tenacious; in a humid environment, it can live for several days. Also, the microorganism is practically not sensitive to cold and tolerates temperatures of minus 75 degrees. Get rid of spirochetes only with the help of disinfectants or in the process of boiling.

Ways of infection

Most often, infection of children occurs in utero. In the event that a pregnant woman becomes infected with the disease, spirochetes can penetrate the placenta to the fetus, while at. Intrauterine infection is determined by specific changes in the placenta. If the fetus was affected at 20-28 weeks of development, then the pregnancy may end in premature birth. The fetus is born already dead with characteristic changes in the liver, spleen and respiratory organs.

If the mother was infected with a spirochete at the beginning of the third trimester of pregnancy, the signs of the disease in the newborn appear both in utero and immediately after birth.

Serological blood tests give a positive result for syphilis in the third month of a baby's life. If the mother of a sick child has no signs of an illness, in almost 90% of cases this indicates that her illness proceeds in a latent form.

Other ways of transmission:

• A germinal pathway in which the mother's egg or father's sperm is infected with spirochete pallidum.
• Infection during passage through the birth canal, through the skin, mucous membranes, or when the placenta is torn off.
• If the rules of hygiene are not observed, the pale spirochete enters the body to the child through the umbilical wound.
• Also, a newborn can become infected with syphilis through direct contact with infected relatives through kisses, household items or utensils. In this case, syphilis will be considered acquired.

Signs of early congenital disease

Symptoms of syphilis in newborns appear after a few days or even months. Sometimes a baby is born already with signs of the disease. In the initial stage, the disease affects the skin and mucous membranes. After the first year of the disease, its symptoms disappear, and syphilis becomes chronic.

Pemphigus

It can be congenital or occurs within seven days after the birth of the newborn. It manifests itself in the form of vesicles with cloudy contents along the periphery surrounded by an inflamed border. It affects the soles and palms, the flexion surfaces of the limbs. In more rare cases, pemphigus appears on the baby's body or face.

Runny nose

With syphilis, a runny nose occurs a few days after the birth of the baby:

• Initially, nasal congestion appears.
• Breathing is difficult, there is sniffling. The child is practically unable to suckle at the breast.
• Purulent mucus streaked with blood begins to ooze from the nose.
• Shrinking crusts appear in the nose.
• Ulcers appear on the nasal septum.
• If left untreated, the cartilaginous septum of the palate and nose is destroyed.
• If the larynx is affected, the baby develops hoarseness.

Gochsinger infiltration

Highly characteristic symptom for syphilis affecting the feet, hands, face and genitals. It occurs in 65% of newborns:

• The skin becomes rough and dense, they lose elasticity and shine.
• The baby's face becomes like a mask.
• Around the lips and eyelids and nose, the skin becomes hyperemic, then it becomes covered with scars.
• At the next stage, the skin in the affected area becomes brownish and covered with scabs resembling eczema.
• The child's eyelashes and eyebrows fall out. If the process affects the scalp, partial baldness appears.
• The skin of the soles and palms becomes red and shiny, sometimes it separates in layers.
• The mucous membrane in the mouth is covered with ulcers with a small amount of white plaque.
• The skin of the buttocks is inflamed and covered with weeping erosions, sometimes the process extends to the labia or scrotum.

Changes in the internal organs

Lues usually affects the internal organs of the child:

• Diffuse hepatitis or cirrhosis occurs, which in most cases is not accompanied by jaundice or fluid accumulation in the abdominal cavity. Yellowing of the skin appears when the process of scarring begins and the outflow of bile is disturbed.
• The spleen enlarges to a large size and becomes dense.
• The bronchi expand, the larynx is covered with ulcers.
• With syphilis, children often experience digestive disorders, manifested in the form of vomiting and diarrhea.
• In some cases, the kidneys are affected, and the amount of protein in the urine increases.
• Sometimes boys develop dropsy of the testicles.
• All of these symptoms may be accompanied by fever.

Bone lesion

In newborns with syphilis, the bones are affected very often, and this manifests itself in the form of the following signs:

• Skull deformities. In such children, the frontal tubercles are highly developed, they hang over the eyebrows, and the cranial veins are greatly dilated.
• , in which it becomes too snub-nosed or saddle-shaped.
• In almost 80% of sick children, cartilage and adjacent areas of bones become inflamed (osteochondritis). Most often, the tibia, bones of the shoulder and forearm are affected.
• Less commonly, inflammation of the bone tissue and periosteum occurs.
• Pseudo-paralysis of Parro, in which the arm or leg appears paralyzed as a result of the inflammatory process.

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Damage to the nervous system

Most newborns diagnosed with syphilis have:

• Disorders of mental development.
• The iris of the eyeball becomes inflamed, inflammation of the choroid of the eyes and retina occurs.
• Hearing is lost.
• There may be dropsy of the brain.
• Seizures.
• Lag in physical development.

Often, children with syphilis have pseudoleukemic anemia. With this pathology, blood clotting is impaired, the number of erythrocytes is reduced, and their sedimentation rate is increased. With syphilis in a newborn, the lymph nodes are enlarged, especially in the elbows.

Signs of late congenital disease

Syphilis in children can occur in a latent form, and its first signs appear in a child no earlier than 3 years old, most often at 14-17 years old. In its clinical picture, it resembles the third degree of the acquired form.

There are three unconditional symptoms that directly indicate a congenital disease, all the rest are probable. At the same time, all the signs of the disease appear very rarely.

Symptom	How does it manifest
Hutchinson's teeth (unconditional symptom).	In children with syphilis, semicircular recesses with missing enamel are formed along the edge of the middle incisors. The tooth thickens in the neck area and resembles a barrel.
Labyrinth deafness (unconditional symptom).	This sign is observed in 6% of children with secondary syphilis. Most often it appears in girls whose age is from 5 to 15 years. As a result of the inflammatory process, the auditory nerves are damaged, and the child becomes deaf. If the symptom develops before the age of 4 years, then deafness is combined with speech problems or muteness.
Parenchymal keratitis (unconditional symptom).	Initially, the disease develops in one eye, after six months it begins in the second. Its manifestations include photophobia, corneal clouding, blepharospasm, lacrimation. The patient has a sharp and irreversible decrease in visual acuity. With atrophy of the optic nerve, complete blindness occurs.
Specific drives (conditional symptom).	Manifested as a chronic inflammation of the synovial membrane. The result is an accumulation of fluid in the joint cavity. Visually, this manifests itself in the form of puffiness. Accompanied by pain and stiffness.
Saber-shaped legs (conditional symptom).	The inflammatory process provokes the rapid growth of bones. In this case, the tibia, under the weight of the weight, bends forward. The cause is syphilitic osteochondritis transferred in infancy.
Nose deformity (conditional symptom).	Almost 20% of children with symptoms of the late form of the disease have a saddle-shaped nose with protruding nostrils. Pathology occurs as a result of the fact that the nasal cartilage and bones are destroyed.
Deformation of the teeth (conditional symptom).	On the underdeveloped chewing surface of the fangs, a thin conical process "pike tooth" appears.

Acquired

In the event that syphilis is transmitted to a child by household means, its incubation period is from 3 to 4 weeks. It develops gradually and at different stages is accompanied by various symptoms.

First stage

• At the initial stage of syphilis upon completion incubation period on the body of the baby, most often on the face or mucous membrane of the mouth, at the site of the introduction of the pale spirochete, a single hard chancre develops. It is an ulcer with jagged edges and a smooth bottom. Chancre may be honey or dark in color with a grayish coating in the middle. Purulent contents ooze from the ulcer. To the touch, the bottom of the hard chancre is dense, resembling cartilage.
• The ulcer does not cause pain, so this period of syphilis in 40% of cases goes unnoticed. In parallel, closely spaced lymph nodes increase. They are practically painless, without suppuration and changes in the skin over them.
• After the hard chancre heals, a red scar remains in its place, which turns white over time. The seal under it resolves within a month. In most cases, a child's chancre quickly disappears or does not develop at all.

Second stage

• About two months after the appearance of a hard chancre, the body of the child begins to become covered with a rash. By this time, all peripheral lymph nodes are already enlarged.
• The rash can be in the form of spots, pustules with purulent contents, mother-of-pearl nodules, small ulcers. Weeping often appears in infants. The rash can affect not only the skin, but also the mucous membranes. Moistures are the most contagious, they contain the largest number of treponemas.
• Disappearing, the rash leaves behind brown pigment spots, which eventually lighten and become invisible.
• If the treatment was carried out poorly, syphilis can recur six months after infection. A rash appears on the skin again, and on the mucous membranes there are papules or condylomas, reaching large sizes with an ulcer in the center.
• There are bald spots on the head.

29.06.2017

Syphilis is a sexually transmitted infection that is transmitted during intimacy. The disease used to be called lues.

The causative agent of an infectious disease are bacteria called treponema pallidum. When entering the body, pathogenic microorganisms affect the skin, mucous membranes, vital organs, nervous and skeletal systems.

Syphilis can be contracted through vaginal, oral or anal sex. It is not uncommon for patients to become infected through a kiss. This happens when an infected person has sores on the lips, on the mucous membrane of the oral cavity.

A child can become infected with syphilis in utero or during the birth process. The causative agents of syphilis easily cross the placental barrier. This can provoke severe gestation of the fetus and the development of serious abnormalities in it.

What happens in the child's body when infected

If during pregnancy the expectant mother suffered a secondary stage of syphilis, then the child may develop early congenital syphilis. Its manifestations can be seen already in the second month of a baby's life.

Congenital syphilis contributes to the defeat of the central nervous system, vital organs, mucous membranes and cause significant changes in the skin.

Congenital syphilis occurs in conjunction with pseudoparalysis, that is, soft tumors are formed in the long tubular bone.

When the nervous system is affected, meningitis develops, accompanied by convulsive syndromes; eye pupils have a different size and shape; paralysis.

The development of syphilitic meningitis occurs gradually, the temperature gradually rises. In the first ten days of life, the baby is hyperexcitable and has occasional seizures.

A frequent complication of congenital syphilis is a violation of the normal development of the brain. Hydrocephalus develops due to hypersecretion of cerebrospinal fluid and narrowing of the CSF space.

This is due to syphilitic lesions of the membrane and epithelial membrane of the cardiac ventricles.

Three months after birth, an infectious disease may be accompanied by distal peripheral paralysis of the upper extremities.

Up to four years, the child has neurological disorders that cause specific endarteritis. vascular obliteration and cerebral ischemia.

There are frequent cases of central hemiparesis with a focal or secondary generalized convulsive attack.

The vascular form of syphilis may be accompanied by isolated reflex immobility of the pupils and different size, feeling of the upper eyelid, strabismus and atrophy of the optic nerve.

The clinical course delays the intellectual development of the baby.

After four years, congenital syphilis develops into inflammation of the cornea, labyrinthine deafness, saddle nose deformity, and tooth dystrophy.

Paralysis begins to progress from the age of twelve and neurological symptoms slowly increase, namely, mental and mental development, behavioral disorders.

If appropriate treatment is not started in time, then pregnancy can end in miscarriage, premature birth, and the development of intrauterine pathologies. It is possible that the baby will still be born or die a few months after birth.

Syphilis and kindergarten

No matter how hard parents try and protect their child, there are diseases that cannot be avoided. Especially, it concerns "collective" diseases.

Most of the diseases, the child picks up in kindergarten because children share personal hygiene items such as toilet, bedding, dishes, and so on. A child with an infection can easily pass it on to another kindergarten student.

It's a shame that in our time, it is easier for medical workers to pay money to the inspection commission than to carefully monitor the order and cleanliness in the kindergarten.

This is not a reason not to take your child to kindergarten, you just need to take care of an additional measure of security.

If parents with syphilis who are undergoing appropriate treatment send their child to a kindergarten, they must notify the management of the preschool institution about this.

Parents must provide a certificate stating that the child is healthy and they are undergoing treatment.

If during the passage of the medical commission, one of the employees was diagnosed with an infectious disease, then the doctors must check the rest of the employees and all children. At the same time, the sick caregiver is suspended from work.

Until the doctors check all the children, the kindergarten is closed for quarantine.

Symptoms of an infectious disease in children

Syphilis develops in several stages and its symptoms depend on it. In medical practice, very often there are situations when a pregnant woman is unaware of the development of an infection in her body, and passes it on to her unborn child.

When a woman is planning a child, she should carefully monitor her body. She should be alerted by the appearance of ulcers on the skin or mucous membranes.

Ulcers begin to appear a month after infection. A woman may not notice the formation of ulcers in the mouth or in the vagina. If treatment is not started, then the symptoms may disappear, but at this time, syphilis pathogens continue to multiply and spread throughout the body, thanks to the circulatory system.

The first symptoms of syphilis are an increase in lymph nodes, the appearance of skin rashes on the palms and feet.

During pregnancy, such symptoms can occur in any month. Because of this, the risk of intrauterine infection increases.

After the baby is born, it is examined by specialists. If there are skin rashes, damage to the skin on the genitals and around the anus, nasal discharge, enlarged lymph nodes, pneumonia and anemia, then these are the first symptoms of syphilis in children.

How does syphilis manifest itself in children? Syphilis in children, as in adults, can occur without obvious symptoms, but after two or three months, signs of syphilis in children will definitely appear.

After a few years, syphilis can manifest itself as a neurological disease, bone and tooth deformity. The child may become deaf or blind. Therefore, it is very important to diagnose the disease on early term development.

Diagnosis of syphilis in childhood

It is necessary to diagnose syphilis based on the characteristic skin rashes and the internal state of the child's body. First of all, the doctor conducts an epidemiological history, which indicates the presence of patients with syphilis in the family. And of course, laboratory tests are carried out.

Laboratory diagnosis is carried out using bacterioscopic and serological studies.

In order to optimally influence the children's body, doctors perform dark-field and phase-contrast microscopy.

Histological preparations are prepared, which are impregnated with silver. For research, the detachable part of the chancre, punctate of the lymph node and scraping of roseola, etc. are taken.

Serological reaction is the main method of laboratory research of the syphilis pathogen. In addition to diagnosis, it is used to evaluate the effectiveness of treatment and to observe the healing process.

There are two types of serological reaction:

1. Nonspecific is carried out without the participation of pale treponema. Diagnosis is carried out by the Wasserman reaction (express diagnosis of syphilis) and a laboratory study of a sexually transmitted disease. To do this, take a biological material and place it on a glass slide, adding cardiolipin-lecithin-cholesterol Ar to it. A positive reaction can be in the middle of the primary and during the secondary stage, in the third stage, the result can be negative.
2. Specific. Treponema pallidum immobilization reaction and immunofluorescence reaction are carried out. The results can be positive in most cases of primary seronegative period.

Treatment of syphilis in children

If the baby was born without any signs of syphilis, but the mother is infected, then treatment is still carried out. These kids are being watched for a long time.

Doctors regularly take samples for serological testing. In such cases, syphilis in children is treated as indicated.

Previously, salvarsan and mercury were used to treat syphilis in childhood. Novarsenol for newborns was prescribed 20 mg per 1 kg of total weight. For children aged two to four years - 10 mg per 1 kg of total weight, and 15 mg for older children.

A dosage for newborns of 10 mg per kg of weight will be considered appropriate, and if the newborn is weakened, then 5 mg at all. Novarsenol is administered intravenously, you need to dilute it in hot sterile saline.

Miarsenol has a positive effect, which is administered in the same way as Novarsenol. The dosage is the same.

In medicine, the drug Sovarsen is used, with a dosage of 2.5 mg for children under one year old, 5 mg for children under three years old and 10-20 mg from three years old.

Doctors can prescribe osarsol with a dosage of 3 mg for infants, after a year - 6 mg, after two years 15 mg. medicinal product taken three times a day.

First, the child is injected with Novarsenol or Miarsenol by injection, after 30 minutes an injection is made with bioquinol or mercury. The dosage has been halved. This method of therapy is carried out once every 6 days.

If the baby was diagnosed with late syphilis, then doctors prescribe 5% potassium iodide 10 mg three times a day. The course of treatment is carried out in periods. the child must go through at least six such periods.

If doctors prescribe large doses, then the treatment lasts three months. During this time, the child should receive calomel and neosalvar injections, each with 12 pieces.

If, with a repeated Wasserman reaction, the results are positive, then the child undergoes an additional course of treatment.

To date, for the treatment of a newborn diagnosed with syphilis, penicillin is a great success. The injection is carried out every five hours. Treatment begins with a minimum dosage and gradually increase it.

The course of treatment lasts two weeks, then there is a break and a second course is carried out. In general, there should be three such courses. After that, the child receives combined treatment.

Prevention of infectious disease

There is no specific immunoprophylaxis, so it is worth paying attention to non-specific preventive measures.

For the prevention of acquired syphilis, regular preventive examinations of people who work in medical and children's institutions and food enterprises are used.

In schools and institutes, teachers should carry out health education and teach teenagers the basic rules of personal hygiene and sexual literacy and organize individual prevention.

In order to prevent congenital syphilis, a woman during the gestation period should be on a dispensary examination in a antenatal clinic. A pregnant woman undergoes a double serological control in the first and third trimester.

When a woman diagnosed with syphilis gives birth to a child, doctors monitor the child for the first year of life. The next observation is carried out at the age of 16 years.

If syphilis is acquired and diagnosed at an early stage, then doctors put a favorable prognosis, but congenital syphilis has a less favorable outcome.