Diagnosis

Syphilis can be diagnosed by testing samples of:

  • Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the bacteria that cause syphilis remain in your body for years, so the test can be used to determine a current or past infection.
  • Cerebral spinal fluid. If it's suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).

Through the Centers for Disease Control and Prevention, your local health department offers partner services, which will help you notify your sexual partners that they may be infected. That way, your partners can be tested and treated and the spread of syphilis can be curtailed.

Treatment

When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor will suggest another antibiotic.

A single injection of penicillin can stop the disease from progressing if you've been infected for less than a year. If you've had syphilis for longer than a year, you may need additional doses.

Penicillin is the only recommended treatment for pregnant women with syphilis. Women who are allergic to penicillin can undergo a desensitization process that may allow them to take penicillin. Even if you're treated for syphilis during your pregnancy, your newborn child should also receive antibiotic treatment.

The first day you receive treatment you may experience what's known as the Jarisch-Herxheimer reaction. Signs and symptoms include a fever, chills, nausea, achy pain and headache. This reaction usually doesn't last more than one day.

Treatment follow-up

After you're treated for syphilis, your doctor will ask you to:

  • Have periodic blood tests and exams to make sure you're responding to the usual dosage of penicillin
  • Avoid sexual contact until the treatment is completed and blood tests indicate the infection has been cured
  • Notify your sex partners so that they can be tested and get treatment if necessary
  • Be tested for HIV infection
Aug. 17, 2016
References
  1. Syphilis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/syphilis/default.htm. Accessed March 28, 2016.
  2. Hicks CB, et al. Pathogenesis, clinical manifestations, and treatment of early syphilis. http://www.uptodate.com/home. Accessed March 28, 2016.
  3. Longo DL, et al., eds. Syphilis. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed March 28, 2016.
  4. Hicks CB. Diagnostic testing for syphilis. http://www.uptodate.com/home. Accessed March 28, 2016.
  5. Centers for Disease Control and Prevention, et al. Sexually transmitted diseases: Treatment guidelines 2015. MMWR. 2015;64:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm. Accessed March 28, 2016.
  6. Partner services FAQs for the public and consumers of partner services activities. Centers for Disease Control and Prevention. http://www.cdc.gov/nchhstp/partners/faq-public.html. Accessed March 28, 2016.
  7. Syphilis – 2015 sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention. http://www.cdc.gov/std/tg2015/syphilis.htm. Accessed March 28, 2016.