Diagnosis

Tests

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 syphilis-causing bacteria remain in your body for years, so the test can be used to determine a current or past infection.
  • Cerebrospinal 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 limited.

Treatment

Medication

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 may suggest another antibiotic or recommend penicillin desensitization.

If you are diagnosed with primary, secondary or early-stage latent syphilis (by definition, less than a year), the recommended treatment is a single injection of penicillin. 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 be tested for congenital syphilis and if infected, 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 a 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. Your specific follow-up will depend on the stage of syphilis you're diagnosed with.
  • Avoid sexual contact with new partners 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.

Coping and support

Finding out you have syphilis can be extremely upsetting. You might experience anger if you feel you've been betrayed, or shame if you think you've infected others.

However, hold off placing blame. Don't assume that your partner has been unfaithful to you. One (or both) of you may have been infected by a past partner.

Preparing for your appointment

Most people don't feel comfortable sharing the details of their sexual experiences, but the doctor's office is one place where you have to provide this information so that you can get the right care.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all medications, vitamins or supplements you're taking.
  • Write down questions to ask your doctor.

Some basic questions to ask your doctor include:

  • What's the medical name of the infection I have?
  • How, exactly, is it transmitted?
  • Will it keep me from having children?
  • If I get pregnant, could I give it to my baby?
  • Is it possible to catch this again?
  • Could I have caught this from someone I had sex with only once?
  • Could I give this to someone by having sex with that person just once?
  • How long have I had it?
  • I have other health conditions. How can I best manage them together?
  • Should I not be sexually active while I'm being treated?
  • Does my partner have to go to a doctor to be treated?

What to expect from your doctor

Giving your doctor a complete report of your symptoms and sexual history will help your doctor determine how to best care for you. Here are some of the things your doctor may ask:

  • What symptoms made you decide to come in? How long have you had these symptoms?
  • Are you sexually active with men, women or both?
  • Do you currently have one sex partner or more than one?
  • How long have you been with your current partner or partners?
  • Have you ever injected yourself with drugs?
  • Have you ever had sex with someone who has injected drugs?
  • What do you do to protect yourself from sexually transmitted infections (STIs)?
  • What do you do to prevent pregnancy?
  • Has a doctor or nurse ever told you that you have chlamydia, herpes, gonorrhea, syphilis or HIV?
  • Have you ever been treated for a genital discharge, genital sores, painful urination or an infection of your sex organs?
  • How many sex partners have you had in the past year? In the past two months?
  • When was your most recent sexual encounter?

What you can do in the meantime

If you think you might have syphilis, it's best to avoid sex until you've talked with your doctor. If you do engage in sexual activity before seeing your doctor, be sure to follow safe sex practices, such as using a condom.