Syphilis

Diagnosis

Your healthcare providers can diagnose syphilis by the following:

• Physical examination: Your healthcare provider is going to ask about your past sexual experiences, including if you engage in safe sexual behavior. It’s important that you be truthful during this assessment. Your healthcare provider can assist in determining your risk and suggest testing for additional STIs.
• Blood test: Antibody proteins can be confirmed by blood testing. These are produced by the immune system to combat infections. The body retains syphilis-causing bacteria antibodies for years. Therefore, blood testing can be used to detect infection, either past or present.
• Discharge from a sore: To verify if syphilis was the source of the sore, a laboratory can examine this fluid under a microscope.
• Lumbar puncture: Your healthcare provider may suggest testing the fluid that surrounds the spinal cord and brain, if they believe you have syphilis-related nervous system issues. Cerebrospinal fluid is extracted using a needle from the space between two back bones.

You can alert your sexual partners that they could be infected if you find the infection early. By investigating and managing your relationships, you may stop the spread of syphilis.

Treatment

Early Detection and Treatment
Syphilis, when identified and treated in its initial stages, can be effectively cured. Penicillin, an antibiotic, is the primary treatment option for all stages of syphilis as it effectively eliminates the bacteria responsible for the infection.

Alternatives for Penicillin Allergy
For individuals allergic to penicillin, alternative antibiotics may be recommended. Alternatively, a penicillin desensitization process can be conducted, allowing the individual to safely receive penicillin. This procedure, overseen by an allergist or immunologist, involves administering incrementally increasing doses of penicillin over approximately 4 hours.

Treatment regimens

• Early syphilis (primary, secondary, early-stage latent): A single dose of penicillin is recommended.
• Late-stage syphilis (over one year): Multiple doses may be required.
• Pregnant individuals: Penicillin is the only endorsed treatment to prevent congenital syphilis in newborns. Those allergic to penicillin can undergo desensitization.

Post-treatment for newborns
Newborns should be tested for congenital syphilis, receiving antibiotic treatment if infected.

Potential initial reaction
Following treatment, individuals might experience the Jarisch-Herxheimer reaction, characterized by fever, chills, nausea, aches, and headache. This reaction typically lasts no more than one day.

Follow-up and precautions

• Regular monitoring: Post-treatment, it is crucial to undergo regular blood tests and examinations to confirm the effectiveness of the penicillin treatment, with the frequency and type of follow-up tests varying according to the syphilis stage.
• Sexual activity: It is advised to abstain from sexual contact with new partners until the completion of the treatment regimen. Clearance should be confirmed through blood tests, and any sores should have healed before resuming sexual activity.
• Partner notification: Informing sexual partners about the infection is essential for their testing and potential treatment.
• HIV testing: Getting tested for HIV is also recommended as part of the syphilis treatment follow-up.