The symptoms of secondary syphilis will go away with or without treatment. However, without treatment, the infection will progress to the latent and possibly tertiary stage of disease. The latent hidden stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis.
Without treatment, the infected person will continue to have syphilis in their body even though there are no signs or symptoms. Early latent syphilis is latent syphilis where infection occurred within the past 12 months.
Late latent syphilis is latent syphilis where infection occurred more than 12 months ago. Latent syphilis can last for years. Tertiary syphilis is rare and develops in a subset of untreated syphilis infections;, it can appear 10—30 years after infection was first acquired, and it can be fatal. Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms of tertiary syphilis vary depending on the organ system affected.
Syphilis can invade the nervous system neurosyphilis , visual system ocular syphilis , or auditory system otosyphilis at any stage of infection. These infections can cause a wide range of symptoms. When a pregnant woman has syphilis, the infection can be transmitted to her unborn baby. All pregnant women should be tested for syphilis at the first prenatal visit.
Some women need to be tested again during the third trimester 28 weeks gestation and at delivery. This includes women who live in areas of high syphilis morbidity, are previously untested, had a positive screening test in the first trimester, or are at higher risk for syphilis i.
Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases. An infected baby born alive may not have any signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks.
Untreated babies may become developmentally delayed, have seizures, or die. All babies born to mothers who test positive for syphilis during pregnancy should be screened for syphilis and examined thoroughly for evidence of congenital syphilis.
Treponemal tests e. Treponemal antibodies appear earlier than nontreponemal antibodies and usually remain detectable for life, even after successful treatment. If a treponemal test is used for screening and the results are positive, a nontreponemal test with titer should be performed to confirm diagnosis and guide patient management decisions.
Based on the results, further treponemal testing may be indicated. Reverse sequence testing can identify persons previously treated for syphilis and those with untreated syphilis.
False-positive results can occur in those with low likelihood of infection with reverse sequence testing as well. Special note: Because untreated syphilis in a pregnant woman can infect her developing baby, every pregnant woman should have a blood test for syphilis. All women should be screened at their first prenatal visit. Some patients should receive a second test during the third trimester at 28 weeks and again at delivery.
All infants born to mothers who have reactive nontreponemal and treponemal test results should be evaluated for congenital syphilis. A quantitative nontreponemal test should be performed on infant serum and, if reactive, the infant should be examined thoroughly for evidence of congenital syphilis.
Suspicious lesions, body fluids, or tissues e. Other recommended evaluations may include analysis of cerebrospinal fluid by VDRL, cell count and protein, CBC with differential and platelet count, and long-bone radiographs. For further guidance on evaluation of infants for congenital syphilis, please refer to the STI Treatment Guidelines.
There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. The recommended treatment for adults and adolescents with primary, secondary, or early latent syphilis is Benzathine penicillin G 2. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is Benzathine penicillin G 7.
CSF is a clear liquid found in your brain and spinal cord. For this test, your CSF will be collected through a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:. You don't need any special preparations for a syphilis blood test. For a lumbar puncture, you may be asked to empty your bladder and bowels before the test. There is very little risk to having a blood test.
You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. If you had a lumbar puncture, you may have pain or tenderness in your back where the needle was inserted. You may also get a headache after the procedure. If your screening results were negative or normal, it means no syphilis infection was found.
Since antibodies can take a couple of weeks to develop in response to a bacterial infection, you may need another screening test if you think you were exposed to the infection.
Ask your health care provider about when or if you need to be re-tested. If your screening tests show a positive result, you will have more testing to rule out or confirm a syphilis diagnosis. If these tests confirm you have syphilis, you will probably be treated with penicillin, a type of antibiotic.
Most early-stage syphilis infections are completely cured after antibiotic treatment. Later-stage syphilis is also treated with antibiotics. Antibiotic treatment for later-stage infections can stop the disease from getting worse, but it can't undo damage already done. Learn more about laboratory tests, reference ranges, and understanding results. If you are diagnosed with syphilis, you need to tell your sexual partner, so he or she can get tested and treated if necessary.
The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.
Syphilis Tests. What are syphilis tests? What are they used for? Syphilis tests are used to screen for and diagnose syphilis. Screening tests for syphilis include: Rapid plasma reagin RPR , a syphilis blood test that looks for antibodies to the syphilis bacteria. Antibodies are proteins made by the immune system to fight foreign substances, such as bacteria. Venereal disease research laboratory VDRL test, which also checks for syphilis antibodies. A VDRL test can be done on blood or spinal fluid.
The VDRL test checks blood or spinal fluid for an antibody that can be produced in people who have syphilis. This antibody is not produced as a reaction to syphilis specifically, so the test result could be "abnormal" for reasons other than syphilis. Rapid plasma reagin RPR test. The RPR test also finds syphilis antibodies. Rapid immunochromatographic test.
This test checks for antibodies that are specific to syphilis. Unlike other tests, the blood sample is not sent to a laboratory. You can find out the results at your doctor visit. Tests to confirm syphilis Tests used to confirm a syphilis infection include: Enzyme immunoassay EIA test. This blood test checks for syphilis antibodies. This test also checks for antibodies.
It can be used to find syphilis except during the first 3 to 4 weeks after exposure. The test can be done on a sample of blood or spinal fluid. Treponema pallidum particle agglutination assay TPPA. It is used after another method tests positive for syphilis.
This test is not done on spinal fluid. Darkfield microscopy. This test uses a special microscope to look for the syphilis germ in a sample of fluid or tissue from an open sore. This test is used mainly to diagnose syphilis in an early stage.
The MHA-TP is used to confirm a syphilis infection after another test shows positive results for syphilis. Why It Is Done A syphilis infection can spread through the bloodstream to all parts of the body. A test for syphilis is done to: Screen for syphilis or check how well treatment is working. Screening tests help your doctor look for a certain disease or condition before any symptoms appear. This increases the chance of finding the infection when it can be cured or treated to avoid long-term problems.
How To Prepare Tell your doctor if you: Are taking any medicines, such as antibiotics. Are allergic to any medicines, especially antibiotics or medicine used to numb the skin anesthetics. Take a blood thinner , or if you have had bleeding problems. Are or might be pregnant. How It Is Done A syphilis test may be done on a sample of blood, sore, skin, or spinal fluid, depending on which type of test is done.
Blood sample Blood test from a finger stick For a fingertip sample, the health professional taking the sample will: Clean your hand with soap and warm water or an alcohol swab. Massage your hand without touching the puncture site.
Puncture the skin on the side of your middle or ring finger with a small instrument called a lancet. Wipe away the first drop of blood.
Place a small tube on the puncture site and collect a small amount of blood. Put a gauze pad or cotton ball over the puncture site as the tube is removed.
Put pressure on the site and then put on a bandage. Blood test from a vein The health professional taking a sample of your blood will: Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein. Clean the needle site with alcohol. Put the needle into the vein. More than one needle stick may be needed. Attach a tube to the needle to fill it with blood. Remove the band from your arm when enough blood is collected.
Put a gauze pad or cotton ball over the needle site as the needle is removed. Sore or skin sample A sample of fluid or tissue may be taken from an open sore or from a rash that might be caused by syphilis.
A fluid sample is obtained by gently pressing the sore. Skin or mucous membrane samples may be obtained by gently rubbing a cotton-tipped swab over the area. Spinal fluid sample A spinal tap lumbar puncture is done to collect a spinal fluid sample for syphilis testing. How It Feels Blood sample The blood sample is taken from a vein in your arm or from your fingertip.
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