Diagnosis
You may be able to use a test that's available without a prescription, sometimes called an at-home test, to see if you have syphilis. If that test shows you have syphilis, you'll need to see a healthcare professional to confirm the diagnosis and start treatment.
Your healthcare team can find syphilis by testing samples of:
- Blood. Blood tests can confirm the presence of proteins called antibodies. The immune system makes these to fight infections. The antibodies to the bacteria that causes syphilis stay in the body for years. So blood tests can be used to find a current or past infection.
- Fluid from a sore. A laboratory can study this fluid under a microscope to confirm that syphilis caused the sore.
- Fluid that surrounds the brain and spinal cord. Another name for this is cerebrospinal fluid. If your care team thinks that you have nervous system problems from syphilis, they might recommend testing this fluid. A needle is used to take a sample of cerebrospinal fluid from between two of the bones in the back. This procedure is called a lumbar puncture.
Remember, your local health department may offer partner services. These help you notify your sexual partners that they may be infected. Your partners can be tested and treated, limiting the spread of syphilis.
Treatment
Medications
Syphilis is simple to cure when it's found and treated in its early stages. The preferred treatment at all stages is penicillin. This antibiotic medicine can kill the bacteria that causes syphilis.
If you're allergic to penicillin, your health care team may suggest another antibiotic. Or they may recommend a process that safely helps your body get used to penicillin over time.
The recommended treatment for primary, secondary or early-stage latent syphilis is a single shot 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 people with syphilis. Those who are allergic to penicillin can follow a process that may allow them to take the medicine. The procedure is called penicillin desensitization.
It's done by a specialist called an allergist or an immunologist. It involves taking tiny amounts of penicillin every 15 to 20 minutes over about 4 hours.
Even if you're treated for syphilis during your pregnancy, your newborn should be tested for congenital syphilis. A baby infected with the syphilis bacterium receives antibiotic treatment.
The first day you receive treatment, you may have what's known as the Jarisch-Herxheimer reaction. Symptoms include a fever, chills, nausea, achy pain and a headache. Most often, this reaction doesn't last more than one day.
Treatment follow-up
After you're treated for syphilis, your health care team likely will ask you to:
- Have regular blood tests and exams to make sure the penicillin treatment is working. The follow-up tests you need depend on the stage of syphilis you have.
- Do not have sexual contact with new partners until the treatment is finished. Blood tests should show that the infection has been cured, and any sores should be gone.
- Tell your sex partners so they can be tested and get treatment if needed.
- Get tested for HIV.
Coping and support
Finding out you have syphilis can be upsetting. You might get angry if you feel you've been betrayed by a partner. Or you might feel shame if you think you've infected others.
Hold off placing any 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
Many people don't feel comfortable sharing the details of their sexual experiences. But it's important to have a private talk with your health care team about this information, so 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 have. Include any that may not seem related to the reason for which you made the appointment.
- Make a list of all medicines, vitamins or supplements you take. Include the amounts you take, also called the doses.
- Write down questions to ask your health care team.
Some basic questions to ask include:
- What's the medical name of the infection I have?
- How does it spread?
- 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 stop sexual activity while I'm being treated?
- Does my partner have to be treated?
What to expect from your doctor
Give your health care team a complete report of your symptoms and sexual history. This helps the team figure out how to best care for you. Here are some of the things you may be asked:
- What symptoms made you decide to come in? How long have you had these symptoms?
- With whom do you have sex?
- 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 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 not have any sexual contact until you've talked with your health care team. If you have sexual activity before you see your care team, follow safe sex practices such as using a condom.