Syphilis In Women (cont.)

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How is syphilis diagnosed?

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Syphilis can be diagnosed by scraping the base of the ulcer and looking under a special type of microscope (dark field microscope) for the spirochetes. However, since these microscopes are rarely detected, the diagnosis is most often made and treatment is prescribed based upon the appearance of the chancre. Diagnosis of syphilis is complicated by the fact that the causative organism cannot be grown in the laboratory. Therefore, cultures of affected areas cannot be used for diagnosis.

Special blood tests can also be used to diagnose syphilis. The standard screening blood tests for syphilis are called the Venereal Disease Research Laboratory (VDRL) and Rapid Plasminogen Reagent (RPR) tests. These tests detect the body's response to the infection, but not to the actual Treponema organism that causes the infection. These tests are thus referred to as non-treponemal tests. Although the non-treponemal tests are very effective in detecting evidence of infection, they can also produce a positive result when no infection is actually present (so-called false-positive results for syphilis). Consequently, any positive non-treponemal test must be confirmed by a treponemal test specific for the organism causing syphilis, such as the microhemagglutination assay for T. pallidum (MHA-TP) and the fluorescent treponemal antibody absorbed test (FTA-ABS). These treponemal tests directly detect the body's response to Treponema pallidum.

What is the treatment for syphilis?

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Depending on the stage of disease and the clinical manifestations, the treatment options for syphilis vary. Long-acting penicillin injections have been very effective in treating both early and late stage syphilis. The treatment of neurosyphilis requires the intravenous administration of penicillin. Alternative treatments include oral doxycycline (Vibramycin, Oracea, Adoxa, Atridox and others) or tetracycline (Achromycin).

Women who are infected during pregnancy can pass on the infection to the fetus through the placenta. Penicillin must be used in pregnant patients with syphilis since other antibiotics do not effectively cross the placenta to treat the infected fetus. Left untreated, syphilis can lead to blindness or even death of the infant.

Syphilis pictures

Syphilis Chancre on Penis
Syphilis Chancre on Penis

Syphilis Rash on Hands
Syphilis Rash on Hands

Syphilis on the Back
Syphilis on the Back

Medically reviewed by Mikio Nihira, MD; American Board of Obstetrics and Gynecology

Previous contributing author: Carolyn Janet Crandall, MD, FACP


"Pathogenesis, clinical manifestations, and treatment of early syphilis"

Medically Reviewed by a Doctor on 3/4/2014

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Syphilis In Women - Symptoms Question: What were your Syphilis symptoms?
Syphilis In Women - Diagnosis Question: Please describe the tests and exams that led to a diagnosis of syphilis.
Syphilis In Women - Treatment Question: What forms of treatment, including medication, did you receive for syphilis?