Overview
Syphilis is a bacterial STI caused by Treponema pallidum. It can progress through primary, secondary, latent and late stages if untreated. Testing and treatment are highly effective when managed medically.
Causes and transmission
- Syphilis is usually transmitted through sexual contact with an infectious lesion.
- It can also be transmitted during pregnancy or rarely through blood transfusion.
How it is assessed
- Diagnosis may combine lesion examination, darkfield microscopy where available and blood tests such as VDRL, RPR, TPHA or TPPA.
- Screening tests may require confirmatory testing.
Management considerations
- Treatment depends on stage and medical history.
- Follow-up serology is often used to monitor response.
Prevention
- Avoid sexual contact with active lesions.
- Testing and treatment of partners can reduce transmission.
- Condoms reduce but may not eliminate risk when lesions are outside covered areas.
Key points
- Stage affects symptoms and testing
- Can cause ulcers, rash and systemic disease
- Treatable with appropriate antibiotics
- Partner testing may be needed
When to seek care
- Genital ulcer
- Unexplained rash
- Positive syphilis screening
- Partner diagnosis