Syphilis In Women (cont.)
How is syphilis diagnosed?
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?
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.
Next: Syphilis in Women At A Glance »
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