Syphilis in Women

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What tests are used to diagnose syphilis?

There are two types of tests used to diagnose syphilis: treponemal tests (that identify antibodies to the causative organism) and non-treponemal tests (that identify the body's response to the infection but not to the organism itself).

The blood tests used to screen 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. While these are good screening tests, they are not specific enough to establish the diagnosis. These tests can give false-positive results, so a positive screening VDRL or RPR test must be followed by a treponemal test to detect the organism.

A number of different tests are available that detect antibodies to Treponema pallidum bacteria. Examples include the microhemagglutination assay for T. pallidum (MHA-TP) and the fluorescent treponemal antibody absorbed test (FTA-ABS). These tests can confirm the diagnosis of syphilis if a nontreponemal test such as VDRL or RPR is positive.

What is the treatment for syphilis?

Penicillin is the treatment of choice for syphilis in all stages. One intramuscular injection of long-acting benzathine penicillin G (2.4 million units) is sufficient for a person who has primary, secondary, or early latent syphilis. Three doses of this drug at weekly intervals are recommended for individuals with late latent syphilis or latent syphilis of unknown duration. While treatment kills the bacteria and prevents further organ damage, it will not reverse damage to the organs that has already occurred. Treatment with penicillin is safe during pregnancy.

What are the potential complications of syphilis?

As mentioned, untreated syphilis spreads throughout the body and causes complications with various organ systems. Some of the better known complications of late syphilis include blindness, dementia, aortic aneurysm, deafness, stroke, and other complications related to spread of the infection to the brain. Late stage syphilis can cause fatal complications.

Medically Reviewed by a Doctor on 2/23/2015

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