The recommended treatment for adults and adolescents with primary, secondary, or early latent syphilis is Benzathine penicillin G 2. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is Benzathine penicillin G 7.
The recommended treatment for neurosyphilis, ocular syphilis, or otosyphilis is Aqueous crystalline penicillin G million units per day, administered as million units intravenously every 4 hours or continuous infusion, for days. Treatment will prevent disease progression, but it might not repair damage already done. Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis.
Combinations of some penicillin preparations e. Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, potentially ceftriaxone. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure.
Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary. Any person with signs or symptoms suggestive of syphilis should be tested for syphilis.
Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with syphilis should be tested for syphilis. Some people should be tested screened for syphilis even if they do not have symptoms or know of a sex partner who has syphilis. Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for syphilis or other STDs.
After appropriate treatment, clinical and serologic response to treatment will be followed. However, even following successful treatment, reinfection can occur. Persons with signs or symptoms that persist or recur or who have a sustained fourfold increase in nontreponemal test titer likely were reinfected or experienced treatment failure.
For further details on the management of persistent syphilis or reinfection, refer to the STI Treatment Guidelines. Because asymptomatic chancres can be present in the vagina, rectum, or mouth, it may not be obvious that a sex partner has syphilis.
Unless a person knows that their sex partners have been tested and treated, they may be at risk of being reinfected by an untreated partner. Correct and consistent use of latex condoms can reduce the risk of syphilis when the infected area or site of potential exposure is protected. However, syphilis transmission can occur with lesions not covered by a latex condom. The surest way to avoid transmission of sexually transmitted infections, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to not have an infection.
Partner-based interventions include partner notification — a critical component in preventing the spread of syphilis. Sexual partners of patients with syphilis should be considered at risk and provided treatment per the STI Treatment Guidelines. More information is available at www. Centers for Disease Control and Prevention. HIV Surveillance Report ; Sexually Transmitted Disease Surveillance, Sexually Transmitted Infections Treatment Guidelines, Alexander, J.
Obstet Gynecol, Discordant results from reverse sequence syphilis screening—five laboratories, United States, Pathela P et al. Clinical Infectious Diseases ; HIV prevention through early detection and treatment of other sexually transmitted diseases—United States. Congenital Syphilis: Preliminary Data. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. In the latent stage, which can last for years, the bacteria are still present in the body, but there are no symptoms or signs.
The main manifestations of tertiary syphilis are neurological disease neurosyphilis , cardiovascular disease cardiosyphilis and granuloma gummatous lesions or gumma. Tertiary syphilis can affect any organ system up to 30 years or more after infection and can be life- threatening. Neurosyphilis can occur at any stage of syphilis infection, even in the first few months. Early neurological manifestations include acute changes in mental status, meningitis inflammation of the membranes surrounding your brain and spinal cord , stroke, cranial nerve dysfunction and auditory or ophthalmic and ocular abnormalities.
Mother-to-child transmission may occur if the expectant mother has syphilis. Mother-to-child transmission of syphilis congenital syphilis is usually devastating to the fetus in cases where maternal infection is not detected and treated sufficiently early in pregnancy. If syphilis is left untreated during pregnancy it can lead to early birth, low birth-weight, stillbirth, death shortly after birth or other sequelae in the baby, including inflammatory manifestations affecting the eyes, ears and joints, as well as skeletal malformations resulting from developmental damage during the early stages of syphilis.
It is important to keep in mind that many infants with syphilis infection may not have obvious clinical signs or symptoms. Mother-to-child transmission of syphilis is preventable and can be achieved through early screening and treatment with the right antibiotic penicillin. Syphilis diagnosis is usually based on medical history, physical examination, and laboratory testing. Point-of-care rapid diagnostic tests RDTs for syphilis infection screening can provide results in 10—15 minutes and can be performed in any setting since they do not require refrigerated storage or laboratory equipment.
However, a positive result from a syphilis RDT does not distinguish between active infection and previously treated infections but it is an important resource for treatment initiation particularly among pregnant women and hard to reach populations. Syphilis can in most cases be easily cured with antibiotics penicillin.
A fetus can also be easily cured with treatment, and the risk of adverse outcomes to the fetus is minimal if the mother receives adequate treatment during early pregnancy — ideally before the second trimester. Adults with sexually transmitted syphilis or other genital ulcers have an estimated two- to fivefold increased risk of contracting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter the bloodstream during sexual activity.
If you're pregnant, you may pass syphilis to your unborn baby. Congenital syphilis greatly increases the risk of miscarriage, stillbirth or your newborn's death within a few days after birth. There is no vaccine for syphilis. To help prevent the spread of syphilis, follow these suggestions:.
If tests show that you have syphilis, your sex partners — including current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested. If they're infected, they can then be treated. Official, confidential partner notification can help limit the spread of syphilis.
The practice also steers those at risk toward counseling and the right treatment. And since you can contract syphilis more than once, partner notification reduces your risk of getting reinfected. People can be infected with syphilis and not know it.
In light of the often deadly effects syphilis can have on unborn children, health officials recommend that all pregnant women be screened for the disease.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Syphilis is a bacterial infection usually spread by sexual contact. Primary syphilis Open pop-up dialog box Close. Primary syphilis Primary syphilis causes painless sores chancres on the genitals, rectum, tongue or lips.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Syphilis — CDC fact sheet detailed. Centers for Disease Control and Prevention. Accessed July 14, Hicks CB, et al. Syphilis: Epidemiology, pathophysiology, and clinical manifestations in HIV-uninfected patients. Merck Manual Professional Version. Syphilis: Treatment and monitoring. Syphilis: Screening and diagnostic testing. Syphilis — CDC fact sheet. Accessed July 30, Jameson JL, et al.
In: Harrison's Principles of Internal Medicine.
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