What is syphilis?
Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It can cause a wide range of symptoms and complications, including rashes, sores, fever, and damage to internal organs. If left untreated, syphilis can lead to serious health problems, including blindness, dementia, and even death. Syphilis can be treated with antibiotics, but it is important to catch the infection early in order to prevent serious complications.
What are the early symptoms of Syphilis?
The early symptoms of syphilis, also known as primary syphilis, usually appear within 3 to 90 days after infection. They include:
A painless sore or sores, called chancres, which typically appear on or around the genitals, anus, or mouth
Swollen lymph nodes in the area of the sore
As the infection progresses, some people may develop a rash on the palms or soles , fever, headache, and muscle aches.
These symptoms may last for a few weeks and then go away, even without treatment. However, if left untreated, syphilis will progress to a later stage and can cause serious health problems.
What investigations are done for syphilis?
There are several investigations that can be done to diagnose syphilis, including:
Blood tests: A blood test can be done to detect syphilis antibodies, which are produced by the body in response to the bacteria that causes the infection.
Darkfield microscopy: This test is used to examine a sample of the fluid from a chancre, or sore. It can detect the presence of the Treponema pallidum bacteria that causes syphilis.
PCR (Polymerase Chain Reaction) test: This test can be used to detect the DNA of Treponema pallidum in a sample of blood, spinal fluid, or other body fluid.
Rapid plasma reagin (RPR) test: This test is used to detect syphilis antibodies in the blood. It is not as specific as the other tests, but it is less expensive, quicker, and can be used to screen large number of people.
Venereal Disease Research Laboratory (VDRL) test: This test is similar to the RPR test and it is used to detect syphilis antibodies in the blood.
It’s important to note that a positive result on a syphilis test does not necessarily mean that you have an active syphilis infection. It may mean that you were infected at some point in the past and have since been treated and cured or even that you have been vaccinated against syphilis. A positive test result should be followed up with additional testing and a clinical evaluation to confirm the diagnosis and stage of the infection.
Does VDRL test once positive become negative after treatment of syphilis?
The VDRL test (Venereal Disease Research Laboratory test) is a type of blood test that is used to detect syphilis antibodies in the blood. It is similar to the RPR (Rapid Plasma Reagin) test.
After treatment, most people will develop a negative VDRL test result within 6 to 12 months, although it may take longer for some people. However, in some cases, the test may remain positive for life, even after successful treatment. This is known as a “non-treponemal test serofast reaction” or “serofast state”, it’s not uncommon.
When a person has a positive VDRL test result, it is important to follow up with additional testing and a clinical evaluation to confirm the diagnosis and stage of the infection and to monitor the response to treatment. This may include repeat VDRL test, as well as specific treponemal tests, such as the FTA-ABS (Fluorescent Treponemal Antibody Absorption test) or the TP-PA (Treponema Pallidum Particle Agglutination test) which are specific for syphilis.
Does TPHA test turn negative after treatment of syphilis?
The TPHA (Treponema Pallidum Hemagglutination assay) test is a type of blood test that is used to detect syphilis antibodies in the blood. Like other tests for syphilis, it is used to confirm a diagnosis of syphilis and to monitor response to treatment.
After treatment, most people will develop a negative TPHA test result within 6 to 12 months, although it may take longer for some people. However, in some cases, the test may remain positive for life, even after successful treatment..
It’s important to note that a positive TPHA test result does not necessarily mean that you have an active syphilis infection, it may mean that you were infected at some point in the past and have since been treated and cured.
When a person has a positive TPHA test result, it is important to follow up with additional testing and a clinical evaluation to confirm the diagnosis and stage of the infection and to monitor the response to treatment. This may include repeat TPHA test, as well as specific treponemal tests, such as the FTA-ABS (Fluorescent Treponemal Antibody Absorption test) or the TP-PA (Treponema Pallidum Particle Agglutination test).
It’s also important to note that while these tests can help diagnose and monitor syphilis, they should not be used as a sole diagnostic tool, as they can have false positive results, and a clinical evaluation and medical history is important for the accurate diagnosis and treatment of syphilis.
What are treatment protocols for Syphilis?
The treatment for syphilis depends on the stage of the infection and the overall health of the person. The standard treatment for syphilis is antibiotics, typically a single injection of long-acting benzathine penicillin G or a course of oral antibiotics such as doxycycline or azithromycin.
The treatment protocols for syphilis are as follows:
Primary, Secondary, and Early Latent Syphilis: A single injection of long-acting benzathine penicillin G is the recommended treatment.
Late Latent Syphilis and Syphilis of unknown duration: A course of oral antibiotics such as doxycycline or azithromycin, or a series of injections of benzathine penicillin G may be recommended.
Neurosyphilis: Intravenous penicillin G is recommended for the treatment of neurosyphilis.
Congenital Syphilis: Penicillin G is recommended for the treatment of congenital syphilis, given to the mother during delivery or to the infant shortly after birth.
It’s important to note that treatment with antibiotics will stop the progression of syphilis but it will not repair any damage that has already occurred. It’s also important to avoid sexual contact until the infection is completely treated and to inform any sexual partners so they can be tested and treated as well. Repeat testing is recommended 3, 6, 12 and 24 months after treatment, to ensure that the infection is fully eradicated.
In case of Penicillin allergy, other antibiotics such as Doxycycline or Azithromycin can be used to treat syphilis, but it is less effective and may require a longer course of treatment. It’s important to inform your doctor if you have a penicillin allergy before starting treatment
