Syphilis is the first disease to have been identified as a sexually transmitted infection in 1494. Caused by the bacterium Treponema pallidum, Syphilis behaves differently from other STIs and is often seen to affect parts of the body other than the male/female genitalia.
The first effective treatment for Syphilis became available after the discovery of Penicillin in 1943. In the last few years, Syphilis has started to make a resurgence in the UK and other countries.
At a glance
Most patients will not experience any symptoms of Syphilis, until a late stage.
Syphilis is an STI, mostly caused by unprotected sex.
Syphilis was a common STI in Europe for almost 500 years until the end of the second world war. There was a massive spike of Syphilis cases between 1943-1950 in the UK, but thanks to the discovery of penicillin and venereal disease clinics, the cases of infectious syphilis virtually disappeared by 1950 and remained so until 2000. The cases began to reappear again from around 2000 and have kept increasing since then.
Between 2010 and 2020, there has been a massive increase, more than 300% increase, in cases of syphilis in the UK. There were about 8000 cases of syphilis diagnosed in the UK in 2018, most of them being in gay men. However, there has been alarming rise of these cases in the heterosexual population as well.
Syphilis, after HIV, is the second most serious sexually transmitted infection.
New worldwide cases
In 2012, according to WHO there were approx. 5.6 million new cases of Syphilis.
Total worldwide cases
In 2012, according to WHO there was an estimated 18 million total cases of Syphilis.
Total worldwide Syphilis in pregnancy related problems
In 2012, according to WHO there was an estimated 930,000 maternal Syphilis infections resulting in 350 000 adverse pregnancy outcomes, including stillbirths, neonatal deaths, preterm births and infected infants.
Key demographics affected
Approximately 75% of all Syphilis diagnoses in 2018 were made in MSM (Men who have Sex with Men).
In 2017, the median age of MSM (Men who have Sex with Men) diagnosed with Syphilis was 37 years old and the majority were white (74%) and 45% were born in the UK.
49% of cases of Syphilis in England were seen in those who live in London.
Key features of the infection
Syphilis is contagious to others, without treatment, in the first 2 years after getting the infection. This period of infectiousness can last upto 4 years in those with HIV infection. Receiving early treatment reduces this period of infectivity, apart from preventing progression to next stage and the complications.
Syphilis becomes non-contagious 2 years after getting the infection, even without adequate treatment. The progression to next stages of Syphilis however does go on in the absence of adequate treatment.
Clinical symptoms and staging of Syphilis
Most patients with Syphilis will have no symptoms and are diagnosed on a routine blood test as part of a sexual health check-up. There are some patients who present with a genital ulcer or a skin rash to a sexual health clinic which prompts a suspicion of Syphilis and the test is undertaken.
However, common symptoms produced by early Syphilis like fever, sore throat, lymph nodes, mouth ulcers and skin rash, being away from genitalia, do not raise the suspicion of a sexually transmitted infection. The patients do not seek advice or attend a non-specialist clinic where Syphilis is not considered. Most of these symptoms disappear in a few weeks and the patient thinks that their problem is gone. The reality is that Syphilis in such patients is progressing to the next stage with greater risk of complication and greater risk to your health. That is why a delay in the diagnosis and treatment of Syphilis is common.
The clinical staging of Syphilis refers to how advanced the effect of Syphilis has been in a given patient, and takes into account the following:
- How long you have the Syphilis for
- Nature of symptoms
- Presence of signs in different body systems
- Details of latest Syphilis blood test
- Details of previous Syphilis blood tests where available.
The stages of Syphilis are described as
- Incubating Syphilis
- Primary Syphilis
- Early latent Syphilis
- Secondary Syphilis
- Late latent Syphilis
- Tertiary Syphilis
- Congenital Syphilis (refers to infection acquired at the time of birth)
Local to a mutli-system disease
When someone gets the Syphilis infection, it is a local infection, producing symptoms in the part of the body where the initial exposure to the infection had occurred.
As it progresses through different stages with the passage of time over months and years, it begins to affect more than one system in the body. Thus Syphilis, soon after its first stage called primary Syphilis, can affect virtually any system in the body including skin, eyes, liver, brain, nerves and heart. In later stages, the effect produced by Syphilis becomes irreversible despite treatment.
From the day of exposure to Syphilis, it usually takes about 3 weeks for the signs and symptoms of Syphilis to appear. But the symptoms could present as soon as 9 days or 90 days after exposure. This time interval is called the incubation period and the Syphilis blood tests may be negative in this time period.
If an infected patient is testing within this incubation period and their Syphilis blood test is negative, they may develop signs and symptoms of Syphilis days or weeks later.
If the infection is left untreated, many such patients will have positive Syphilis blood tests when repeated days or weeks later and subsequently develop symptoms and signs of Syphilis.
One option of managing such situations is to offer treatment based on the history of exposure even though their Syphilis test may be negative. This successfully aborts any Syphilis infection developing in the first place. Such an approach for managing exposure to a confirmed case of syphilis is also described as epidemiological treatment.
Symptoms of Syphilis can start as painless cuts, grazes, skin changes or ulcers at the area where the infection entered the body. This can last 4-6 weeks.
These symptoms are often associated with the enlargement of local lymph nodes – lymph nodes help your body to fight off infections. Enlargement of these lymph nodes is very important as they keep the infection localised in the area, and prevent its spread through the bloodstream into the rest of the body.
The lesion at the point where the infection entered the body is called a ‘chancre’ and together with local enlarged lymph nodes, this stage of Syphilis is described as ‘Primary Syphilis’.
These lesions and enlarged lymph nodes, in most patients, are without much pain or tenderness. As a result of this, the symptoms are not noticed by patients and they do not seek professional advice. If there is any pain or tenderness, then this may indicate the presence of a secondary infection (e.g. Herpes).
Examples of Primary Syphilis:
(a) Male genitalia
The classical picture of Syphilis is a single painless ulcer on the penis with enlargement of lymph nodes in the groin area, on one side or the both.
However, in reality, practice does not follow theory and it is common to see many lesions over the genitals indicating the infection has entered the body from multiple points. Sometimes the lesions are present on the genitalia but without any swelling over the groin area.
(b) Female genitalia
Erosions or ulcers or patches can occur over the vulva, vaginal wall and cervix. However they often go unnoticed due to the following reasons:
- There is minimal, if any, pain and thus patients do not notice.
- They are located internally (vaginal wall and cervix) making it difficult for patients to see.
- The lymph nodes in the groin do not swell up when there are ulcers on the vaginal wall and cervix – these areas get drained to lymph nodes inside the pelvis which is even harder to detect.
When the infection enters through the mouth or tongue, the lesion (erosion, ulcer or patch) develops on the lining of the mouth or tongue. This leads to swelling of lymph nodes in the neck. This is often seen in MSM (Men who have Sex with Men) and can easily occur in heterosexual women giving unprotected oral sex.
Sometimes lesions due to primary Syphilis in the mouth tend to be sore due to infection from the other bacteria normally present in the mouth.
When the infection enters through the back passage or surrounding skin, the lesion (erosion, ulcer or patch) develops on the lining of the back passage, sometimes a bit higher up that they cannot be seen from outside. Lymph node swelling is not noticed as well, as the enlarged lymph nodes are deep inside the pelvis.
This is often seen in gay men and can easily occur in the heterosexual women during anal sex without a condom.
The lesions in primary Syphilis do not produce headache or fever, and tend to disappear in 4-6 weeks even without any antibiotic treatment. Patients go through a period when they have no symptoms and signs called Latent Syphilis.
Early Latent Syphilis
When the patient’s test for Syphilis is positive, and they have no symptoms or signs, they are in the stage of Early Latent Syphilis if it is within 2 years of acquiring the infection.
Late Latent Syphilis
When the patient’s test for Syphilis is positive, and they have no symptoms or signs, they are in the stage of Late Latent Syphilis if it is after 2 years of first acquiring the infection.
Latent Syphilis of uncertain duration
When the patient’s test for Syphilis is positive, and they have no symptoms or signs, they are in the stage of Latent Syphilis of uncertain duration if it is difficult or even impossible to work out when the patient may have acquired the infection.
Why is it important to distinguish between ‘Early’ and ‘Late’ Latent Syphilis?
- Syphilis onto someone else only in first 2 years of getting the infection (early latent infection).
- One can only get secondary Syphilis in the first 2 years after getting the infection.
- Damage to various internal parts of the body in the first 2 years of getting Syphilis can be reversed with adequate antibiotic treatment.
- Damage to various internal organs in Syphilis after 2 years of getting the infection is not likely to be reversible. Treatment, however, will prevent further progression to the damage.
Symptoms and signs of Secondary Syphilis usually appear within 3-6 months but can occur anytime within the first 2 years after getting Syphilis. Patients, once diagnosed, respond very well to the treatment. In some patients, waves of secondary Syphilis can occur more than once.
Whilst Primary Syphilis is due to the presence of bacteria only in a local area where it entered the body, in Secondary Syphilis the bacteria causing Syphilis (spirochaetes) spills into the blood circulation and has spread widely in the body through the bloodstream.
This is the most infectious stage of Syphilis as there are huge amounts of bacteria in the blood, body fluids, mucous membranes and lesions on skin.
The presence of spirochaetes in the bloodstream produces an immune response from the body, producing a picture of ‘prolonged flu like illness with a skin rash’ in the forms of:
- Night sweats
- Poor appetite
- Weight loss
As the infection spreads throughout the body, symptoms specific to various organ systems develop. Some patients will develop symptoms more specific to certain organ systems whilst others may develop symptoms across multiple organ systems. These may include:
- Skin rash, ulcers in the mouth
- Loss of hair (scalp, eye brows, eye lashes etc)
- Redness of eyes
- Floaters and reduction in vision (ocular Syphilis)
- Impairment of hearing
- Abnormal liver function
- Heart and Brain affected (rarely in secondary Syphilis)
Furthermore, Secondary Syphilis is very dangerous to pregnant mothers and infects the foetus in almost 100% of cases. This can lead to catastrophic consequences like miscarriage, stillbirth, premature birth, death of the newborn and congenital Syphilis. This is the reason that Syphilis testing has been an integral part of antenatal care across the world for more than 50 years.
When the Syphilis infection has been present in the body for more than 2 years, the spirochaetes become fewer in number. These bacteria lodge themselves in various important parts of the body including the brain, spine, nerves, heart, large arteries, liver and bones where they produce chronic inflammation around them.
This process can go on for years without producing any symptoms. By the time symptoms are produced, significant damage has already been done. Diagnosis of tertiary Syphilis is made typically 10-40 years after getting the infection. The emphasis on early diagnosis and treatment of Syphilis is to prevent development of tertiary Syphilis.
This is the most serious form of Syphilis, affecting the foetus or newborn baby. Women who have Syphilis during pregnancy are at great risk of miscarriage, stillbirth or passing Syphilis onto their child. Syphilis is easily detectable with a blood test and effective treatment available to prevent the baby from getting infected.
Can I have Syphilis without any symptoms?
Yes. Most people diagnosed with Syphilis will have no symptoms at the time of taking the test. Some will be able to recollect having had symptoms in the past which may be consistent with a diagnosis of Syphilis.
Often people come forward for a Syphilis test because someone they have sexual contact with has been diagnosed with Syphilis (contact tracing).
Other circumstances through which many people come to know of their Syphilis diagnosis are the antenatal blood tests, at the time of blood donation and routine sexual health check-ups.
Complications of Syphilis usually arise when a Syphilis infection has gone undetected or untreated for years or decades. This is known as Tertiary Syphilis. It can spread to other areas of the body and may cause:
- Dementia symptoms
- Loss of coordination
- Vision problems or blindness
- Heart problems
Syphilis has been called a ‘great imitator’ as it can cause all sorts of skin changes.
Please be advised that the images are highly graphic in nature.
How do I get Syphilis?
- Unprotected vaginal, anal or oral sex
- Contact with infected skin lesions
- During childbirth from infected mother (via the placenta)
- Transfusion of infected blood (very rare in the UK)
There is no evidence that Syphilis can be spread from:
- Close contact (e.g. kissing and/or hugging)
- Sharing showers, towels, swimming pools
- Toilet seats
What increases my chances of getting Syphilis?
- If you are a man and have sex with other man
- Being on PrEP
- Sexual contact with partners from abroad
- Sexual contact with an Escort or a commercial sex worker
How can I prevent getting Syphilis?
- Have protected vaginal, oral and anal sex
- Use a condom, femidom and/or dental dam with a new partner
- You and your new partner get tested before having sex
- Recommend your partner to get tested if they’ve had another partner recently
- Take antibiotics if you recently had sex with someone with Syphilis
The routine test for Syphilis looks for the presence of antibodies in the blood.
For those experiencing ‘chancres’ which are suspected to be Syphilis may require a Syphilis swab which looks for the the DNA of Treponema pallidum (the bacteria that causes Syphilis).
9-90 days after exposure (avg. is 28 days)
Sample required for men
Blood from the vein
Time for test results
Within 20 minutes
Cost of test
£100 (or £50 if taken with another test)
How is Syphilis diagnosed?
There are 2 different types of tests to diagnose or rule out Syphilis.
(1) Syphilis Blood Test
The Syphilis blood test looks for different antibodies produced by the patient after getting exposed to the infection. This is the key method of diagnosing and monitoring Syphilis in patients.
Some of these blood tests remain positive for the rest of the patient’s life, despite successful treatment. Other parts of the blood can change to indicate the level of activity of the Syphilis infection – this can help to monitor the success of treatments and any possible reinfection.
The Syphilis blood test is a complex test as it looks for many parameters which together gives the clinicians a more detailed picture of the infection.
(2) Syphilis Swab Test
The Syphilis swab test is a PCR test which is recommended when symptoms appear (namely, changes or breaks in the skin or mucous membranes) which are suspected to be Syphilis. This test can be carried out earlier than the blood test as Syphilis antibodies take longer to become detectable (learn more below).
A note on the difference of these tests
Both the Syphilis blood test and swab test may be recommended when dealing with patients who may be in the early stages of Syphilis. In fact, the Syphilis swab test may be positive whilst blood test is negative.
Having access to both the Syphilis swab test and blood test allows for the timely diagnosis and treatment of Syphilis, and prevents further spread of the infection to others.
Some leading authorities recommend that Syphilis and Herpes PCR on ulcer swabs should be undertaken as a matter of routine practice to prevent missing ‘atypical Syphilis’.
What does Syphilis blood test look for?
Specific Treponemal Infection:
- Treponemal IgG
- Treponemal IgM
These three are called specific treponemal tests because they only appear in the blood in patients who have Syphilis.
Syphilis TPPA and Treponemal IgG remain positive for life even after successful treatment. This is often referred to as ‘scar’ in the blood.
Non-Specific Treponemal Infection:
1. RPR (VDRL)
RPR (VDRL) are called non-specific treponemal tests because RPR can appear in the blood due to conditions other than Syphilis. However, they are useful in determining the stage of Syphilis the patient has (learn more here) and helping to monitor the treatment.
The RPR (VDRL) test is the only test that helps in diagnosing the reinfection of Syphilis (because TPPA and Treponemal IgG will remain positive for the rest of the patient’s life).
What is the window period of Syphilis?
Syphilis usually appears after 21 days post exposure.
However, the window period can range from 9 days to 90 days, for the first symptoms of primary Syphilis to appear and for the blood test of Syphilis to be positive. A negative blood test 3 months after the exposure will exclude Syphilis.
However, in about one third of patients the symptoms of primary Syphilis do not occur, and in such patients the first signs of secondary Syphilis occur a few months, sometimes upto 2 years, after getting the infection. Unfortunately in a small number of patients, a diagnosis of Syphilis is made much later, years and decades later, when the damage to heart and nervous system has already occurred.
Why are blood tests for Syphilis often repeated?
There are 4 scenarios where a blood tests for Syphilis should be repeated:
(1) After the window period
Blood tests for Syphilis become positive in most individuals 21 days after the exposure, but needs to be done at 90 days to exclude it completely.
(2) After diagnosis and treatment
In most cases, blood tests are repeated 3, 6 and 12 months after receiving treatment for Syphilis, as per existing guidelines from the professional bodies.
This is to monitor the part of the blood called RPR (or VDRL) which rises in new infections and drops with successful treatment and passage of time. When RPR (or VDRL) eventually becomes negative or stable at a particular level, it indicates that a satisfactory outcome has been achieved.
(3) In case of re-infection
The RPR (or VDRL) part of Syphilis blood test rises significantly when one gets exposed to the infection for a second time and gets reinfected. Therefore blood tests are repeated to diagnose the re-infection.
(4) During pregnancy when there is a high risk of infection
Apart from the usual antenatal checks for Syphilis at 12 weeks of pregnancy, it is recommended that Syphilis blood test is repeated at 28-32 weeks of gestation, and again at delivery.
Do I need a Syphilis test?
Test for Syphilis is recommended in the following circumstances:
- As part of routine STI tests
- After your sexual contact has been diagnosed with Syphilis
- Presence of symptoms or signs suggestive of Syphilis
- To rule out Syphilis as a work up of complex medical problems where an underlying cause has not been found
- Syphilis tests are routinely done for blood donors and as a diagnostic work up for dementia and peripheral neuropathy
- After a diagnosis of another STIs, especially gonorrhoea and HIV
- In women
- Before planning to conceive
- Before assisted fertility treatment
- Recurrent miscarriages
What do the results mean?
The Syphilis blood tests are complex and require plenty of experience and expertise in interpreting the test results and make sense of it for you. Our team has years of experience in helping patients with various stages and presentations of Syphilis.
What happens if my test is positive?
Our clinicians will assess you completely with a medical assessment, review of your sexual history and your Syphilis blood test results.
If you are tested positive for Syphilis (i.e. it is Detected) then we will discuss what it means for you, provide medication to manage the condition and ensure you don’t pass it on to your partner.
Do I have to tell my partner if I test positive?
As most cases of Syphilis in the UK are sexually transmitted a more careful assessment of your sexual history will be undertaken to ensure your suspected partners are tested.
For those who have primary Syphilis, we will look back at your partners in approx. the last 3 months. For those with early latent Syphilis, we will look back at your partners in approx. the last 2 years. In some cases the look back period can be much longer, and rarely may include all lifetime sexual partners.
Syphilis can be acquired during birth, and this possibility is considered in clinical assessment of Syphilis, even in sexually active adults. In rare cases, Syphilis test for mother is recommended where congenital Syphilis is suspected.
All of this and more will be discussed at the time of your treatment.
Syphilis PCR Swab Test
The Syphilis swab test requires a swab taken from a suspected lesion to look for Treponema Pallidum (the bacteria which causes Syphilis). A positive result will confirm the diagnosis of Syphilis.
Whilst the Syphilis blood test looks at the response of the infected person after getting the infection, the Syphilis swab test looks for the genetic material of the infective organism. Furthermore, Syphilis swab test can be positive whilst the blood test may be negative, especially very early in the course of primary Syphilis.
The lesions from which swabs are taken from can be taken in the form of cuts, erosions, ulcers and patches, which may be present on male genitalia, and in some cases from the anus, mouth and the female genitalia. Rarely such a test can also be run on biopsy specimens. PCR tests on blood samples are sometimes done as part of research studies.
Sometimes, these lesions can be due to the presence of more than one infection at the same time, for example Herpes, Syphilis and Chancroid. PCR tests from the swabs help us in making the exact diagnosis, and thus help us offer the correct treatment.
Furthermore, the swab can also be taken from lesions that are not suspected to be Syphilis to objectively rule out Syphilis.
Sample required: Swab from the lesion
Results in: 4 working days
Price: £150 (or £100 if taken with another test)
Before we proceed with the treatment of Syphilis, it is important to determine the clinical stage of Syphilis. This will help us determine the right course of treatment for you.
Furthermore, we will discuss any tests and treatment your partner(s) may need to prevent further transmission of this infection.
Methods of treatment
a) Penicillin injection
b) Oral antibiotics
Length of Treatment:
Varies upon stage of syphilis
+ Re-test in 1, 3, 6 & 12 months
+ Treat partner(s)
Cost of treatment
a) Penicillin injection – £200/dose (first dose £250 if tested elsewhere)
b) Oral antibiotics – £100 (or £150 if tested elsewhere)
Can Syphilis be treated?
Yes, Syphilis can be treated.
What is the treatment for Syphilis?
A special type of antibiotics from the Penicillin group, administered by the injection in buttocks, is the most effective treatment for all types of Syphilis. It is important to note that commonly used penicillin antibiotics do not effectively treat Syphilis.
If you are allergic to penicillin, there are other types of antibiotics we can use. This will be discussed at the time
The duration of course of antibiotics depends on what stage of Syphilis infection you have.
How effective is the treatment for Syphilis?
Syphilis is a curable infection after the correct treatment is given.
In early Syphilis, adequate treatment of Syphilis cures the symptoms, prevents complications and stops transmission to sexual partners.
In late Syphilis, treatment of Syphilis prevents further complications and progress of the disease although it may not reverse the symptoms that have already set in. There is no concern about transmission of the infection to others in late Syphilis.
Failure of treatment is uncommon, and is recognised by monitoring of Syphilis blood tests, and may warrant further courses of antibiotics.
Are there any side effects of Syphilis treatment?
Most patients receive treatment of Syphilis without much problem and achieve a cure.
The side effects of treatment can be considered as follows:
Side effects of the antibiotics
Penicillin injections: pain at the injection site and allergic reactions
Oral antibiotics: nausea, sickness, abdominal pain, skin rash
Effect from death of Syphilis producing bacteria due to the antibiotics
The patients develop fever, headache, body pains and chill within 24 hours of starting the course of antibiotics, and often following the first dose.
These symptoms usually last for 24-48 hours and is believed to result from release of toxins from the dying Syphilis bacteria. This tends to be more noticeable in the stages of Syphilis where Syphilis bacterial load is high, as in secondary Syphilis.
This reaction has been described as the Jarisch Herxheimer Reaction. General measures like bed rest, drinking plenty of fluids to keep hydrated and paracetamol is all that is needed to deal with this.
However, special precautions are needed in pregnant women and those with Syphilis of delicate organs like the brain, heart and eyes.
Will my sexual partner need the treatment for Syphilis?
If their Syphilis test result is positive, they will be given treatment based on the stage of their Syphilis – this will be determined at the time of the test.
If their Syphilis test result is negative, the way forward can be either repeating the Syphilis blood test at a later date, or give them a course of antibiotics on an epidemiological basis.
How long do I have to wait before having sex?
The exact length of time varies depending on the case. Precise instructions will be given to you during your appointment to ensure you do not pass the infection onto your partner.
For most patients, it is recommended waiting at least 7 days after completing the course of antibiotics before you have sex. However, in specific cases, this period can be further extended by up to 2 weeks.
Late Syphilis, which is more than 2 years after acquiring the Syphilis infection, is not infectious. However, it is often recommended to avoid sexual contact for 7 days after completing the course of antibiotics as a matter of precaution.
When do I have to get retested?
The effectiveness of Syphilis treatment is assessed by repeating the blood test at regular intervals, usually 3, 6 and 12 months after completion of treatment. Occasionally an earlier follow-up blood test is done a month later.
Patients with underlying HIV infection have their Syphilis test done every year for the rest of life.
This is to monitor the level of a non-specific reaction in the blood called RPR or VDRL which rises in new infection and drops with successful treatment and passage of time. When RPR / VDRL eventually becomes negative or stable at a particular level, it indicates that a satisfactory outcome has been achieved.
Can I get Syphilis again?
Yes, you can get Syphilis again. Getting Syphilis infection once does not make you immune from getting it a second time. There are reported cases where patients got the Syphilis infection multiple times due to repeated exposure to the infection.
What happens if I don’t get treatment?
Syphilis is a serious infection. If left untreated (or undiagnosed for that matter), it can cause symptoms as seen in primary, secondary and tertiary Syphilis (click here on the link leading to the stages of Syphilis).
Long term damage to the nervous system, eyes and heart are serious concerns.
In women with untreated Syphilis, this can lead to miscarriages, stillbirth and congenital Syphilis of the newborn, the most serious form of Syphilis.
Page reviewed by Dr. Manoj Malu (Clinical Director)
Last reviewed date: 8 July 2020
Next review due: 8 July 2023
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- World Health Organisation (WHO): Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016
- Family Planning Association: Sexually transmitted infections factsheet – Factsheets
- Public Health England: Addressing the increase in syphilis in England: PHE action plan
- Public Health England: Syphilis epidemiology in London 2017 data update
- Center for Disease Control: Syphilis in Pregnancy – 2015 STD Treatment Guidelines
- British Medical Journal: UK Sexual health clinics may be missing atypical syphilis
- Comparative genomics and full-length Tprk profiling of Treponema pallidum subsp. pallidum reinfection
- Sexually Transmitted Diseases: The signs and symptoms of secondary syphilis
- Annals of Pharmacotherapy: Reexamining Syphilis: An Update on Epidemiology, Clinical Manifestations, and Management
- British Medical Journal: Bony symptoms in secondary syphilis
- JAMA: Physician Recognition of the Signs and Symptoms of Secondary Syphilis
- Therapy in Practice: Cutaneous Manifestations of Syphilis
- British Medical Journal: Syphilis consequences and implications in delayed diagnosis: five cases of secondary syphilis presenting with ocular symptoms
- JAMA Dermatology: Visceral Syphilis: Syphilis of the stomach
- Sexually Transmitted Diseases: Prevalence Estimates of Complicated Syphilis
- Clinical Infectious Diseases: Syphilis and HIV Infection: An Update
- The New England Journal of Medicine: Congenital Syphilis Presenting in Infants after the Newborn Period
- American Family Physician: Resolving the Common Clinical Dilemmas of Syphilis
- Expert Review of Anti-infective Therapy: Syphilis and HIV: a dangerous duo
- NHS: Syphilis – Testing
- Lab Tests Online: Syphilis Test
- Neurology Clinical Practice: Diagnostic tests for syphilis
- NICE: Syphilis
- Center for Disease Control: Syphilis in Pregnancy – 2015 STD Treatment Guidelines
- British Medical Journal: UK Sexual health clinics may be missing atypical Syphilis
- Clinical Infectious Diseases: Treatment of Syphilis, 1993 | Clinical Infectious Diseases
- JAMA: Serological Response to Syphilis Treatment: A New Analysis of Old Data
- Expert Opinion on Pharmacotherapy: Syphilis treatment: old and new
If you think you may have Syphilis
It is important to refer to a healthcare provider as soon as possible. Our experience combined with timely detection can help put you on the right track without delay and avoid complications in the future.