Testing for Syphilis

FAQ About Syphilis Testing

Any sexually active person should regularly test for sexually transmitted diseases (STDs). Some avoid tests out of fear of their results. One of the most commonly feared STDs is syphilis. 

Syphilis derives from the Treponema pallidum bacterium. Typically, syphilis spreads through oral, vaginal, or anal sex from syphilitic sores. Syphilis may also spread through childbirth if the pregnant person has syphilis. 

Left untreated, syphilis causes severe damage to the body, which is why so many people are afraid of a positive syphilis result. However, the only way to remain safe is by testing for syphilis using rapid STD testing. The earlier people know, the earlier they can act. 

With same-day STD testing, responsible sex practices are easier than ever. People can test from the comfort of their homes and receive the results online quickly. This removes some of the embarrassment many people associate with STD testing and protects their safety and their partners’.

Understanding the Stages of Syphilis: Why Timely Testing Is Crucial

Early detection is important for any STD diagnosis, especially when it comes to syphilis. Syphilis progresses quickly over several stages and comes with severe symptoms if left untreated. The stage of syphilis a patient has will influence the testing method required and the results they receive. 

Latent Syphilis

Latent syphilis is a period during which patients experience no syphilis symptoms. If sexually active individuals wait to test until they experience symptoms, syphilis could progress further. Sexually active people can use serologic testing, a type of blood test that detects antibodies, to stay safe. 

Primary Syphilis

Primary syphilis is the first stage of syphilis with symptoms. Patients will have one or more painless sores around the site of infection. This might be the penis, vulva, or vagina. While patients may think the painlessness of the sore indicates it isn’t an issue, this isn’t true. Diagnosing syphilis early is essential for effective treatment. 

Secondary Syphilis

When primary syphilis progresses into secondary syphilis, patients experience:

  • Rashes on their palms or soles of their feet
  • Swollen lymph nodes
  • Fevers
  • Fatigue
  • Growths near moist areas of the body
  • Loss of appetite and, consequently, weight loss

In some cases, patients also begin to experience liver damage or infections of the eyes and nervous system. 

Tertiary Syphilis

In the tertiary stage, patients experience inflammatory masses. These are called gummas, and they appear on the patients’ skin, bones, and internal organs. As a result, patients have severe bone pain. Tertiary syphilis also causes heart damage. 

Neurosyphilis

In the neurosyphilis stage, the syphilis targets the patients’ nervous system. They will have frequent headaches, declining coordination, numbness, and even paralysis. In severe cases, patients also develop dementia at this stage. This causes them to lose their memories.

Ocular Syphilis

During ocular syphilis, patients’ sight declines, ultimately resulting in blindness. This is one of the most severe stages of syphilis. 

Otosyphilis

The last stage of syphilis is otosyphilis. After patients develop blindness, they will also experience hearing loss or ringing in their ears. They may struggle with vertigo and nystagmus, a quick jerking eye movement. 

When testing for syphilis, the stage and type of test will influence how and when the patient receives their results. 

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Decoding Syphilis Tests: From Darkfield Examinations to Molecular Tests

Another way to relieve anxiety about syphilis testing is by understanding exactly how they work. There are many syphilis myths out there, and misinformation is rampant. Knowing what to expect helps patients feel prepared, providing stability during a scary time. 

Who Should Test for Syphilis?

Anyone sexually active can contract syphilis. However, certain demographics are more at risk than others. These groups should pay special attention when monitoring themselves for symptoms and should get STD tests frequently in case of latent syphilis. 

These groups include: 

  • Sexually active males under 29
  • Sex workers
  • Living in areas with high syphilis infection rates

Additionally, pregnant women, men who have sex with men, and people with HIV should regularly test for syphilis. For pregnant women, this means testing at their first prenatal visit, at the 28-week mark, and delivery. Everyone else should test at least annually.

Diagnostic Methods

Sexually active people should practice regular screening, monitoring, and diagnostic testing. Screening involves testing regularly, even without symptoms. Monitoring requires patients to evaluate their bodies for symptoms. 

Diagnostic testing occurs when patients begin experiencing symptoms and require testing to determine whether they have syphilis and, if so, what stage of syphilis they have. 

The primary diagnostic methods for syphilis include darkfield examinations, molecular tests, nontreponemal tests, and treponemal tests. 

Darkfield examinations involve taking a fluid sample from the patient’s skin sores or lymph nodes. Doctors then test that fluid for syphilis using a microscope designed to detect the Treponema pallidum bacterium.

Molecular tests, also called polymerase chain reaction (PCR) tests, evaluate the patients’ DNA for the presence of Treponema pallidum. PCR is a laboratory technique whereby testers amplify DNA strands to study it in greater detail. 

Nontreponemal tests and treponemal tests are blood tests. Nontreponemal tests are part of the screening process and cannot diagnose syphilis on its own. Rapid plasma reagin (RPR) and venereal disease research laboratory (VDRL) tests are common nontreponemal tests. 

RPR detects reagin antibodies, which bodies commonly produce in response to a syphilis infection. VDRL uses cerebral spinal fluid or blood to detect other common antibodies the body produces in the first weeks after the first syphilis sore develops. 

A cerebrospinal fluid evaluation is especially effective for diagnosing neurosyphilis. False positives may occur from nontreponemal tests when a patient has tuberculosis, endocarditis, or other systemic infections.

On the other hand, Treponemal antibody tests test for antibodies that are detectable earlier than those nontreponemal tests can detect. However, treponemal tests cannot distinguish between past and present syphilis infections.

This means even if a patient no longer has syphilis but did in the past, they could get a false positive result. A patient with other inflammatory diseases, such as systemic lupus erythematosus could also receive a false positive from this test.

Traditional Algorithm vs. Reverse Sequence Algorithm

A combination of treponemal and nontreponemal tests is necessary for an accurate syphilis diagnosis. 

Historically, doctors began with the nontreponemal test, followed by the treponemal test to confirm the results. More recently, doctors have been using a reverse sequence algorithm that puts the treponemal test first. If that result is positive, they follow with a nontreponemal test.

This change arose from the development of automated and rapid treponemal tests and made using treponemal tests first a more cost- and time-efficient method. 

Navigating Treatment Options: The Penicillin Paradigm

When patients receive a positive result, they should seek treatment immediately. Without proper treatment, syphilis develops quickly. Thankfully, there are several treatment options. Penicillin is the first treatment option for all stages. While this antibiotic can treat syphilis, it cannot undo the damage late-stage syphilis causes.

Treating Syphilis With Penicillin G

Penicillin G benzathine is the ideal treatment for syphilis. The dosage and length of this antibiotic treatment depend on the stage of syphilis the patient has. Longer treatment is required for those with latent or tertiary syphilis. This is also the only treatment proven effective for instances of syphilis during pregnancy. 

If a pregnant patient is allergic to penicillin G, they must go through a desensitizing process before treatment. 

Patients should know that this treatment regimen sometimes causes a Jarisch-Herxheimer reaction on the first day. This is normal. Symptoms include nausea, fever, chills, headaches, and body aches. 

Doctors may prescribe alternative types of penicillin, but penicillin G is historically the most effective treatment method. 

Other Treatment Options

Patients who aren’t pregnant and are allergic to penicillin G may also receive treatment by: 

  • Doxycycline 
  • Ceftriaxone 
  • Azithromycin 
  • Tetracycline 

Taking Care of the Community

Patients can use antibiotics and rapid STD testing to protect themselves, but they must also protect their communities. After receiving a positive result, they should immediately contact any recent sexual partners. These partners should test for syphilis as soon as possible. 

They should also refrain from having sex with any other partners until the infection is gone. Doing so, even with protection, risks spreading syphilis to more people. Keeping the infection as contained as possible is vital to overall community health.

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Choose Rapid Testing for Rapid Relief

There is a stigma around STDs that prevents people from testing. At Rapid STD Testing, we’re working to break this stigma. The more people are open about sexual health, the safer everyone will be. Most STDs, including syphilis, only get worse as time goes on. Catching them early on benefits patients at the individual and community level.

The only way to catch STDs early is through widespread regular testing. All sexually active individuals should test and speak openly with their partners about their results. Now, they can use a rapid STD test to get quick and easy results. Using a 10-panel STD test is an easy way to test for the most common STDs at once.

Testing for syphilis may seem scary or even unnecessary to some. However, we must get ahead of this infection before its late stages, which is why testing is the most logical solution. It’s time for sexually active people to take their sexual health into their own hands. This is as simple as visiting a clinic or ordering a rapid test online. Don’t wait — take action now.