Syphilis

Presentation

Appropriate Tests

 

Syphilis serology - serum. Screening EIA, followed by specific confirmatory assays (RPR, TPPA & FTA).

Primary syphilis

Syphilis test mucocutaneous ulcer; lesion fluid for microscopy or NAA testing.

Syphilis testing - serum or CSF should be repeated in 4-6 weeks if initially negative. Investigation for other sexually transmitted diseases (including HIV infection) should also be performed.

Syphilis is a notifiable disease; the source of infection should be traced.

  • Chancre

 

  • Lymphadenopathy (localised)

 

Secondary syphilis

 

  • Rash

 

  • Lymphadenopathy (generalised)

 

  • Condyloma latum

 

  • Mucous patches

 

Tertiary syphilis

 

  • Gumma

 

  • Aortitis

 

  • Neurosyphilis

Syphilis testing - serum or CSF.

Cerebrospinal fluid examination including microscopy, protein (oligoclonal bands), glucose.

Congenital syphilis

Syphilis serology - serum (mother and infant, including IgM in infant).