The diagnosis of syphilis can be corrected arrived at after the doctor looks at the patient's medical history, conducts blood tests and other tests such as a spinal fluid examination.
Syphilis can be difficult to diagnose as it can masquerade as any disease. If you have symptoms of syphilis or any sexually transmitted disease, visit a doctor as soon as possible. Treatment of syphilis in its early stages can cure it completely and the chances of serious complications decrease as well.
Diagnosis of Syphilis
History and Examination: Your doctor will ask you about the symptoms, when they appeared, your sexual history, use of condoms and if your sexual partners show any similar symptoms. During examination the doctor will check your genitals for sores (in men the penis, foreskin and urethra will be examined and in women the doctor will do an internal examination of the vagina). The mouth and anus of both men and women may be examined.
Tests: After the examination, a blood test for syphilis will be done. Besides this you may be tested for other sexually transmitted infections, including HIV.
- Blood test: Infection with syphilis causes your body to make antibodies against the syphilis bacteria. When your blood is tested, it may show the antibodies that are present. A positive result means that you either have the infection or have had it in the past (the antibodies persist in the body for years; even after successfully treatment of an infection). If the blood test is negative, it does not necessarily mean that you are not infected. The antibodies against syphilis bacteria may not be detected for up to three months after infection. Your doctor may advise repeat test after three months to confirm the diagnosis. Blood test for syphilis is done in every pregnant woman as the infection can affect the baby (it can result in death of the foetus or newborn baby or cause other complications). The test is usually done at weeks 11-20 of pregnancy. The common blood tests done for syphilis include:
- RPR (rapid plasma reagin).
- VDRL (venereal disease research laboratory).
- FTA-ABS (fluorescent treponemal antibody absorption) or MHA-TP (microhemagglutination assay for T pallidum).
- Swab: If the patient has sores the doctor will take a sample from the sore and examine it under a microscope (perform a dark-field microscope examination). The test is useful in the primary and also sometimes in the secondary phase of infection.
- Spinal fluid examination: During the tertiary phase, the examination of a sample of spinal fluid obtained by spinal puncture may be done to check for infection and to measure the success of treatment.
Other Sexually transmitted infections (STDs): Your doctor will do tests for the presence of other STDs such as HIV, chlamydia and gonorrhoea, as it is possible that you may have more than one STD at a time.
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