Treatment:

Syphilis can be treated with antibiotics, such as penicillin G benzathine, doxycycline, or tetracycline (for patients who are allergic to penicillin). Length of treatment depends on how severe the syphilis is, and factors such as the patient's overall health.

For treating syphilis during pregnancy, penicillin is the drug of choice. Tetracycline cannot be used because it is dangerous to the unborn baby. Erythromycin may not prevent congenital syphilis in the baby. People who are allergic to penicillin should ideally be desensitized to it, and then treated with penicillin.

Several hours after getting treatment for the early stages of syphilis, people may experience Jarish-Herxheimer reaction. This is caused by an immune reaction to the breakdown products of the infection.

Symptoms and signs of this reaction include:

• Chills
• Fever
• General feeling of being ill (malaise)
• Headache
• Joint aches
• Muscle aches
• Nausea
• Rash

These symptoms usually disappear within 24 hours.

Follow-up blood tests must be done at 3, 6, 12, and 24 months to ensure that the infection is gone. Avoid sexual contact when the chancre is present, and use condoms until two follow-up tests have indicated that the infection has been cured.

All sexual partners of the person with syphilis should also be treated. Syphilis is extremely contagious in the primary and secondary stages.

Expectations (prognosis):

Syphilis can be cured if it is diagnosed early and completely treated.

Secondary syphilis can be cured if it is diagnosed early and treated effectively. Although it usually goes away within weeks, in some cases it may last for up to 1 year. Without treatment, up to one-third of patients will have late complications of syphilis.

Late syphilis may be permanently disabling, and it may lead to death.

Complications:

• Cardiovascular complications (aortitis and aneurysms)
• Destructive sores of skin and bones (gummas)
• Neurosyphilis
• Syphilitic myelopathy - a complication that involves muscle weakness and abnormal sensations
• Syphilitic meningitis

In addition, untreated secondary syphilis during pregnancy may spread the disease to the developing baby. This is called congenital syphilis.

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of syphilis.

If you have had intimate contact with a person who has syphilis or any other STD, or have engaged in any high-risk sexual practices, including having multiple or unknown partners or using intravenous drugs, contact your doctor or get screened in an STD clinic.