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Syphilis - primary

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Primary syphilis

Treatment:

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

Syphilis during pregnancy: Penicillin is recommended as the drug of choice. Tetracycline cannot be used because of toxicity to the fetus, and erythromycin may fail to prevent congenital syphilis in the fetus. Penicillin-allergic individuals should ideally be desensitized, then treated with penicillin.

Several hours following the treatment of early stages of syphilis, individuals may undergo a reaction called Jarish-Herxheimer reaction, caused by an immune reaction to the breakdown products of the organism. Symptoms of this reaction include:

• fever
• chills
• headache
• nausea
• general feeling of being ill ( malaise )
• joint aches
• muscle aches

These symptoms usually disappear within 24 hours.

Follow-up blood tests must be done at 3, 6, 12, and 24 months to ensure the infection has been eliminated. Abstinence from sexual contact is encouraged when the chancre is present and condoms should be used until two follow-up tests have indicated that the infection has been cured. The sexual partner should also be treated. Syphilis is extremely contagious in the primary and secondary stages.

Expectations (prognosis):

Syphilis can be completely cured if diagnosed early and treated thoroughly.

Complications:

• secondary syphilis
• tertiary syphilis
• congenital syphilis
• neurosyphilis
• cardiovascular syphilis
• syphilitic meningitis

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms suggestive 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, you should contact your doctor or be screened in an STD clinic.

• Review Date: 2/13/2006
• Reviewed By: Monica Gandhi, M.D., M.P.H., Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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