How to diagnose and treat syphilis


  • Diagnostics
  • Treatment
  • Prevention

If symptoms and signs of syphilis are identified, it is necessary to conduct an examination in order to prescribe an effective course of treatment. Treatment should appoint a doctor dermatovenerologist. Self-treatment and with the help of folk remedies is unacceptable and can lead to irreparable complications.


As a rule, men turn to a dermatologist with a suspicion of syphilis when a chancre is found on the penis. After a visual inspection, the doctor takes biological fluids for analysis:

  • chancre content (for primary syphilis);
  • discharge from one of the nodules on the body (in the secondary form);
  • puncture of the enlarged lymph node.

The resulting material is subjected to bacterioscopic and microscopic examination.


The basis for the diagnosis of syphilis in the second stage are serological test methods, which determine the nature of the interaction of antigens in the blood (the product of foreign microorganisms) and antibodies (substances produced by the immune system in response to the invasion). For this purpose, antigens of various origins are introduced into the blood sample under laboratory conditions and a reaction is observed. Wasserman reaction was taken as the basis for many tests: if antibodies to pale treponema are present in the blood, they will contact the antigen and precipitate.

There are several similar research methods (PHA, REEF, RIBT). For reliable results, two are usually used. The optimal diagnostic option is the simultaneous use in the laboratory of the RPR and ELISA tests IgG / IgM. The same methods are used to monitor the dynamics of the course of the disease during therapy.

Rapid test RPR can be purchased at the pharmacy and hold their own. The kit includes a reagent kit and detailed instructions.

The most reliable result is obtained when the analysis is conducted one week after the appearance of the chancre. For tertiary syphilis, the test may be false negative because the amount of antibodies is reduced. If the test is carried out against the background of other diseases that lead to tissue damage, the result is false-positive.


There is a clear treatment regimen for syphilis. Individual dosage and selection of drugs produced by the doctor. It is advisable to conduct therapy in the hospital.

The main component in the treatment of syphilis on an outpatient basis are penicillin derivatives :

  • Retarpen, Extensillin (entered once a week);
  • Bicillin-1 (once every 5 days);
  • Combined means: Billillin-3, Billillin-5 (twice a week).

In a hospital setting, water soluble penicillin is injected every 2-3 hours. Twice a day, they inject procaine benzylpenicillin salt.

If the patient is allergic to penicillin drugs, then prescribe erythromycin, cephalosporin, tetracycline. The course of therapy is 2-4 weeks. With joint intolerance to these drugs with penicillin, Cefazolin is prescribed .

If a specific type of pallid treponema demonstrates resistance to antibacterial drugs (for late latent syphilis), then “heavy artillery” is used — bismuth (biyoquinol) or arsenic (noarsenol) preparations.

In complicated forms of the disease and in neurosyphilis, antibacterial drugs are injected directly into the lymphatic vessels.

In addition to antibiotics, immunomodulators (Amixin) based on interferons (human-related proteins) are used. To stimulate the production of protective cells (phagocytes, lymphocytes), Imunofan, Taktivin, Timogen, Galavit, Likopid is used. To improve blood microcirculation and stimulate the healing of ulcers, Wobenzym, Flogenzyme is prescribed. When syphilis is recommended taking vitamins of group B and ascorbic acid.

Pale treponema is very sensitive to temperature conditions: optimal conditions for reproduction are 37 ° C, with a significant increase or decrease in temperature, the bacteria freezes and may die. Therefore, Pyrogenal is used as an auxiliary drug in the treatment of syphilis (slightly increases body temperature).

Chancran and all types of lesions are treated with a solution of chlorhexidine or dimexidum. The dense bases of chancre are lubricated with heparin.

The prognosis for the treatment of syphilis before the occurrence of irreversible destruction of organs, facial and cranial bones is favorable. After 2 weeks of complex therapy tests are carried out, the dynamics of the disease is determined. If the result is unsatisfactory, the course is repeated, replacing the drugs.


Since syphilis is transmitted mainly through sexual contact, the use of barrier contraceptives is recommended as a preventive measure, although the secretions also get into other parts of the body as well as into the oral cavity. Only monogamous relationships can protect against infection.

In the case of domestic contact with persons suspected of being infected (shaking hands, touching common objects), wash hands with Chlorhexidine.

If sexual contact with a syphilis carrier nevertheless occurred, and also if there is a risk of transdermal (through a wound on the skin) infection, preventive treatment is applied on an outpatient basis: Extencillin, Retarpen, Bitsillin-1, 3, 5 are administered once a week (according to 2 injections weekly). The course is usually 2 weeks, then monitored.

If a man has contacted an infected person and has consulted a doctor only several months later, then such a patient is placed under observation. Twice with an interval of 2 months, studies are conducted using serological reactions, as well as clinical examinations. If more than six months have passed after the contact, the patient is examined once.

Video about the treatment and prevention of syphilis:

Syphilis, although a fairly common and dangerous disease, is rarely taking shape at present, in which irreversible malformations or deaths occur. Even the tertiary late form is successfully treated with several courses of drug therapy. If within 5 years the patient does not have a relapse, then he is removed from the register and is considered cured.