Syphilis: symptoms, testing and where to get treated

Syphilis is a bacterial infection passed on through direct contact with a syphilis sore during vaginal, anal or oral sex. It can also pass from a pregnant woman to her baby.

According to the CDC, the right antibiotic cures syphilis, but having had it does not protect you: you can get it again. Untreated, it can stay quiet in the body for years and, 10 to 30 years later, damage the heart, brain and other organs.

Primary. A sore, usually painless, appears where the bacteria entered: the genitals, anus, lips or mouth. It lasts 3 to 6 weeks and heals on its own, with or without treatment. The sore going away does not mean the infection has.

Secondary. A rash appears on one or more parts of the body, often on the palms of the hands and soles of the feet, and usually does not itch. It can come with fever, swollen glands and tiredness.

Latent. There are no symptoms, but the infection is still there and only a blood test finds it.

Tertiary. Years later, it can affect many organs. Also, according to the CDC, syphilis can reach the eyes, ears or nervous system at any stage.

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According to the CDC’s 2021 STI Treatment Guidelines, the recommended treatment for primary and secondary syphilis is a single injection of benzathine penicillin G into the muscle. That injection is given in person. If your test is positive, the doctor explains the result and tells you where to go to get it.

The Puerto Rico Department of Health runs Centers for the Prevention and Treatment of Communicable Diseases (CPTET) in its eight regions, and an HIV and STI line: (787) 765-1010. If you are allergic to penicillin, say so in the visit: the doctor goes over the options in the guidelines with you.

The CDC recommends repeating the blood tests 6 and 12 months after treatment to confirm it worked. You can do that review with us in a follow-up visit.

According to the CDC, the sex partners of someone with early syphilis (primary, secondary or early latent) from the 90 days before the diagnosis should be treated even if their test is negative. Partners from before that need testing.

For telling partners, the CDC counts back: 3 months plus how long symptoms lasted for primary syphilis, 6 months plus how long symptoms lasted for secondary, and 1 year for early latent. Each partner needs their own evaluation with a doctor. The doctor helps you plan how to tell them.

If you are pregnant and have syphilis or a positive result, you need your OB-GYN right away. According to the CDC, untreated syphilis in pregnancy can lead to a low-birth-weight baby, stillbirth, or a baby born with syphilis who may have cataracts, deafness or seizures. The CDC recommends syphilis testing at the first prenatal visit. A syphilis test is also part of the Puerto Rico health certificate.

If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.

For your safety, go to the emergency room or call 911 if you have any of these signs. See when to go to the ER.

• Sudden changes in your vision, or hearing loss
• Confusion, weakness on one side of the body, or a severe headache with a stiff neck
• Sexual assault
• Possible HIV exposure in the last 72 hours, to be evaluated for preventive treatment (PEP)