Syphilis tests are essential for detecting and diagnosing this common sexually transmitted infection. Often asymptomatic in its early stages, syphilis can cause serious complications if left untreated. This article explores the different types of tests, their importance, and the process and interpretation of the results.
Syphilis tests are used to screen for and diagnose syphilis. Syphilis is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection that is spread through vaginal, oral, or anal sexual contact with an infected person. It can also be transmitted during pregnancy to the fetus.
Syphilis usually develops in several stages. Each stage has different signs and symptoms that can last for weeks, months, or even years. Initially, signs and symptoms may be mild. You might not notice them. So you could have syphilis and not know it. You could pass the infection on to someone else.
Syphilis is easier to treat in the early stages of infection. If left untreated and progresses to an advanced stage, it can cause permanent damage to your health. Treatment may still help, but it won't be able to reverse the damage. In rare cases, untreated syphilis can even lead to death.
Syphilis tests can help diagnose infection in the early stages, when it is easiest to treat. Detecting and treating the infection early can also prevent the spread of syphilis to others.
Other names: rapid plasma reaction (RPR), venereal disease research laboratory (VDRL), fluorescent treponemal antibody absorption test (FTA-ABS), agglutination test (TP-PA), dark field microscopy
Syphilis tests detect and diagnose syphilis by looking for certain antibodies in your blood. Antibodies are proteins that your immune system produces when it finds harmful substances in your body.
Syphilis screening generally involves two steps. In most cases, the first step is a screening test to check for the presence of antibodies linked to a syphilis infection. But other factors can trigger your immune system to produce these antibodies, such as autoimmune diseases, other infections, and vaccinations.
Syphilis tests generally include:
If the result of your screening test shows that you have antibodies linked to syphilis infections, you will need a second test to confirm whether or not you have syphilis.
In general, the second test looks for antibodies that your immune system makes just to fight syphilis. If you have these antibodies, it means that you currently have a syphilis infection, or that you have had a syphilis infection that has been treated in the past. Common tests to check for antibodies to syphilis include:
In some cases, a health professional will use a test that looks for syphilis bacteria, rather than antibodies. These tests are used less often because they can only be performed in specialized laboratories.
You should get tested for syphilis if you have symptoms of syphilis or if your sexual partner has recently been diagnosed with syphilis. Symptoms usually appear about two to three weeks after infection and include:
Even if you don't have symptoms, you should get tested regularly if you have a high risk of contracting syphilis. You are more likely to get syphilis if you have:
Ask your provider how often you should get tested.
You will also need a syphilis test if you are pregnant. If you pass it on to your baby, it could cause serious, and sometimes fatal, health problems for the baby.
If you are pregnant, the Centers for Disease Control and Prevention recommends getting tested for syphilis during your first antenatal visit. If you are more likely to contract syphilis, you should be tested again at 28 weeks of pregnancy and at birth.
A syphilis test is usually a blood test. During a blood test, a health professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected in a test tube or vial. You may feel a slight prick when the needle goes in or out. This usually takes less than five minutes.
At any time, syphilis can affect your brain, spinal cord, and nerves. If your symptoms show that syphilis could be affecting your brain and nervous system, your provider may request a syphilis test of your cerebrospinal fluid (CSF).
CSF is a clear liquid found in your brain and spinal cord. To get a sample of the fluid, a provider will perform a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:
You do not need special preparations for a syphilis blood test. For a lumbar puncture, you may be asked to empty your bladder and bowel before the test.
There are very few risks in taking a blood test. You may feel a slight pain or bruise where the needle was inserted, but most symptoms go away quickly.
If you have had a lumbar puncture, you may experience pain or tenderness in your back where the needle was inserted. You may also experience a headache after the procedure. Headaches can last from a few hours to over a week.
If your screening test results are negatives (normal), this means you probably don't have a syphilis infection. But after being infected, it may take a few weeks for antibodies to develop. So you may need another screening test if you think you have been exposed to syphilis. Your provider can tell you if you need another test.
If your screening test results are positives, this means you have antibodies that may come from a syphilis infection. You will need another test to confirm whether or not you have syphilis.
If your follow-up test confirms that you have syphilis, you will likely be treated with penicillin, a type of antibiotic. Antibiotic treatment completely cures most early stage syphilis infections. More advanced syphilis is also treated with antibiotics, but this treatment cannot undo the damage caused by syphilis.
If you have questions about your test results or about syphilis, talk to your provider.
Learn more about lab tests, reference ranges, and understanding results.
If you are diagnosed with syphilis, you should inform everyone you have had sexual contact with so that they can get tested and treated if needed. You will likely need repeated syphilis tests to see how well your treatment is working. Avoid sexual contact with others until tests show that you are healed.
You may see “self-collection” test kits for syphilis and other sexually transmitted diseases in stores and online. These kits allow you to take a sample of your blood at home and send it to a laboratory for analysis. They only test for the presence of antibodies against the syphilis bacteria. You will therefore need another test to confirm your diagnosis. Talk to your provider to find out if a self-collection test is right for you.
In some parts of the world, there are bacteria that are closely related to the bacteria that cause syphilis. These other bacteria are generally spread through non-sexual skin contact with lesions on an infected person. They can cause illnesses called yaws, bejel, and pinta. Blood tests cannot tell the difference between syphilis and their related bacteria. But a provider can make a diagnosis by examining skin lesions and asking questions about your medical and travel history.
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