Exams and Tests

Syphilis can masquerade as any disease. Therefore, your doctor will carefully sort out the symptoms, ask when they appeared, and take a complete sexual history. The doctor may ask about your use of condoms and if your sexual partners show any similar symptoms.

• During the primary phase, the doctor will look for a single, painless sore on the male or female genitalia. The mouth, anus, and other parts of the body may also be the site of the initial infection. Lymph nodes near a sore may be swollen.
  
  
  • During the primary phase, the doctor may obtain a sample of your sore and perform a dark-field (microscope) exam. This test may also be useful during the secondary phase.
  
  
• Secondary syphilis frequently presents with a diffuse rash and swollen lymph nodes. Your doctor will also ask you about the progression of the rash. Your accurate and descriptive answers are very important. Lesions on the palms and soles of the feet make a diagnosis of syphilis more likely.
  
  
  • Blood testing is the cornerstone of diagnosis during the secondary phase. The doctor will usually order one of the following tests. All three help diagnose a syphilis infection.
    
    
    • RPR (rapid plasma reagin)
      
      
    • VDRL (venereal disease research laboratory)
      
      
    • FTA-ABS (fluorescent treponemal antibody absorption) or MHA-TP (microhemagglutination assay for T pallidum)
  
  
• During the tertiary phase, the doctor may need to obtain a sample of your spinal fluid to check for infection and to measure the success of treatment.