TRANSMISSION Syphilis is transmitted by direct contact with the lesions of an infected person If lesions are internal or unnoticed, transmission can occur without either partner being aware of the disease The primary mode of transmission is by anal, oral and vaginal sexual contact A pregnant woman can transmit syphilis infection to her unborn child, which can result in miscarriage, stillbi. [...] Anyone with risk behaviours/potential exposures to infectious syphilis Contacts of known syphilis cases; Men who have sex with men (MSM); Street involved/homeless persons; Injection drug users; Those with multiple sexual partners; Those with history of STIs; Those originating from or having sex with an individual from a high prevalence country or a province where there is an outbreak. [...] Clinical history Typical signs/symptoms in the past 12 months Known contact of a confirmed case History of previous syphilis infection Physical examination Lymph nodes Skin of torso Palms and soles Genital, perineal and oropharyngeal areas Abdomen Neurological exam Laboratory diagnosis Serological testing is performed to identify Treponema pallidum (T. [...] pallidum antigens Usually reactive for life Cannot be used to assess treatment response This is the first test in the series done by the Newfoundland and Labrador Public Health Laboratory (PHL) (refer to Figure 2) Includes o TP (T. [...] *NP- Test Not Performed Indications for testing cerebrospinal fluid (CSF) CSF examination is indicated in patients with suspected/confirmed syphilis with a presence of: Neurologic or ophthalmic signs and symptoms; Congenital syphilis Treatment failure TREATMENT Long-acting benzathine penicillin G (Bicillin® L-A) as a single dose of 2.4 million units IM is the preferred treatment for non-pr.
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