I am often asked by patients, “I am fine and have no symptoms, how can I have syphilis?” “I don’t have any discomfort, do I not need treatment?”
Before answering these questions, let’s understand what latent syphilis is. Latent syphilis, also known as latent syphilis, refers to untreated or under-treated syphilis, no clinical symptoms, positive syphilis seropositivity (excluding the presence of other diseases that can cause positive syphilis seropositivity), and normal cerebrospinal fluid. After human infection with syphilis, due to the strength of individual resistance, the use of antibiotics and other reasons, resulting in some patients do not appear typical syphilis symptoms, or symptoms last for a short time and then disappear, entering the latent syphilis stage, in this case, it is difficult to detect the disease. Although there are no symptoms, the syphilis spirochete still exists in the body, which can cause damage to the body and is somewhat contagious. Wu Minzhi, Department of Dermatology and Venereology, Suzhou Fifth People’s Hospital
These patients’ disease is discovered by finding positive syphilis serologic reactions, some during blood donation physical exams, some during marriage physical exams, and some during treatment for other STDs. Syphilis serology tests generally include two: 1 Rapid plasma reactin ring card test (RPR), 2 Syphilis spirochete particle agglutination test (TPPA). the RPR is generally used as a preliminary screening test, and positive individuals need to have their titers done in order to compare with the retest titers after treatment. the TPPA is used as a confirmatory syphilis test, and its positivity is required to finalize the diagnosis of syphilis.
After the diagnosis is established, treatment is recommended as soon as possible, usually with long-acting penicillin (in case of a negative skin test) once a week for three weeks. In case of penicillin allergy, doxycycline, erythromycin, azithromycin, ceftriaxone, etc. can be used as appropriate. Since syphilis is a sexually transmitted disease and is contagious, patients are advised to treat their sexual partners together.
After anti-syphilis treatment, a follow-up period of 2 to 3 years is required, with a review every 3 months in the first year and every 6 months thereafter, preferably in the same laboratory, to review the RPR titer and compare it with the previous titer to see if it has decreased and how much it has decreased.
In response to the problem of syphilis, we call for the establishment of awareness of safe sex and the importance of marriage and perinatal examinations in order to detect and diagnose the disease as early as possible and to achieve eugenic reproduction.