Syphilis: The Great Imitator

01 March 2024

While cases of syphilis (Treponema pallidum) are on the rise in South Australia, it's encouraging to see a surge in proactive testing. SA Pathology processes an average of 1,000 syphilis serology tests weekly, demonstrating a growing commitment to early detection and treatment.

Standard syphilis serology tests are highly effective (95-100%) for detecting later stages, but less so (71-78%) for early infections. To address this, SA Pathology uses a highly sensitive automated test for screening samples. Further confirmatory / supplementary testing may also be required. This ensures accurate diagnosis, even in the crucial early stages when prompt treatment is essential.

In some suspected cases of primary syphilis, we offer a specialised molecular test, PCR, at the Frome Road laboratory. This test directly detects the bacterial DNA in chancre lesions, providing definitive confirmation. Additionally, for diagnosing late-stage syphilis, we perform various serological assays on blood and cerebrospinal fluid samples.

Individuals with a previous syphilis diagnosis might still have detectable antibodies. However, by comparing current test results with past results, we can distinguish between a new infection and past exposure, ensuring patients receive the appropriate treatment. Our historical syphilis results date back decades.

The Challenge Continues:

Despite ongoing efforts to control the spread of syphilis, cases continue to rise. This is partly driven by the recent outbreak, highlighting the need for continued vigilance and awareness.

Together, we can control the spread of syphilis and protect the health of our community.

Stages and Symptoms of Syphilis:

Primary syphilis – Painless sore or sores in or around mouth, anus, penis, vagina, or cervix. Sores usually go away by themselves after 2 to 6 weeks, although patient is still infectious.

Secondary syphilis – Red rash on palms, soles of feet, chest or back (rash is slightly lumpy but not itchy or painful). This can be coupled with a fever, enlarged glands in armpits and groin, hair loss, headaches, and tiredness.

Latent syphilis – Generally no obvious symptoms, with infection only found in blood tests.

Tertiary syphilis – The bacteria can damage almost any part of the body and can cause heart disease, mental illness, neurological problems, and blindness.