Patient discussions

Patients should be informed that future treponemal-specific testing will reveal previously treated syphilis infection.

Before receiving antibiotic treatment, all patients should be advised of the possibility of the Jarisch-Herxheimer reaction occurring, particularly those patients with early syphilis. The reaction may occur within the first 24 hours after antibiotic therapy due to the rapid killing of treponemes. It is characterised by acute fever, headache, and myalgia. In pregnant women this may cause fetal distress and premature labour.

Patients with primary syphilis should be advised to avoid sexual activities (including oral sex) until the lesions have resolved. Specifically, abstinence from sexual activity is recommended for at least 2 weeks after the lesions of primary syphilis have fully healed, and until 2 weeks after therapy is complete.[3]

Social stigma remains regarding syphilis infection and there may be patient concern about future disclosure issues (e.g., antenatal screening).

Contact tracing of sexual partners should be undertaken to identify asymptomatic patients at risk of syphilis. CDC: syphilis - fact sheet external link opens in a new window

Patient information from recommended websites may be useful. NHS Choices: syphilis external link opens in a new window

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