What should you know about syphilis the great imitator?

Possible findings include a sore in the genital, anal, or mouth area; swollen glands; a rash on the body, palms, or soles; fever; sore throat; or patchy hair loss. Later problems may involve the eyes, ears, brain, spinal cord, heart, or blood vessels. These features overlap with other conditions, which is why a careful sexual and medical history is useful even when the symptom seems unrelated.

Arrange confidential testing if you have a new unexplained sore or rash, a possible sexual exposure, or a partner with syphilis. Explain the timing, body locations, previous treatment, allergies, and pregnancy status. Blood testing is common; a clinician may also examine a lesion or assess the eyes, ears, and nervous system. If diagnosed, take the prescribed antibiotics and follow advice about partners and sexual contact.

Seek prompt care for a new painless sore, a rash with fever, eye pain or vision change, hearing change, severe headache, weakness, numbness, balance trouble, or confusion. Sudden loss of vision, sudden weakness, or severe neurological change needs emergency help. Pregnancy with possible exposure also warrants prompt assessment.

Ask what other conditions are being considered, which tests will distinguish them, whether a repeat test is needed, whether symptoms suggest eye or nervous-system involvement, and when follow-up should occur after treatment.