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Syphilis — recognition, serology interpretation, and management

A Canadian clinical summary of syphilis — recognition, serology interpretation, and management, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team · Clinical editorial review · reviewed 2026-08-20 · due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Syphilis guide: Treatment and follow-up. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:PHAC syphilis

Source-attributed clinical priorities

  • Interpret treponemal and non-treponemal tests with symptoms, prior treatment, pregnancy and exposure history.
  • Stage infection carefully because treatment and follow-up differ, and assess neurologic, ocular and otic involvement urgently.
  • Treat with the current PHAC and local public-health regimen, arrange serial serology and coordinate partner notification.
  • Stage syphilis from history, examination and prior serology because treatment and follow-up depend on stage.
sources for this section:PHAC syphilis

Practical assessment and management workflow

1
Ask about symptoms, pregnancy, partners, prior treatment and neurologic, ocular or otic features.
2
Use both treponemal and nontreponemal serology and lesion testing when available.
3
Treat with the stage- and pregnancy-appropriate Canadian regimen and test for HIV and other STIs.
4
Follow quantitative titers and coordinate partner notification through public health.
sources for this section:PHAC syphilis

Safety, red flags and urgent escalation

  • Ocular, otic or neurologic symptoms need urgent specialist assessment for neurosyphilis treatment.
  • Syphilis in pregnancy requires immediate treatment and fetal and neonatal coordination.
  • Warn about Jarisch-Herxheimer reaction without delaying required therapy.
sources for this section:PHAC syphilis

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:PHAC syphilis

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:PHAC syphilis

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Public Health Agency of CanadaSyphilis guide: Treatment and follow-upaccessed 2026-08-20
    view source
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