Box 3.4. Treatment must be initiated without waiting for the test results

In case of:

active syphilis
positive serological tests combined with clinical data
epidemiological reason: consider immediate prophylactic treatment of past and present sexual partners, especially for partners of pregnant women.

Patients should be immediately referred to secondary care in the following cases:

pregnancy (also to the gynaecologist)
gum disease
cardiovascular symptoms
neurological symptoms
eye symptoms

Patients should be referred to secondary care after receiving serological results, or even after starting treatment, in the following cases

difficult interpretation of serological tests (as this may influence the duration of treatment)
reinfection