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Syphilis in Miami: Symptoms, Testing and Treatment

Updated · Sources are cited in the text

Syphilis in Miami: Symptoms, Testing and Treatment

This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Syphilis is a bacterial infection that is easy to miss and very treatable. The CDC says it can pass through several stages, and the early signs are often painless or mild. That is one reason blood testing matters more than waiting for something to look wrong.

This guide explains how syphilis works, what the stages look like, how the blood tests are read, and what treatment involves. It also covers what the Florida Department of Health reports for Miami-Dade County and where free or low-cost testing is available in the city.

The short answers first. Syphilis symptoms vary a great deal from person to person. The syphilis rash is one of the most recognizable signs, but it can be faint. Is syphilis curable? Yes. The CDC says the infection can be cured with penicillin prescribed by a clinician.

The science: what causes syphilis

Syphilis is caused by a bacterium called Treponema pallidum. It is a spirochete, which means it is thin and spiral shaped. The CDC says it spreads mainly through direct contact with a syphilis sore during vaginal, anal or oral sex. It can also pass from a pregnant person to a baby during pregnancy.

The bacterium cannot be grown easily in a routine lab setting. That shapes how syphilis is found. Clinicians rely on blood tests that look for the body's response to the bacterium, not on a culture of the germ itself. Sometimes a clinician also examines fluid from a sore under a special microscope, when that is available.

Research suggests the bacterium can spread through the body early in infection, which is why syphilis can eventually affect many organ systems. The CDC describes this in its STI Treatment Guidelines (2021). It also explains why a sore in one place can be followed by a rash somewhere else.

Anyone who is sexually active can get syphilis, whatever their gender, orientation or relationship status. The CDC notes that some groups have been affected more than others in recent years. Risk is about contact with the bacterium, not about who a person is.

Why the national rise matters

The CDC has reported that syphilis cases have risen across the United States in recent years. That includes congenital syphilis, which happens when the infection passes to a baby during pregnancy. The CDC calls congenital syphilis preventable, because testing and treatment during pregnancy can stop it.

The national rise matters for a practical reason. When more people in a community have syphilis, more people are likely to meet it, including people who have no symptoms. Routine testing is how infections get found early.

The CDC's 2023 state ranking tables list Florida at 19.3 primary and secondary syphilis cases per 100,000 people, ranked 16th among states. For congenital syphilis, the same CDC tables list Florida at 104.7 cases per 100,000 live births (235 cases), ranked 17th.

Those CDC figures are for 2023. The CDC's 2024 state-level STI tables were not published, so 2023 is the most recent state comparison from the CDC.

Syphilis in Miami-Dade: what the state data shows

The Florida Department of Health publishes current numbers through FLHealthCHARTS. For 2025, it lists infectious syphilis (primary plus secondary stages) for Miami-Dade County and for the whole state:

Measure (2025)Miami-Dade CountyFlorida
Infectious syphilis, per 100,00016.8 (472 cases)12.4 (2,903 cases)
Chlamydia, per 100,000471.5 (13,271 cases)410.8 (96,044 cases)
Gonorrhea, per 100,000250.5 (7,052 cases)156.5 (36,596 cases)
New HIV diagnoses, per 100,00023.7 (668 diagnoses)15.0 (3,512 diagnoses)

Source: FLHealthCHARTS, Florida Department of Health, 2025 data. The HIV figures are listed as of June 30, 2026.

The syphilis rate in Miami-Dade is higher than the statewide rate. These are counts of diagnosed cases. They reflect who got tested as well as who was infected, so they are a guide and not a full picture.

The state figures above come from FLHealthCHARTS for 2025. The CDC figures in the previous section are for 2023. They come from different sources and years, so they should not be compared line by line.

Many STIs occur together. The CDC recommends that anyone diagnosed with syphilis also be offered an HIV test, and a clinician may suggest other tests too. For a closer look at another common infection, see this guide to chlamydia symptoms, testing and treatment in Miami.

The stages of syphilis

The CDC divides syphilis into stages. A person can move through them over months or years, and some stages produce no signs at all. Stage names help clinicians choose the right treatment and follow-up.

Primary syphilis: the first sore

The first sign is usually a single sore called a chancre. The CDC describes it as firm, round and typically painless. Because it does not hurt, it can go unnoticed, especially when it is inside the mouth, vagina or rectum.

The CDC says the sore can appear about three weeks after exposure, though the range is wide. It usually heals by itself over several weeks. Healing does not mean the infection is gone. The bacterium can still be in the body, and only a clinician or a test can tell what is going on.

Secondary syphilis: the rash and other signs

The syphilis rash is the best-known sign of the secondary stage. The CDC describes it as rough, red or reddish-brown spots that can appear on the palms of the hands and the soles of the feet. It can also show up on the chest, back or other areas, and it does not always itch.

Some people have a very faint rash that is easy to overlook. Others have a rash that looks like other common skin conditions. Skin changes alone cannot confirm syphilis, so a clinician usually pairs an exam with a blood test.

The CDC lists other secondary syphilis symptoms as well:

  • Fever and tiredness
  • Sore throat
  • Swollen lymph glands
  • Patchy hair loss
  • Headaches and muscle aches
  • Weight loss
  • Moist, wart-like patches in warm areas of the body, or sores in the mouth or genital area

These signs can also come and go on their own. A person might feel fully well again within weeks, even though the infection has not been treated.

Latent syphilis: no signs

The CDC calls the stage with no symptoms latent syphilis. A person may feel and look entirely well. The infection can only be found by a blood test.

Clinicians divide latent syphilis into early and late. Which one applies depends on how long ago the infection likely began, and that affects treatment. A clinician works this out from your history and test results.

Tertiary syphilis and other serious complications

The CDC says that without treatment, some people go on to tertiary syphilis, usually many years after the first infection. It can affect the heart, blood vessels, brain and nervous system. The CDC notes that treatment can stop further damage but cannot undo damage that has already happened.

The nervous system, the eyes and the ears can also be affected at earlier stages. This is called neurosyphilis, ocular syphilis and otosyphilis. Symptoms can include severe headache, vision changes or hearing changes. Anyone with those symptoms should be seen by a clinician promptly.

Blood tests for syphilis: how they work

Most syphilis diagnoses start with a blood draw. The CDC describes two types of blood tests. Each answers a different question, so clinicians often use both.

Treponemal tests

Treponemal tests look for antibodies made specifically against the syphilis bacterium. Examples named in CDC guidance include enzyme immunoassays, chemiluminescence immunoassays and the TP-PA test. The CDC says these tests usually stay reactive for life, even after successful treatment.

That means a reactive treponemal test shows that the body has met the bacterium at some point. It does not show, by itself, whether an infection is new, old or already treated.

Non-treponemal tests

Non-treponemal tests, such as the RPR and VDRL, measure a different marker that the body makes in response to the infection. They report a number called a titer, such as 1:8. Research suggests these titers tend to rise with active infection and fall after effective treatment.

That makes them useful for follow-up. A clinician compares the number over time to see whether treatment is working.

Why two tests are used

The CDC's STI Treatment Guidelines (2021) describe two testing approaches. In the traditional order, a non-treponemal test comes first and a treponemal test confirms it. In the reverse order, used by many large labs, a treponemal test comes first and a non-treponemal test follows.

Either way, the combination of both tests helps a clinician sort out whether a result points to current infection, past treated infection or a result that needs another look. Results can be confusing, so reviewing them with a clinician is important.

Timing and false negatives

Very early in an infection, the body may not yet have made enough antibodies for a blood test to detect. A negative result right after a possible exposure therefore may not tell the full story. The CDC's guidance and a clinician can explain whether a repeat test is useful in your situation.

This guide does not give a specific number of days, because timing depends on the test and the stage. The CDC's syphilis pages and the clinician who orders your test are the right places to ask.

Who is advised to be screened

The U.S. Preventive Services Task Force recommends screening for syphilis in people at increased risk and in everyone who is pregnant. The CDC recommends regular screening for sexually active gay, bisexual and other men who have sex with men, with frequency based on risk. Clinicians can talk through what applies to you without judgment.

Is syphilis curable? Treatment from a clinician

Yes. Is syphilis curable is one of the most common questions, and the CDC's answer is clear. Syphilis can be cured with the right antibiotic prescribed by a clinician. Penicillin is the CDC's preferred treatment for every stage.

The kind of penicillin, how it is given and for how long all depend on the stage of infection and your health history. Those decisions belong to a clinician. This guide does not list doses or schedules for that reason.

Treatment stops the infection from progressing. As noted above, it cannot reverse damage that already happened in late stages, which is another reason early testing helps.

Safety profile and what to tell your clinician

Penicillin has been used for syphilis for decades. The CDC describes it as effective and well studied. A few safety points are worth knowing:

  • Allergy. Tell your clinician if you have ever had a reaction to penicillin. The CDC notes that many reported allergies turn out not to be true allergies, and clinicians can sometimes evaluate this. For some non-pregnant people with a true allergy, clinicians may choose a different antibiotic.
  • Pregnancy. The CDC says penicillin is the only recommended treatment for syphilis in pregnancy. A pregnant person with a penicillin allergy is typically referred for specialized care so penicillin can still be used.
  • A short-term reaction. The CDC describes a reaction called Jarisch-Herxheimer that can happen within about a day of treatment. It can include fever, chills, headache and muscle aches. It usually passes within a day or so. Tell the clinic if symptoms are strong or you are worried.
  • Other conditions and medicines. Share your full health history, including HIV status and any medicines you take, so the clinician can plan safely.

Do not use leftover antibiotics or antibiotics from another person. The wrong drug can ease symptoms without curing syphilis, and it can make later testing harder to interpret.

Follow-up blood tests

Treatment is not the end of care. The CDC's guidelines call for repeat blood tests after treatment to confirm that the non-treponemal titer is falling as expected. For early syphilis, the CDC describes follow-up at about 6 and 12 months. A clinician sets the exact schedule, and people with HIV or later-stage infection may need different timing.

Because treponemal tests can stay reactive for life, a positive result on that type of test after treatment is expected and does not mean treatment failed. The follow-up number is what a clinician watches.

Partners and prevention

The CDC advises that recent sexual partners be told so they can get tested and, when appropriate, treated. For some partners, clinicians may treat as a precaution before test results are back. Clinics and the health department can help with notifying partners, and many people find that easier with a professional's help.

Florida lists syphilis as a reportable condition under Rule 64D-3.029 of the Florida Administrative Code, and labs and practitioners report it to the Department of Health. Health department staff may follow up on partner notification as part of that process.

Condoms and dental dams lower the chance of passing syphilis when they cover the sore area, though a sore in an uncovered spot can still pass the infection. In 2024, the CDC issued guidance on doxycycline taken after sex (often called doxy-PEP). The CDC says clinicians may offer it to some men who have sex with men and transgender women who have had a bacterial STI in the past year, to lower the chance of syphilis, chlamydia and gonorrhea. Whether it fits your situation is a conversation for a clinician.

The Miami clinic information available for this guide does not name a doxy-PEP prescriber. Ask a clinic or the health department what they offer.

Pregnancy and syphilis in Florida

Florida Administrative Code Rule 64D-3.042 sets testing rules for pregnancy. It says practitioners providing prenatal care must test for chlamydia, gonorrhea, hepatitis B, HIV and syphilis at the first exam for the current pregnancy. They test again at 28 to 32 weeks. A person may decline in writing.

The rule also covers delivery. People who arrive at delivery or within 30 days after with no prenatal care, no record of testing, or no record of testing after the 27th week must be tested before discharge for HBsAg, HIV and syphilis. Anyone with a reactive syphilis test during pregnancy must be tested as soon as possible at or after delivery.

The statute behind this rule is Fla. Stat. § 384.31. If you are pregnant or planning a pregnancy, ask your prenatal clinician which tests are part of your care.

Privacy, minors and the law in Florida

Under Fla. Stat. § 384.30, Florida sets no minimum age for a minor to consent to examination and treatment for sexually transmissible diseases. The statute says a minor's consultation, examination and treatment are confidential and may not be disclosed directly or indirectly, such as by billing a parent or guardian, except as provided in § 384.29. It applies to the Department of Health, licensed physicians and other qualified licensed professionals and health facilities.

Florida also has a disclosure law. Under Fla. Stat. § 384.24(1), a person who knows they have syphilis and has been told they may transmit it may not have sexual intercourse with another person unless that person has been informed and consents. Violation is a first-degree misdemeanor under § 384.34(1). A clinic can help you understand how to talk with partners.

Quality indicators: choosing a place to get tested

Syphilis tests are only as useful as the care around them. A few signs point to a good testing experience, whichever site you choose:

  • A licensed clinic or health department. Clinicians can order the right tests, read results in context and prescribe treatment.
  • Clear information about which tests are done. Ask whether the syphilis blood test is included, since some sites list only certain tests.
  • Treatment or a referral. A site that can treat, or connect you to treatment, saves a step.
  • Privacy. Ask how results are shared and how billing works.
  • Follow-up. Ask how you will get results and when repeat tests would happen.

Because clinics change hours and services, call or check the clinic's page before you go.

Where to get tested in Miami

Here are local options, with what each source says. For a full list with costs, see our guide to STD testing in Miami: where to get tested and what it costs, or the local testing list.

Florida Department of Health in Miami-Dade County

The health department runs two STI clinics. Its STI page says, "We offer low or no-cost testing for chlamydia, gonorrhea, syphilis, and HIV." Call 305-575-3800 to schedule an appointment. The page does not state whether walk-ins are accepted, and it does not publish a fee schedule.

  • Health District Center: 1350 NW 14th St., Suite 350, Miami, FL 33125. The health department lists Monday through Friday, 8 a.m. to 3:30 p.m., closing at noon on the 1st and 3rd Fridays.
  • West Perrine Health Center: 18255 Homestead Ave., Miami, FL 33157. Listed hours are Tuesday, Thursday and Friday, 8 a.m. to 3:30 p.m., closing at noon on 3rd Fridays.

The disease control line is 305-470-5660. The HIV testing line is 786-792-5269. More details are on the health department's STI page.

Community health centers

  • Care Resource, Midtown Miami: 3510 Biscayne Blvd., Miami, FL 33137. Phone 305-576-1234. Testing hours are listed as Monday through Friday, 8:15 a.m. to 4:30 p.m. CDC GetTested lists free STI and HIV tests and says no appointment is required. Care Resource says it offers a sliding fee scale for people who are uninsured or underinsured. Ask whether syphilis is part of the STI panel.
  • Borinquen Medical Centers, Main Office: 3601 Federal Hwy, Miami, FL 33137. Phone 305-576-6611. CDC GetTested lists STI and HIV tests as free, with no appointment required, and says Borinquen accepts insurance, Medicaid and Medicare and offers a sliding scale.
  • Jessie Trice Community Health System, Main Center: 5361 NW 22nd Ave, Miami, FL 33147. Phone 305-637-6400. CDC GetTested lists sliding scale pricing and no appointment required. It lists HIV, chlamydia and gonorrhea tests but does not list syphilis for this site, so ask when you call.
  • UM Rapid Access Wellness Clinic and PrEP Program: 1120 NW 14th St, Miami, FL 33136. Phone 305-243-2584. CDC GetTested lists STI and HIV tests as free and says an appointment is required.

Pridelines, an LGBTQ+ community center, lists testing through its Thrivelines program at 1130 Washington Ave, First Floor, Miami Beach, FL 33139, phone 305-571-9601. It is in Miami Beach, not the City of Miami. Its page describes HIV testing as fast, free and confidential. Check with Pridelines about syphilis testing and its walk-in policy.

You can also look up more clinics on the CDC's GetTested locator. Hours and services change, so confirm with the clinic first.

Questions to bring to your visit

  • Which tests will be done, and does that include a syphilis blood test?
  • What will I pay, and is there a sliding scale if I do not have insurance?
  • How and when will I get my results?
  • If a result is reactive, what stage does the clinician think it is, and what treatment do they prescribe?
  • When should I have follow-up blood tests?
  • Should my partners be tested or treated?
  • Should I also be tested for HIV and other infections?

Asking is part of good care. Clinicians hear these questions every day.

The bottom line

Syphilis symptoms can be subtle, painless or absent, and the syphilis rash can be mild. Blood tests are the reliable way to find out. The CDC says syphilis is curable with penicillin from a clinician, and follow-up blood tests confirm that treatment is working.

If you are wondering about syphilis treatment or testing, a visit to a local clinic is a practical next step. Free and low-cost options exist across Miami.

Sources