Because the infectious agent of syphilis cannot be cultured in vitro, diagnostic measures must rely mainly on serologic testing, microscopic detection of T pallidum in lesions, and other examinations (biopsies, lumbar puncture, x-rays)…

Essentials of Diagnosis
  •  Infiltrative tumors of skin, bones, liver (gummas).
  •  Aortitis, aneurysms, aortic regurgitation.
  •  Central nervous system disorders, including meningovascular and degenerative changes, paresthesias, shooting…

A. Specific Measures

1. Penicillin - Penicillin, as benzathine penicillin G or aqueous procaine penicillin G, is the drug of choice for all forms of syphilis and other spirochetal infections. Effective tissue levels must be…

Introduction

Syphilis is a complex infectious disease caused by Treponema pallidum, a spirochete capable of infecting almost any organ or tissue in the body and causing protean clinical…

The Jarisch-Herxheimer reaction is ascribed to the sudden massive destruction of spirochetes by drugs and release of toxic products and is manifested by fever and aggravation of the existing clinical picture. It…

Avoidance of sexual contact is the only completely reliable method of prophylaxis but is an impractical public health measure for obvious reasons. Annual screening for syphilis among men who have sex with men has been…

Congenital syphilis is a transplacentally transmitted infection that occurs in infants of untreated or inadequately treated mothers. The physical findings at birth are quite variable: The infant may have many or minimal signs or even…

All pregnant women should have a nontreponemal serologic test for syphilis at the time of the first prenatal visit. In women suspected of being at increased risk for syphilis or for populations in which…

Interpretation of serologic tests should be the same for HIV-positive and HIV-negative individuals. Because syphilis has variable clinical manifestations and an unpredictable course, evaluation of case reports of unusual clinical or…

Essentials of Diagnosis
  •  No physical signs.
  •  History of syphilis with inadequate treatment.
  •  Positive serologic tests for syphilis.

General Considerations & Treatment

Latent syphilis is…

The essentials of diagnosis are the same as in secondary syphilis.

The lesions of secondary syphilis heal spontaneously, but secondary syphilis may relapse if undiagnosed or inadequately treated. These relapses may include…

Essentials of Diagnosis
  •  Generalized maculopapular skin rash.
  •  Mucous membrane lesions, including patches and ulcers.
  •  Weeping papules (condylomas) in moist skin areas.
  •  Generalized nontender…

Essentials of Diagnosis
  •  History of sexual contact (often unreliable).
  •  Painless ulcer on genitalia, perianal area, rectum, pharynx, tongue, lip, or elsewhere 2-6 weeks after exposure.
  •  Nontender…