infectious diseases
Syphilis
Key Points
Syphilis has 3 sequential clinical, symptomatic stages separated by periods of asymptomatic latent infection. A characteristic skin lesion (chancre) typically appears at the site of primary infection. Subsequently, almost any organ can be affected, but skin, mucous membranes, eyes, bone, aorta, meninges, and the brain are commonly affected. Diagnose using a nontreponemal (reaginic) test (eg, rapid plasma reagin [RPR] or Venereal Disease Research Laboratory [VDRL]), and confirm positive results using a treponemal antibody test. Treat with benzathine penicillin (Bicillin L-A) whenever possible, except that ocular syphilis, otic syphilis, and neurosyphilis are treated initially with IVpenicillin G. Report cases of syphilis to public health agencies. 