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Syphilis

Melissa Badowski, PharmD, MPH and Mahesh C. Patel, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A chronic, systemic infectious disease caused by Treponema pallidum

  • Transmitted sexually by direct contact with an active lesion, vertically (maternal–fetal), and via blood transfusio...

DIAGNOSIS

HISTORY

  • As a “great imitator,” a high index of suspicion is often required for accurate diagnosis.

  • Previous sexual contact with partner with known infection or high-risk sexual behavior

  • Genital...

TREATMENT

GENERAL MEASURES

  • Advise patients to notify partner(s) and to avoid intercourse until treatment is complete (5)[A].

  • Test for HIV infection (3,5)[A].

  • Management of sexual contacts (5)[A]

    • Presump...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Clinical and serologic evaluation 6 to 12 months after treatment; if >1 year duration, check at 24 months (5)[A].

  • In HIV-infected persons, clinical and serologi...

REFERENCES

1
Gomez GB, Kamb ML, Newman LM, et al. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ.  2013;91(3):217–226...

SEE ALSO

Chlamydia Infection (Sexually Transmitted); Gonococcal Infections 

CODES

ICD10

  • A53.9 Syphilis, unspecified

  • A51.0 Primary genital syphilis

  • A53.0 Latent syphilis, unspecified as early or late

  • A51.5 Early syphilis, latent

  • A52.9 Late syphilis, unspecified

  • A51.49 Other secondar...

CLINICAL PEARLS

  • Screen all HIV-positive patients and patients with high-risk sexual behaviors for syphilis.

  • Penicillin remains the treatment of choice for syphilis.

  • Syphilis rates are rising—particularl...

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