Syphilis--an STD on the increase

The number of reported cases of syphilis, including primary, secondary and congenital syphilis, has been rapidly rising since 1987. The greatest increases have occurred in urban areas. An association between human immunodeficiency virus infection and syphilis has been established. Primary syphilis is manifested by a clean, painless ulcer called a chancre. Secondary disease often presents with constitutional symptoms and a maculopapular rash. Most infants with congenital syphilis are born without signs of infection. Serologic testing for both nontreponemal and treponemal antibodies is essential for diagnosis. Penicillin is the treatment of choice for all stages of syphilis. Case reporting and treatment of sexual contacts are two aspects of this disease that warrant greater attention from physicians.