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Syphilis--an STD on the increase.

¹Department of Community and Family Medicine, Georgetown University School of Medicine, Washington, D.C.

American Family Physician

|September 1, 1991

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Syphilis cases, including primary, secondary, and congenital syphilis, are surging, especially in urban areas. Early diagnosis via serologic testing and penicillin treatment are crucial for managing this rising public health concern.

Area of Science:

Infectious Diseases
Public Health
Epidemiology

Background:

Reported cases of syphilis (primary, secondary, congenital) have significantly increased since 1987.
The rise in syphilis incidence is most pronounced in urban settings.
A known association exists between syphilis and human immunodeficiency virus (HIV) infection.

Purpose of the Study:

To summarize the epidemiology and clinical presentation of syphilis.
To emphasize diagnostic methods and treatment protocols for syphilis.
To highlight the need for improved case reporting and partner management in syphilis control.

Main Methods:

Review of clinical manifestations of primary, secondary, and congenital syphilis.
Discussion of serologic testing for diagnosis, encompassing both nontreponemal and treponemal antibodies.

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Identification of penicillin as the primary treatment modality.

Main Results:

Syphilis incidence shows a rapid upward trend, particularly in urban populations.
Primary syphilis presents as a painless chancre; secondary syphilis involves constitutional symptoms and rash.
Congenital syphilis often presents asymptomatically in newborns.

Conclusions:

Effective management of syphilis requires prompt diagnosis through serologic testing.
Penicillin remains the cornerstone treatment for all syphilis stages.
Enhanced physician attention to case reporting and sexual contact treatment is vital for disease control.