Primary herpes simplex and primary syphilis: a description of seven cases

This report describes the cases of seven patients who had primary genital infection with herpes simplex virus and whose initial nontreponemal and treponemal tests for syphilis were nonreactive. On routine posttreatment examination, a change in the consistency of the ulcers was noticed, and the inguinal nodes, which had been soft and tender, were hard and non-tender. The morphologic changes indicated the probable presence of concomitant primary infection with Treponema pallidium, which was confirmed serologically for all seven patients and by a positive darkfield examination for two patients. Clinicians should be aware that different sexually transmitted diseases often coexist. Patients who have primary genital herpes should be followed clinically and serologically until recovery is complete.