Portuguese Italian Spanish English French German


Syphilis is a worldwide chronic sexually transmitted disease caused by the spirochete Treponema pallidum. Notorious for its variable clinical manifestations, syphilis is often referred to as the "great imitator." Prior to World War II, syphilis was a common disease in the United States, with about 1 of every 13 Americans infected. With the advent of penicillin in the 1940s, along with improved public health measures, disease rates declined markedly. Syphilis became relatively rare in the United States, resulting in a lack of familiarity with the disease by most clinicians. In the late 1980s and early 1990s, syphilis made a resurgence, which was linked to the acquired immunodeficiency syndrome epidemic and later with epidemics of illegal drug use, especially crack cocaine. Since then, syphilis rates have declined markedly, with an all-time low rate of 2.5 cases per 100,000 population in 1999, making future eradication of the disease a possibility.

To continue this trend and prevent the potentially devastating sequelae of untreated syphilis, primary care physicians should be familiar with the diagnosis and management of syphilis. The most common clinical dilemmas that arise are how to interpret serologic findings, when to perform a lumbar puncture, and how to assess response to therapy.


Men's Health

  might be behind the outbreak buy proscar of microcephaly,