Syphilis

Abstract

In the last half of the 20(th) century, medicine has made tremendous inroads against syphilis chiefly owing to the introduction of penicillin and vigorous public health initiatives. Yet, the world continues to be burdened by this disease. Since 2000, overall rates of syphilis have risen in the US and throughout the world. Furthermore, through its association with an increased risk of HIV infection, syphilis has acquired a new potential for morbidity and mortality. The aim of this review is to survey the latest knowledge about syphilis, including pathogenesis and host response, clinical manifestations, diagnostic methods and, especially, treatment and follow-up.

Interesting Serological Tests from Cases in Sexually Transmitted Disease Clinic: A Note

“…In general, after successful complete antibiotic treatment, the VDRL titer should return to non-reactive for most cases within 1-year period. But in some cases, the VDRL titer may remain at the low level for last long time, known as serofast phenomenon (5)(6). In these cases, although the cerebrospinal fluid VDRL is not recommended due to the low risk of neurosyphilis is indicated but follow up of the VDRL titer is necessary.…”

An estimate of syphilis incidence in Eastern Europe

“…Reductions in HIV prevalence are likely to have a beneficial effect on syphilis prevalence and outcomes. However, syphilis infection increases chances of HIV transmission by 7 times and thus treatment can be seen as a way to reduce HIV prevalence in high risk groups [17]. Possible incentives for progress in this area are commitments to the UN Millennium Development Goals, of which HIV reduction and reducing child mortality, in this case due to congenital syphilis, are both included [17].…”

“…This introduces the probability of diagnostic misclassification bias, especially when considered alongside the poor access to diagnostic technology in several countries. It can be assumed that not all cases were subjected to Treponema testing, serology or dark field microscopy to identify the bacteria, thus diagnoses may have been made purely on clinical presentation or non-treponemal tests, many of which have well documented specificity issues [16][17][18][19]. Random misdiagnoses, while problematic, would not be as damaging to the data' s validity as systematic misdiagnosis based on altered clinical presentation due to co-infection with HIV for example, which has been the subject of several other studies [16][17].…”

Treatment of neurosyphilis

“…During this phase, the disease is not transmissible sexually but may still be passed from mother to child, although the risk of vertical transmission is higher in early syphilis [10,Class III]. In the preantibiotic era, approximately one third of untreated patients developed tertiary syphilis years or even decades later [9••, Class III].…”