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Syphilis on the Rise: Diagnosis, Treatment, and Prevention

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Syphilis on the Rise: Diagnosis, Treatment, and Prevention

Abstract and Introduction

Abstract


Syphilis is often thought to be a disease of the past, largely eradicated in modern United States health care; however, the rates are still extremely high in certain populations. The diagnosis of syphilis may be overlooked by primary-care clinicians due to the presence of nonspecific signs and symptoms that may be indistinguishable from other diseases. Left undiagnosed and untreated, life-threatening complications, including hepatitis, stroke, and nervous system damage, may occur. This article focuses on identifying high-risk patients and diagnosis and treatment options for syphilis infection.

Introduction


Although syphilis is generally considered to be largely eradicated in the United States, incidence of the disease remains quite high in certain populations. Our clinic is an infectious disease practice serving over 1,700 patients living with HIV/AIDS. Because we serve a high-risk population, we routinely screen patients regardless of symptoms, and we have diagnosed about 115 cases of new syphilis infection throughout 2013. In fact, a recent review of our electronic medical record data showed that 19% of our total patient population has had a positive syphilis test at some point in their care.

Syphilis has many nonspecific signs and symptoms that may be overlooked by the uninitiated nurse practitioner (NP), or may simply be indistinguishable from other more common diseases. Regrettably, undiagnosed and untreated syphilis may lead to life-threatening complications such as hepatitis, stroke, and nervous system damage. In this study we describe identification of high-risk patients for screening, diagnosis, and treatment of syphilis infection.

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