Funding: P. J. Read received the Royal Australasian College of Physicians 2012 Novartis Fellowship in Sexual Health Research.
Clinical aspects of adult syphilis
Article first published online: 14 JUN 2012
© 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 6, pages 614–620, June 2012
How to Cite
Read, P. J. and Donovan, B. (2012), Clinical aspects of adult syphilis. Internal Medicine Journal, 42: 614–620. doi: 10.1111/j.1445-5994.2012.02814.x
Conflict of interest: None.
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- Received 6 February 2012; accepted 2 April 2012.
Syphilis has been resurgent in Australian cities for the last decade. The varied presentation of this infection requires the physician to consider syphilis in the differential diagnosis of a broad range of conditions. Most cases are in men who have sex with men, young people in remote Aboriginal communities, or travellers from high-prevalence countries. The diagnosis and staging of syphilis require a sexual history, physical examination and interpretation of serological and microbiological findings. Penicillin remains the mainstay of effective treatment and has been used successfully for over 65 years. Treatment failure is rare, whereas reinfection is common. The interaction of syphilis and human immunodeficiency virus is complex, but standard therapy remains curative, and lumbar puncture is rarely required. Regular testing of high-risk individuals, contact tracing with empirical treatment and serological follow up are important components of syphilis control.