Fast Five Quiz: Common STDs

Michael Stuart Bronze, MD

Disclosures

January 17, 2019

Unprotected sex is the major risk factor for the acquisition of syphilis, especially among men who have sex with men, who account for the vast majority of all syphilis cases in the United States.

Primary syphilis occurs 10-90 days after contact with an infected individual. It manifests mainly on the glans penis in males and on the vulva or cervix in females. Ten percent of syphilitic lesions are found on the anus, fingers, oropharynx, tongue, nipples, or other extragenital sites. Regional nontender lymphadenopathy follows invasion.

Latency may last from a few years to as many as 25 years before the destructive lesions of tertiary syphilis manifest. Affected patients may recall symptoms of primary and secondary syphilis. They are asymptomatic during the latent phase, and the disease is detected only by serologic tests. Latent syphilis is divided into early latent and late latent. The distinction is important because treatment for each is different. The early latent period is the first year after the resolution of primary or secondary syphilis. Asymptomatic patients who have a newly active serologic test after having a serologically negative test result within 1 year are also considered to be in the early latent period. Late-latency syphilis is not infectious; however, women in this stage can spread the disease in utero.

According to the WHO, in settings with a low prevalence of syphilis (< 5%), a single on-site rapid syphilis test should be used to screen pregnant women rather than a single on-site rapid plasma reagin test.

For more on syphilis, read here.

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