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Document 0564
DOCN M9640564
TI Syphilis. A tale of twisted treponemes.
DT 9604
AU Flores JL; Department of Medicine, Veterans Affairs (VA) Medical Center,
San; Francisco, CA 94121, USA.
SO West J Med. 1995 Dec;163(6):552-9. Unique Identifier : AIDSLINE
MED/96137732
AB Despite the widespread availability of effective treatment, the
incidence of primary and secondary syphilis in the United States is on
the rise. In addition, syphilis is occurring in a substantial number of
patients infected with the human immunodeficiency virus (HIV), thus
adding to the complexities of diagnosis and treatment. Primary syphilis
represents a disseminated infection, often accompanied by abnormalities
of the cerebrospinal fluid, that may pass unrecognized and progress to
the myriad manifestations of secondary syphilis. The diagnosis of
syphilis in patients with mucosal or skin lesions may be made by
darkfield examination; once lesions have resolved, serologic tests are
required. Patients with latent syphilis may have asymptomatic
neurosyphilis and risk progression to tertiary disease. The diagnosis of
asymptomatic neurosyphilis is necessary to determine the optimal
treatment of patients with latent disease. The diagnosis of active
neurosyphilis generally requires an inflammatory cerebrospinal fluid
profile and a reactive cerebrospinal fluid VDRL test. Syphilis is common
in HIV-infected patients, who may have an altered antibody response to
infection and an apparent increased incidence of neurologic
complications. The preferred treatment at all stages is penicillin,
which is also the only recommended therapy for neurosyphilis. The
optimal treatment of syphilis in HIV-infected patients is unknown.
DE Human *Syphilis JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).