Syphilis. Updated approach to an old disease.

Syphilis, a sexually transmitted disease caused by Treponema pallidum, is widespread but most common in large cities. The various stages include primary, secondary, latent, tertiary (late), and congenital syphilis and neurosyphilis. Definitive diagnosis is made by finding spirochetes on a darkfield examination of material from a chancre or moist mucosal lesion. Serologic tests for syphilis in common use in the United States include the VDRL and the FTA-ABS. Penicillin is the drug of choice for all stages of syphilis, with tetracycline or erythromycin indicated in certain patients. Accurate and prompt reporting of syphilis cases is an important factor in disease control.