[Sharp increase in the number of syphilis cases in The Netherlands: early recognition and treatment is of great importance].

Syphilis was diagnosed in three men having sex with men, aged 36, 38 and 58 years, who had a variety of skin lesions and other symptoms. In a woman aged 38 years and her 39-year-old husband, syphilis was found during routine pregnancy screening. All patients were successfully treated with intramuscular (benzathin) benzylpenicillin. Early recognition and treatment as well as advice on avoiding high-risk sexual behaviour are important in preventing further spread of the disease. Although generally the risk of HIV transmission during unprotected oral sexual contact is believed to be low, the transmission of Treponema pallidum during this type of contact is possible and is probably the most important transmission route amongst men having sex with men.