Am Fam Physician. 2004 Nov 1;70(9):1646.
to the editor: The article, “Diagnosis and Management of Syphilis”1 by Drs. Brown and Frank in the July 15, 2003, issue of American Family Physician is an excellent review. However, the authors should have made it clearer that the treponemal test might serorevert with effective treatment in the first episode of primary syphilis2,3 and in some patients with human immunodeficiency virus infection.4
Given the fact that a nontreponemal test might remain positive for a long time (if not forever),1,2,5 a printout that shows the patient’s titers at the time the patient was considered cured should be facilitated to avoid unnecessary treatment by another physician.
REFERENCESshow all references
1. Brown DL, Frank JE. Diagnosis and management of syphilis. Am Fam Physician. 2003;68:283–90....
2. Romanowski B, Sutherland R, Fick GH, Mooney D, Love EJ. Serologic response to treatment of infectious syphilis. Ann Intern Med. 1991;114:1005–9.
3. Ooi C, Dayan L. Syphilis. Diagnosis and management in general practice. Aust Fam Physician. 2002;31:629–35.
4. Lukehart SA. Serologic testing after therapy for syphilis: is there a test for cure? [Editorial]. Ann Intern Med. 1991;114:1057–8.
5. Goh BT, van Voorst Vader PC, European Branch of the International Union against Sexually Transmitted Infection and the European Office of the World Health Organization. European guideline for the management of syphilis. Int J STD AIDS. 2001;12:suppl 314–26.
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