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.
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.
Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: firstname.lastname@example.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.
Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
Copyright © 2004 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions