Syphilis

Key Points Syphilis, caused by Treponema pallidum, spreads sexually or congenitally. Rising rates of syphilis highlight the importance of vigilant screening. Symptoms vary by stage and type of infection (primary, secondary, and tertiary acquired syphilis; congenital syphilis; and neurosyphilis) and range from genital ulcers to systemic manifestations. Diagnosis relies on clinical history, physical examination, nontreponemal serologic screening, and treponemal serologic confirmatory testing. Neurosyphilis is diagnosed through cerebrospinal fluid (CSF) analysis. Intravenous (IV) penicillin G is the preferred treatment for any stage of syphilis. Prevention includes safe sexual practices, routine screening for sexually transmitted infections (STIs), and prenatal testing, as early treatment leads to excellent outcomes.