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See Latest ArticlesDilemmas in the Management of Syphilis: A Survey of Infectious Diseases Experts
Clinical Infectious Diseases, 10/29/09
Dowell D et al. – The authors surveyed infectious diseases consultants to determine how they manage syphilis when there are insufficient data to guide management or when guidelines cannot be followed because of a lack of available definitive diagnostic tests. Most providers did not have access to dark–field microscopy. The authors found variation in management of syphilis, especially for patients with human immunodeficiency virus infection.
Dr Deborah Dowell, 11/04/09
| We found that most health professionals do not have access to the tests necessary to reliably diagnose syphilis in its earliest and most infectious stage. Definitive diagnosis of primary syphilis (the earliest stage of syphilis infection) relies on direct fluorescent antibody testing or darkfield microscopy, both of which are often unavailable in a clinical setting. Blood tests are commonly used to diagnose syphilis; however those tests may miss 20-30% of primary syphilis cases, allowing for the possibility of ongoing transmission. Eighty-one percent of our survey respondents did not have access to darkfield microscopy. These clinicians should treat presumptively if they suspect early syphilis in their patients. There is a clinical and public health need for a rapid point of care test to reliably diagnose primary syphilis. |
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