LAUSR

METHODS for laboratory diagnosis of syphilis include direct detection of T. pallidum subsp. pallidum and serologic testing. Serologic testing relies on both nontreponemal and treponemal tests. In newly developed "reverse-sequence screening algorithms," treponemal tests are performed before nontreponemal tests. Management of syphilis requires appropriate staging, treatment, and follow-up of patients, and prompt reporting of infections to public-health authorities to assist with prevention and control efforts. Benzathine penicillin G remains the treatment of choice for all stages of syphilis. Screening of populations at higher risk for syphilis is recommended by the Centers for Disease Control and Prevention, the U.S. Preventive Services Task Force, and the World Health Organization. Part II of this CME reviews testing for and management of sexually acquired syphilis.