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The resurgence of syphilis among men who have sex with men.
Current Opinion Infect Dis 2007;20:54-59.
Peterman TA, Furness BW.
Abstract
PURPOSE OF REVIEW: To identify recent progress and emerging problems in addressing
syphilis among men who have sex with men. RECENT FINDINGS: A resurgence of
syphilis has occurred among men who have sex with men in many developed countries.
Infection has been associated with HIV coinfection, multiple partners, and
recreational drug use. Unlike HIV, oral sex appears to be a common route of
syphilis transmission. Many prevention approaches have shown, at best, modest
success. Variable clinical presentation and potentially inconclusive lab tests
make diagnosis confusing. SUMMARY: As the infection remains relatively rare,
clinicians treating men who have sex with men should maintain a high index
of suspicion for syphilis lesions, and should screen their sexually active
patients for latent disease. Debates about syphilis control and treatment
continue. The clinical manifestations, serologic responses, efficacy of treatment,
and complications of syphilis have always been complicated. HIV coinfection
adds to the confusion.