ARTICLE: The Modern Epidemic of Syphilis

AUTHORS: Khalil G. Ghanem, Sanjay Ram and Peter A. Rice

JOURNAL: N Engl J Med. 2020 Feb 27;382(9):845-854. doi: 10.1056/NEJMra1901593.

Syphilis was first recognized in Europe in the late 15th century1; its cause, Treponema pallidum subspecies pallidum, was identified four centuries later. The advent of penicillin, together with effective public health measures, was responsible for a marked decline in syphilis in the United States and Europe. Today, however, the incidence of syphilis in the United States has returned to levels not seen in more than 20 years, and the numbers of cases reported to the Centers for Disease Control and Prevention (CDC) increased by 81% from 2014 to 2018.2 Recognition of syphilis, with its versatile presentations, can challenge even the most experienced clinician, and the natural history of both untreated and treated disease can be unpredictable.

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