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Syphilis is a sexually transmitted infection caused by Treponema pallidum. With the exception of mother-to-child transmission, syphilis is almost exclusively spread by direct contact with infectious lesions. See Table 143-1.

Table 143-1Syphilis—Clinical and Serological Features

Therapeutic Approach

The aim of treating early or infectious syphilis is to cure the infection, and to break the chain of transmission. The aim of treating noninfectious syphilis is to cure the infection and to halt progress of organ damage. Parenteral penicillin G is the drug of choice, the preparation used (ie, benzathine, aqueous procaine, or aqueous crystalline), dosage, and length of treatment depend on the stage and clinical manifestations of the disease. Patients also need to be screened for other STI/HIV, and sexual contacts of infectious syphilis need to be traced and tested. See Table 143-2.

Table 143-2Syphilis Treatment Table

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