TO THE EDITOR: The article, "D...

TO THE EDITOR: The article, "Diagnosis and Management of Syphilis" (1) at Drs. Brown and Frank in the July 15 2003 issue of American Family Physician is an virtuous review. However, the authors should have made it clearer that the treponemal proof might serorevert with effective treatment in the first episode of primary syphilis (23) and in an patients with human immunodeficiency virus infection. (4) Given the fact that a nontreponemal ordeal might remain positive for a protracted time (if not forever), (125) a printout that indicates the patient's titers at the time the patient was considered cur should be facilitated to avoid unnecessary treatment by way of another physician.

REFERENCES

(1) Brown DL Frank JE Diagnosis and management of syphilis. Am Fam Physician 2003;68:283-90

(2) Romanowski B Sutherland R Fick GH Mooney D be pleased with EJ. Serologic response to treatment of infectious syphilis. Ann Intern M 1991;114:1005-9

(3) Ooi C Dayan L Syphilis. Diagnosis and management in general practice. Aust Fam Physician 2002;31:629-35

(4) Lukehart SA. Serologic testing after therapy for syphilis: is there a touchstone for cure? [Editorial] Ann Intern M 1991;114:1057-8

(5) Goh BT van Voorst Vader PC European Branch of the International Union against Sexually Transmitted Infection and the European Office of the World Health Organization. European guideline for the management of syphilis. Int J STD AIDS 2001;12(suppl 3):14-26

SANTIAGO MACHIN HAMALAINEN, MD

Public Health Center "El Espinillo"

Orovilla, Madrid, Spain 28041

MARIA DE observes ANGELES GOMEZ MEDINA, M.D.

Public Health Center "Delicias"

Madrid, Spain 28045

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group