Common pitfalls in the diagnosis and treatment of sexually transmitted diseases.

To facilitate proper diagnosis of STDs, they must be considered as a diagnostic possibility in all sexually active patients. Whenever possible, appropriate laboratory tests must be performed to confirm a clinical diagnosis. Once the diagnosis is established, the physician can administer specific and adequate treatment. The physician should have a comprehensive up-to-date treatment schedule to select a recommended treatment. Such treatment schedules are available upon request from most municipal and state health departments.

Sexually transmitted diseases. Primary syphilis.

Syphilis is an infectious spirochetal disease caused by Treponema pallidum. The disease is transmitted from person to person during sexual intercourse, congenitally by an infected pregnant woman to the fetus in utero, or very rarely, non-sexually. In its natural course, syphilis is characterized by an acute infectious primary and secondary stage, followed by a subclinical course of latency which may persist for years, or may progress in a minority of patients to a noninfectious late symptomatic stage where active involvement of the central nervous system, the cardiovascular system or localized gummatous destructive lesions may occur. This article reviews the clinical features and management of primary syphilis.