Treatment

Doxycyline or azithromycin/erythromycin

Use erythromycin rather than doxycycline for pregnant women or children with chlamydia.

SYPHILIS

Syphilis is an infection caused by the spirochete Treponema pallidum. Presentation

Syphilis has various stages of manifestation that present in different ways:

■ Primary syphilis—painless hard chancre of the vulva, vagina, or cervix (or even anus, tongue, or fingers), usually appearing 1 month after exposure: Spontaneous healing after 1 to 2 months

■ Secondary syphilis—generalized rash (often palms and soles), condy-loma lata, mucous patches with lymphadenopathy, fever, malaise, usu

Physicians often treat both gonorrhea and chlamydia even if diagnosing only one.

ally appearing 1 to 6 months after primary chancre: Spontaneous regression after about 1 month ■ Tertiary syphilis—presents years later with skin lesions, bone lesions (gummas), cardiovascular lesions (e.g., aortic aneurysms), central nervous system (CNS) lesions (e.g., tabes dorsalis).

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