Syphilis screening in primary care

BACKGROUND. Reported cases of early syphilis have increased dramatically since 1987. Screening high-risk patients has been advocated as an intervention strategy to control the syphilis epidemic. METHODS. This study determined the prevalence of previously unrecognized positive syphilis serologies among patients at an urgent care center. Two hundred sixty-five patients treated empirically for gonorrhea were screened. RESULTS. Two patients had positive serology; both were previously treated for syphilis and had no evidence of recurrent infection. The yield from screening the study population was 0. CONCLUSIONS. Serologic diagnosis of syphilis is not reliable or cost effective in groups with a very low prevalence of disease. Routine screening for syphilis in asymptomatic high-risk patients may not be indicated in all primary care settings.