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Review Article

The Modern Epidemic of Syphilis

List of authors.
  • Khalil G. Ghanem, M.D., Ph.D.,
  • Sanjay Ram, M.B., B.S.,
  • and Peter A. Rice, M.D.

Over the past two decades, the incidence of syphilis has increased sharply. The courses of both untreated and treated disease can be unpredictable. This review presents guidance on clinical recognition of syphilis, diagnostic-test algorithms, and recommended treatment regimens.

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Funding and Disclosures

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

No potential conflict of interest relevant to this article was reported.

This article was updated on February 27, 2020, at NEJM.org.

We thank Sheila A. Lukehart, Ph.D., for her advice and assistance in preparing an earlier version of the manuscript.

Author Affiliations

From the Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore (K.G.G.); and the Department of Medicine and Division of Infectious Diseases and Immunology, University of Massachusetts Medical Center, Worcester (S.R., P.A.R.).

Address reprint requests to Dr. Rice at the Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Lazare Research Bldg., Rm. 321, 364 Plantation St., Worcester, MA 01605, or at .

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