Syphilis on the Rise: Diagnosis, Treatment, and Prevention

•Syphilis is often overlooked and left untreated.•Syphilis has many uncommon presentations and requires a high level of suspicion.•The presentation differs by stage: primary; secondary; early latent; and late latent syphilis.•New syphilis screening algorithms are being used in many labs.•Adequate sexual health history by primary-care providers is important for prevention.

Syphilis is often thought to be a disease of the past, largely eradicated in modern United States health care; however, the rates are still extremely high in certain populations. The diagnosis of syphilis may be overlooked by primary-care clinicians due to the presence of nonspecific signs and symptoms that may be indistinguishable from other diseases. Left undiagnosed and untreated, life-threatening complications, including hepatitis, stroke, and nervous system damage, may occur. This article focuses on identifying high-risk patients and diagnosis and treatment options for syphilis infection.