A 45-year-old man presents in clinic for follow-up after a recent emergency department evaluation for dysuria. He was diagnosed with gonococcal urethritis and treated with intramuscular ceftriaxone and oral azithromycin. His dysuria resolved and he now feels well. He was divorced 10 years previously and has since had multiple sexual partners. He reports sex only with women. His examination is normal, including the genitalia and skin. He has no neurologic deficits. Screening for other sexually transmitted infections reveals hepatitis B virus serologies consistent with previous immunization, a negative human immunodeficiency virus (HIV) enzyme immunoassay (EIA), and reactive syphilis test results (Table 1).
Clement ME, Hicks CB. RPR and the Serologic Diagnosis of Syphilis. JAMA. 2014;312(18):1922-1923. doi:10.1001/jama.2014.2087