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August 2016

Syphilis Screening in Neurology

Author Affiliations
  • 1Department of Neurology, University of Washington, Seattle
  • 2Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle
JAMA Neurol. 2016;73(8):926-927. doi:10.1001/jamaneurol.2016.1955

The US Preventive Services Task Force recommendation statement on syphilis screening in nonpregnant adults and adolescents1 recommends screening asymptomatic patients who are at increased risk for syphilis, in particular men who have sex with men as well as men and women living with human immunodeficiency virus, the groups in whom the incidence of syphilis in the United States is highest. The statement is less directive regarding the best method for and frequency of syphilis screening. The increased risk of false-positive results using the reverse sequence screening algorithm is noted, as is the potential benefit of screening every 3 months compared with annually in those at high risk for disease. While neurologists are unlikely to screen primary care patients for syphilis, the recommendation statement raises issues of relevance to us, which I frame as 3 questions.

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