日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

We report our experience in treating 90 patients diagnosed with male symptomatic active syphilis and discuss future issues in syphilis treatment. In total, 60% of patients visited the clinic within 4 weeks of infection, and 20% visited within 2 weeks of infection. During the first visit, among 81 patients with primary syphilis, there were 45 (56%) patients with TPLA(+) RPR(+), 14 (17%) patients with TPLA(−) RPR(+), 10 (12%) patients with TPLA(+) RPR(−), and 12 (15%) patients with TPLA(−) RPR(−). Treatment consisted of oral amoxicillin, and there were no cases of discontinuation due to adverse events and no invalid cases. The incidence of syphilis has been rapidly increasing since 2021, and the prevalence of social networks has resulted in an increase in the number of patients visiting medical institutions, especially in the early stages after the onset of symptoms. Conversely, because TPLA and RPR are often negative in the early stages of infection, detailed interviews and visual examination of the lesions are more important for diagnosis. Moreover, syphilis is a disease that requires the skill of medical personnel the earlier it occurs.