A 32-year-old man presents with a 4-day history of painless penile lesions (Figure 1). His sex partners are men, and he has had 2 partners in the last 6 months. Physical examination reveals 3 nontender ulcers on the lateral aspect of the penile shaft and firm lymphadenopathy in the right inguinal region that is nontender. Oral examination and skin inspection are normal. He has no neurologic symptoms. A clinical diagnosis of syphilis is strongly suspected; nontreponemal and treponemal serologic tests for syphilis are ordered.
Based on the information at this point, how would you clinically stage syphilis in this man?
Figure 1. Nontender Ulcers on Penile Shaft
Photograph credit: Negusse Ocbamichael, PA; Public Health—Seattle & King County STD Clinic
Figure 2. Syphilis: Natural History and Staging
Illustration: David H. Spach, MD
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Question Last Updated
August 15th, 2024
August 15th, 2024
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