Syphilis is a complex sexually transmitted disease that has a highly variable clinical course. Classification by a clinician with expertise in syphilis may take precedence over the following case definition developed for surveillance purposes.

CLINICAL DESCRIPTION

A stage of infection with Treponema pallidum and characterized by localized or diffuse mucocutaneous lesions, often with generalized lymphadenopathy. The primary chancre (ulcer) may still be present.

1. CONFIRMED
   A clinically compatible case that is laboratory confirmed by:
   
   

   • Demonstration of T. pallidum in clinical speciments by darkfield microscopy, DFA-TP, or equivalent methods.
     
     
2. PROBABLE
   
   • A clinically compatible case with a nontreponemal (VDRL or RPR) titer ≥ 1:4.
     
     
3. POSSIBLE
   
   

   • Not used