{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T07:08:09Z","timestamp":1791097689491,"version":"4.1.0"},"reference-count":101,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,10,27]],"date-time":"2014-10-27T00:00:00Z","timestamp":1414368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Syphilis remains a major public health problem in Europe (both in Eastern Europe since the 1990's and in Western Europe since the re\u2010emergence of the disease in the late 1990's\u2010early 2000's).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This guideline is an update of the <jats:styled-content style=\"fixed-case\">IUSTI<\/jats:styled-content>: 2008 European guideline on the management of syphilis and is produced by the European Guideline Editorial Board (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.iusti.org\/regions\/Europe\/pdf\/2013\/Editorial_Board.pdf\">http:\/\/www.iusti.org\/regions\/Europe\/pdf\/2013\/Editorial_Board.pdf<\/jats:ext-link>) and <jats:styled-content style=\"fixed-case\">EDF<\/jats:styled-content> Guideline Committee.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>It provides recommendations concerning the diagnosis and management of syphilis in Europe. Major advances include (1) broader use of <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>, immunohistochemistry, subtyping of the etiological agent <jats:italic>Treponema pallidum subspecies pallidum<\/jats:italic>, new treponemal tests, and rapid\u2010point\u2010of\u2010care (<jats:styled-content style=\"fixed-case\">POC<\/jats:styled-content>) tests detecting both treponemal and non\u2010treponemal antibodies, (2) more flexible options for screening (<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>\u2010<jats:italic>treponemal test<\/jats:italic>\u2010 first or <jats:styled-content style=\"fixed-case\">NTT<\/jats:styled-content> \u2013<jats:italic>non treponemal test<\/jats:italic>\u2010 first or both <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NTT<\/jats:styled-content>), and (3) procaine penicillin is no longer the first line therapy option in any phase of the disease, i.e. long acting penicillin G (i.e. benzathine penicillin G\u2010<jats:styled-content style=\"fixed-case\">BPG<\/jats:styled-content>) is the only first line therapy regimen in early syphilis and in late latent syphilis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Syphilis is a disease that is relatively easy to detect by appropriate serological tests, however, all laboratory results should be considered together with clinical data and sexual risk anamnesis. Syphilis is also easy to treat with <jats:styled-content style=\"fixed-case\">BPG<\/jats:styled-content>. A major concern about the supply of <jats:styled-content style=\"fixed-case\">BPG<\/jats:styled-content> in many European countries could threaten the efficacy of the policies of eradication of the disease in Europe.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12734","type":"journal-article","created":{"date-parts":[[2014,10,27]],"date-time":"2014-10-27T12:32:26Z","timestamp":1414413146000},"page":"1581-1593","source":"Crossref","is-referenced-by-count":314,"title":["2014 European guideline on the management of syphilis"],"prefix":"10.1111","volume":"28","author":[{"given":"M.","family":"Janier","sequence":"first","affiliation":[{"name":"STD Clinic H\u00f4pital Saint\u2010Louis AP\u2010HP and H\u00f4pital Saint\u2010Joseph Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dermatovenereology Comenius University Bratislava Slovak Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Dupin","sequence":"additional","affiliation":[{"name":"Syphilis National Reference Center H\u00f4pital Tarnier\u2010Cochin AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Unemo","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections Department of Laboratory Medicine Microbiology \u00d6rebro University Hospital \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.S.","family":"Tiplica","sequence":"additional","affiliation":[{"name":"2nd Dermatological Clinic Carol Davila University Colentina Clinical Hospital Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Poto\u010dnik","sequence":"additional","affiliation":[{"name":"Department of Dermatovenereology University Medical Centre Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"French","sequence":"additional","affiliation":[{"name":"Central and North West London NHS Trust and University College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medicine the Royal South Hants Hospital Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"European Union.European Centre for Disease Prevention and Control.http:\/\/www.ecdc.europa.eu\/"},{"key":"e_1_2_6_3_1","unstructured":"World Health Organisation.Sexually transmitted infections management guidelines 1999.http:\/\/www.who.int\/HIV_AIDS"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2008.008510"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200108000-00004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200103000-00007"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181bf5a98"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181c2af86"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.olq.0000253385.49373.1a"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/313689"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2007.0019"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32830184df"},{"key":"e_1_2_6_13_1","unstructured":"MMWR: CDC case definitions for public health surveillance. Oct 19 1990\/vol.39\/No.RR\u201013."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2003.008821"},{"key":"e_1_2_6_15_1","first-page":"107","volume-title":"Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus","author":"Ballard R","year":"2013"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00702-11"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.034314"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050622"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-353"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5700888"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10314.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000006"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001273"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI57173"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.036301"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.8.1.1"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/095646249500600404"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.76.5.403"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis459"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0346-9"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02555-10"},{"key":"e_1_2_6_32_1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1097\/OLQ.0b013e318205491a","article-title":"Evaluation of an IgM\/IgG sensitive enzyme immunoassay and the utility of index values for the screening of syphilis infection in a high\u2010risk population","volume":"38","author":"Wong EH","year":"2011","journal-title":"Sex Transm Dis"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2012.120519"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00316-13"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003347"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1086\/655832"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir524"},{"key":"e_1_2_6_38_1","first-page":"133","article-title":"Discordant results from reverse sequence syphilis screening\u2013five laboratories, United States, 2006\u20132010","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01121-11"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2006.022707"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00624-10"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis928"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182260987"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182036a0f"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181ec51f1"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1086\/511426"},{"key":"e_1_2_6_47_1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2010","volume":"59","author":"Workowski KA","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0092"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646205774763207"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1972.03190320032011"},{"key":"e_1_2_6_51_1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2340\/0001555563409417","article-title":"Central nervous system involvement in early syphilis. Part I. Intrathecal immunoglobulin production","volume":"63","author":"L\u00f6whagen GB","year":"1983","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1985.00360030105020"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-109-11-855"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(88)90220-1"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8635(05)70035-8"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462001915750"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1086\/381227"},{"key":"e_1_2_6_58_1","first-page":"625","article-title":"Symptomatic early neurosyphilis among HIV\u2010positive men who have sex with men\u2013four cities, United States, January 2002\u2013June 2004","volume":"56","author":"Centers for Disease Control and Prevention (CDC)","year":"2007","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.olq.0000230481.28936.e5"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31824c0e62"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2012.012191"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707313370504"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2010.010248"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/20.Supplement_1.S23"},{"key":"e_1_2_6_65_1","first-page":"293","article-title":"Survival of treponemes after treatment, comments, clinical conclusions and recommendations","volume":"61","author":"Dunlop EMC","year":"1985","journal-title":"Genitourin Med"},{"key":"e_1_2_6_66_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2340\/00015555635357","article-title":"Penicillin concentrations in cerebrospinal fluid and serum after intramuscular, intravenous and oral administration to syphilitic patients","volume":"63","author":"L\u00f6whagen GB","year":"1983","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_6_67_1","first-page":"371","article-title":"Penicillin concentrations in serum and cerebrospinal fluid after intramuscular injection of aqueous procaine penicillin 0.6 MU with and without oral probenecid","volume":"60","author":"Goh BT","year":"1984","journal-title":"Br J Venereol Dis"},{"key":"e_1_2_6_68_1","first-page":"223","article-title":"Penicillin concentrations in cerebrospinal fluid (CSF) during repository treatment regimen for syphilis","volume":"64","author":"Van der Valk PGM","year":"1988","journal-title":"Genitourin Med"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.7.1214"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198307000-00011"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1086\/500406"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1086\/313725"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(92)90574-U"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1177\/095646240401500511"},{"key":"e_1_2_6_75_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044284"},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1086\/652239"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040216"},{"key":"e_1_2_6_78_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01095-09"},{"key":"e_1_2_6_79_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181e2c753"},{"key":"e_1_2_6_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12098"},{"issue":"34","key":"e_1_2_6_81_1","first-page":"3","article-title":"The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re\u2010study of the Boeck\u2010Bruusgaard material","volume":"35","author":"Gjestland T","year":"1955","journal-title":"Acta Derm Venereol Suppl (Stockh)"},{"key":"e_1_2_6_82_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199810000-00008"},{"key":"e_1_2_6_83_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199703000-00002"},{"key":"e_1_2_6_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.04.042"},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318249968c"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.1177\/095646249200300302"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/312798"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318285c5a7"},{"key":"e_1_2_6_89_1","doi-asserted-by":"publisher","DOI":"10.1086\/342108"},{"key":"e_1_2_6_90_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199702000-00007"},{"key":"e_1_2_6_91_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001143"},{"key":"e_1_2_6_92_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-010-0900-8"},{"key":"e_1_2_6_93_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.043893"},{"key":"e_1_2_6_94_1","doi-asserted-by":"publisher","DOI":"10.1159\/000018149"},{"key":"e_1_2_6_95_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir671"},{"key":"e_1_2_6_96_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2006.021402"},{"key":"e_1_2_6_97_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis757"},{"key":"e_1_2_6_98_1","doi-asserted-by":"publisher","DOI":"10.1086\/644618"},{"key":"e_1_2_6_99_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01461.x"},{"key":"e_1_2_6_100_1","first-page":"15","article-title":"The effect of prednisolone on the Jarisch\u2010Herxheimer reaction","volume":"48","author":"Gudjonsson H","year":"1968","journal-title":"Acta Dermatol Venereol"},{"key":"e_1_2_6_101_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/OLQ.0b013e3181fe650b","article-title":"Repeat syphilis among men who have sex with men\u2010San Diego county, 2004\u20102009","volume":"38","author":"Katz KA","year":"2011","journal-title":"Sex Transm Dis"},{"key":"e_1_2_6_102_1","doi-asserted-by":"publisher","DOI":"10.1086\/382532"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12734","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.12734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:45:53Z","timestamp":1695570353000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.12734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,27]]},"references-count":101,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1111\/jdv.12734"],"URL":"https:\/\/doi.org\/10.1111\/jdv.12734","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,27]]}}}