Routine serologic screening for syphilis in hospitalized patients: high prevalence of unsuspected infection in the elderly.
OBJECTIVE
To evaluate the potential yield of routine serologic testing for syphilis in hospitalized patients.


METHODS
Sera from consecutive patients admitted to an inpatient general medical service of a Baltimore hospital were tested using the RPR and FTA-ABS tests for syphilis. Two hundred ninety-one (149 males and 142 females) of 344 patients (85%) hospitalized during the study period participated, with ages ranging from 17 to 98 years. Seventy-seven percent of participants were African-American. Results of serologic tests for syphilis and human immunodeficiency virus were correlated with questionnaire responses. Associations were sought between results of serologic testing and demographic characteristics, medical problems, and a history of syphilis.


RESULTS
No patient had an admitting diagnosis of syphilis. Thirty-seven patients (13%) had both reactive RPR and FTA-ABS tests. Although serologic evidence of syphilis was significantly associated with age older than 50 years and with a history of syphilis, 59% of patients with both reactive RPR and FTA-ABS tests did not give a history of syphilis. Ten percent of patients were HIV seropositive; however HIV seropositivity was not significantly associated with serologic evidence of syphilis.


CONCLUSIONS
Unsuspected latent syphilis was common in this population. Routine serologic screening for syphilis should be considered in some hospitals.
Burton
A A
AA
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Flynn
J A
JA
Neumann
T M
TM
Wilson
C
C
Quinn
T C
TC
Hook
E W
EW
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015528:HIV Seroprevalence; D006760:Hospitalization; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D013587:Syphilis / Q000453:epidemiology*