Physician recognition of the signs and symptoms of secondary syphilis

Thirty-four patients with secondary syphilis, seen in a public clinic for sexually transmitted diseases, had been examined previously by 36 community physicians. Secondary syphilis was the primary diagnosis by 14 (39.9%) of the 36 physicians and was included in the differential diagnosis by five others (13.9%). Twelve (33.3%) had not considered syphilis but did obtain a routine serological test that eventually led to the correct diagnosis. Five other physicians (13.9%) failed to include syphilis in the diagnosis and did not order serological tests. (JAMA1981;246:250-251)