ROUTINE SEROLOGIC SCREENING FOR SYPHILIS IN HOSPITALIZED-PATIENTS - HIGH PREVALENCE OF UNSUSPECTED INFECTION IN THE ELDERLY

Background and Objectives: To evaluate the potential yield of routine serologic testing for syphilis in hospitalized patients. Study Design: Sera from consecutive patients admitted to an inpatient general medic al service of a Baltimore hospital were tested using the RPR and FTA-A BS tests for syphilis. Two hundred ninety-one (149 males and 142 femal es) of 344 patients (85%) hospitalized during the study period partici pated, with ages ranging from 17 to 98 years. Seventy-seven percent of participants were African-American. Results of serologic tests for sy philis and human immunodeficiency virus were correlated with questionn aire responses. Associations were sought between results of serologic testing and demographic characteristics, medical problems, and a histo ry of syphilis. Results: No patient had an admitting diagnosis of syph ilis. Thirty-seven patients (13%) had both reactive RPR and FTA-ABS te sts. Although serologic evidence of syphilis was significantly associa ted with age older than 50 years and with a history of syphilis, 59% o f patients with both reactive RPR and PTA-ARS tests did not give a his tory of syphilis. Ten percent of patients were HIV seropositive; howev er HIV seropositivity was not significantly associated with serologic evidence of syphilis. Conclusion: Unsuspected latent syphilis was comm on in this population. Routine serologic screening for syphilis should be considered in some hospitals.