Syphilis screening in adolescents.

Routine screening for syphilis among sexually active adolescents is recommended by the American Academy of Pediatrics, but there are few data about clinical application of these recommendations. We examined the yield of a syphilis screening program in one ambulatory adolescent medicine clinic. A rapid plasma reagin (RPR) has been recommended for all sexually active adolescents. Of 630 patients screened for syphilis by RPR, ten patients had reactive syphilis serologies and 4 had active syphilis. Of these, 2 patients had signs or symptoms consistent with primary or secondary syphilis, and 2 patients with active syphilis had clinical evidence of another sexually transmitted disease but no clinical manifestations of syphilis. Of the 10 reactive serologies, 6 represented previously treated cases or a false positive. We conclude that screening should be done for those at high risk for syphilis or those adolescents with sexually transmitted diseases.