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The 2020 edition of the European guideline on the management of syphilis is an update of the 2014 edition. Main modifications and updates include: ‐The ongoing epidemics of early syphilis in Europe, particularly in men who have sex with men (MSM)‐The development of dual treponemal and non‐treponemal point‐of‐care (POC) tests‐The progress in non‐treponemal test (NTT) automatization‐The regular episodic shortage of benzathine penicillin G (BPG) in some European countries‐The exclusion of azithromycin as an alternative treatment at any stage of syphilis‐The pre‐exposure or immediate post‐exposure prophylaxis with doxycycline in populations at high risk of acquiring syphilis. [ABSTRACT FROM AUTHOR]

Background Syphilis remains a major public health problem in Europe (both in Eastern Europe since the 1990's and in Western Europe since the re-emergence of the disease in the late 1990's-early 2000's). Methods This guideline is an update of the IUSTI: 2008 European guideline on the management of syphilis and is produced by the European Guideline Editorial Board () and EDF Guideline Committee. Results It provides recommendations concerning the diagnosis and management of syphilis in Europe. Major advances include (1) broader use of PCR, immunohistochemistry, subtyping of the etiological agent Treponema pallidum subspecies pallidum, new treponemal tests, and rapid-point-of-care ( POC) tests detecting both treponemal and non-treponemal antibodies, (2) more flexible options for screening ( TT- treponemal test- first or NTT - non treponemal test- first or both TT and NTT), 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- BPG) is the only first line therapy regimen in early syphilis and in late latent syphilis. Conclusions 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 BPG. A major concern about the supply of BPG in many European countries could threaten the efficacy of the policies of eradication of the disease in Europe. [ABSTRACT FROM AUTHOR]

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by Chlamydia trachomatis serotypes L1, L2, and L3. It is endemic in tropical areas, while seldom in industrialised countries. Since 2002, an outbreak of rectal LGV has been observed among men having sex with men, in Netherlands, France, and other countries of Western Europe. After an incubation period of 2 days to 2 months, LGV develops in three stages: ulcerated papule; inflammatory satellite lymph node and/or proctitis; chronic inflammatory complications (fistulas and sclerosis). Chlamydia trachomatis infection is confirmed by PCR and serovars is identified by RFLP of omp1 gene amplified by PCR. Recommended first line treatment is doxycycline for at least 21 days.