Abstract

To the Editor.— We did not intend to detract from the importance of the dark-field examination in the diagnosis of primary syphilis. Seronegative primary syphilis is well known. The point we wish to make is that by the time a patient comes for treatment, the vast majority (91%) will have seropositive results with the FTA-ABS test. Two of the six patients had dark-field-positive, FTA-ABS-negative results two and four months later, respectively, and remained seronegative to both the VDRL and FTA-ABS tests. Two of the patients in our study stated that their lesions had been present only three days: in one, the VDRL test was nonreactive; in the other, the VDRL test was reactive with a titer of 1:2; in both, the FTA-ABS test was reactive. How early is very early?

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