Primary Herpes Simplex and Primary Syphilis

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Abstract
The cases of 7 patients who had primary genital infection with herpes simplex virus and whose initial nontreponemal and treponemal tests for syphilis were nonreactive are described. On routine posttreatment examination, a change in the consistency of the ulcers was noticed, and the inguinal nodes, which had been soft and tender, were hard and nontender. The morphologic changes indicated the probable presence of concomitant primary infection with Treponema pallidum, which was confirmed serologically for 7 patients and by a positive darkfield examination for 2. Clinicians should be aware that different sexually transmitted diseases often coexist. Patients who have primary genital herpes should be followed clinically and serologically until recovery is complete.

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