neurosyphilis. The central nervous system may be involved during any stage of syphilis. Clinical evidence of neurological involvement (e.g. optic or auditory symptoms, or cranial nerve palsies) warrants examination of the CSF. However, examination of the CSF is also highly desirable in all patients with syphilis of more than two years'

itional MeSH headings 'neurosyphilis', 'cardiovascular syphilis', 'latent syphilis' and 'syphilis and treatment'. A search on Embase from 2007-2014 was also con-ducted. Only English language papers were used. Methods The guidelines writing group piloted an updated ver-sion of the BASHH Framework for Guideline Development. If the woman is at low risk for syphilis, lacks signs or symptoms of primary syphilis, has a partner with no clinical or serologic evidence of syphilis, and is likely to follow up, repeat serologic testing within 4 weeks can be considered to determine whether the EIA/CIA remains positive or if the RPR/VDRL or the TP-PA becomes positive. These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate (BASHH), and their comments incorporated. The draft guide-line was placed on the BASHH website and any comments received after three months were reviewed by the authors and acted on appropriately. New in the 2008 guidelines † New guideline format: A single guideline covering screen-ing and investigations for syphilis, clinical features, man- The clinical course of syphilis can be divided into three stages (for a detailed clinical review, refer to the 2006 Centers for Disease Control and Prevention [CDC] guidelines1). Primary syphilis is characterised by a single genital or, occasionally,