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The Wi-Fi Alliance intended WPA as an intermediate measure to take the place of WEP pending the availability of the full IEEE 802.11i standard. WPA could be implemented through firmware upgrades on wireless network interface cards designed for WEP that began shipping as far back as 1999. However, since the changes required in the wireless access points (APs) were more extensive than those needed on the network cards, most pre-2003 APs could not be upgraded to support WPA.

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WPA also includes a Message Integrity Check, which is designed to prevent an attacker from altering and resending data packets. This replaces the cyclic redundancy check (CRC) that was used by the WEP standard. CRC's main flaw was that it did not provide a sufficiently strong data integrity guarantee for the packets it handled.[4] Well-tested message authentication codes existed to solve these problems, but they required too much computation to be used on old network cards. WPA uses a message integrity check algorithm called TKIP to verify the integrity of the packets. TKIP is much stronger than a CRC, but not as strong as the algorithm used in WPA2. Researchers have since discovered a flaw in WPA that relied on older weaknesses in WEP and the limitations of the message integrity code hash function, named Michael, to retrieve the keystream from short packets to use for re-injection and spoofing.[5][6]

Pre-shared key WPA and WPA2 remain vulnerable to password cracking attacks if users rely on a weak password or passphrase. WPA passphrase hashes are seeded from the SSID name and its length; rainbow tables exist for the top 1,000 network SSIDs and a multitude of common passwords, requiring only a quick lookup to speed up cracking WPA-PSK.[31]

Brute forcing of simple passwords can be attempted using the Aircrack Suite starting from the four-way authentication handshake exchanged during association or periodic re-authentication.[32][33][34][35][36]

Syphilis is a systemic disease caused by T. pallidum. The disease has been divided into stages on the basis of clinical findings, which guide treatment and follow-up. Persons who have syphilis might seek treatment for signs or symptoms. Primary syphilis classically presents as a single painless ulcer or chancre at the site of infection but can also present with multiple, atypical, or painful lesions (564). Secondary syphilis manifestations can include skin rash, mucocutaneous lesions, and lymphadenopathy. Tertiary syphilis can present with cardiac involvement, gummatous lesions, tabes dorsalis, and general paresis.

Selection of the appropriate penicillin preparation is important because T. pallidum can reside in sequestered sites (e.g., the CNS and aqueous humor) that are poorly accessed by certain forms of penicillin. Combinations of benzathine penicillin, procaine penicillin, and oral penicillin preparations are not considered appropriate for syphilis treatment. Reports have indicated that practitioners have inadvertently prescribed combination long- and short-acting benzathine-procaine penicillin (Bicillin C-R) instead of the standard benzathine penicillin product (Bicillin L-A) recommended in the United States for treating primary, secondary, and latent syphilis. Practitioners, pharmacists, and purchasing agents should be aware of the similar names of these two products to avoid using the incorrect combination therapy agent for treating syphilis (589).

Tertiary syphilis refers to gummas, cardiovascular syphilis, psychiatric manifestations (e.g., memory loss or personality changes), or late neurosyphilis. Guidelines for all forms of neurosyphilis (e.g., early or late neurosyphilis) are discussed elsewhere in these recommendations (see Neurosyphilis, Ocular Syphilis, and Otosyphilis). Persons with gummas and cardiovascular syphilis who are not allergic to penicillin and have no evidence of neurosyphilis by clinical and CSF examination should be treated with the following regimen.

All persons who have tertiary syphilis should receive a CSF examination before therapy is initiated and have an HIV test. Those persons whose HIV test results are negative should be offered HIV PrEP. Persons with CSF abnormalities should be treated with a neurosyphilis regimen. Certain providers treat all persons who have cardiovascular syphilis with a neurosyphilis regimen. These persons should be managed in consultation with an infectious disease specialist. Limited information is available concerning clinical response and follow-up of persons who have tertiary syphilis.

Hospitalization and consultation with an infectious disease specialist are recommended for initial therapy, especially for persons who might not comply with treatment, have an uncertain diagnosis, or have purulent synovial effusions or other complications. Examination for clinical evidence of endocarditis and meningitis should be performed. 2ff7e9595c