Syphilis management of sexual partners: Difference between revisions
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*Although such manifestations are uncommon after the first year of infection, persons exposed sexually to a patient who has syphilis in any stage should be evaluated [[Syphilis physical examination|clinically]] and [[Syphilis laboratory tests#Serology|serologically]] and treated with a recommended regimen, according to the following recommendations: | *Although such manifestations are uncommon after the first year of infection, persons exposed sexually to a patient who has syphilis in any stage should be evaluated [[Syphilis physical examination|clinically]] and [[Syphilis laboratory tests#Serology|serologically]] and treated with a recommended regimen, according to the following recommendations: | ||
:*Persons who were exposed | :*Persons who were exposed within the 90 days preceding the diagnosis of [[Syphilis pathophysiology#Primary syphilis|primary]], [[Syphilis pathophysiology#Secondary syphilis|secondary]], or [[Syphilis pathophysiology#Latent syphilis|early latent syphilis]] in a sex partner might be infected even if [[Syphilis laboratory tests#Serology|seronegative]]; therefore, such persons should be [[Syphilis medical therapy#Pharmacotherapy|treated presumptively]]. | ||
:*Persons who were exposed | :*Persons who were exposed more than 90 days before the diagnosis of [[Syphilis pathophysiology#Primary syphilis|primary]], [[Syphilis pathophysiology#Secondary syphilis|secondary]], or [[Syphilis pathophysiology#Latent syphilis|early latent syphilis]] in a sex partner should be [[Syphilis medical therapy#Pharmacotherapy|treated presumptively]] if [[Syphilis laboratory tests#Serology|serologic test]] results are not available immediately and the opportunity for follow-up is uncertain. | ||
:*For purposes of | :*For purposes of partner notification and [[Syphilis medical therapy#Pharmacotherapy|presumptive treatment]] of exposed sex partners, patients with syphilis of unknown duration who have [[Syphilis laboratory tests#Nontreponemal test|high nontreponemal serologic test titers]] (i.e., greater than 1:32) can be assumed to have [[Syphilis pathophysiology#Primary syphilis|early syphilis]]. For the purpose of determining a treatment regimen, however, [[Syphilis laboratory tests#Serology|serologic titers]] should not be used to differentiate early from [[Syphilis pathophysiology#Latent syphilis|late latent syphilis]]. | ||
:* | :*Long-term sex partners of patients who have [[Syphilis pathophysiology#Latent syphilis|latent syphilis]] should be evaluated [[Syphilis physical examination|clinically]] and [[Syphilis laboratory tests#Serology|serologically]] for syphilis and treated on the basis of the evaluation findings. | ||
*Sexual partners of infected patients should be considered | *Sexual partners of infected patients should be considered at risk and provided [[Syphilis medical therapy#Pharmacotherapy|treatment]] if they have had sexual contact with the patient within: | ||
:*3 months plus the duration of [[Syphilis history and symptoms#Primary syphilis|symptoms]] for patients diagnosed with [[Syphilis pathophysiology#Primary syphilis|primary syphilis]], | :*3 months plus the duration of [[Syphilis history and symptoms#Primary syphilis|symptoms]] for patients diagnosed with [[Syphilis pathophysiology#Primary syphilis|primary syphilis]], | ||
:*6 months plus duration of [[Syphilis history and symptoms#Secondary syphilis|symptoms]] for those with [[Syphilis pathophysiology#Secondary syphilis|secondary syphilis]], and | :*6 months plus duration of [[Syphilis history and symptoms#Secondary syphilis|symptoms]] for those with [[Syphilis pathophysiology#Secondary syphilis|secondary syphilis]], and | ||
Revision as of 16:29, 19 December 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Management of Sexual Partners
- Sexual transmission of treponema pallidum is thought to occur only when mucocutaneous syphilitic lesions are present.
- Although such manifestations are uncommon after the first year of infection, persons exposed sexually to a patient who has syphilis in any stage should be evaluated clinically and serologically and treated with a recommended regimen, according to the following recommendations:
- Persons who were exposed within the 90 days preceding the diagnosis of primary, secondary, or early latent syphilis in a sex partner might be infected even if seronegative; therefore, such persons should be treated presumptively.
- Persons who were exposed more than 90 days before the diagnosis of primary, secondary, or early latent syphilis in a sex partner should be treated presumptively if serologic test results are not available immediately and the opportunity for follow-up is uncertain.
- For purposes of partner notification and presumptive treatment of exposed sex partners, patients with syphilis of unknown duration who have high nontreponemal serologic test titers (i.e., greater than 1:32) can be assumed to have early syphilis. For the purpose of determining a treatment regimen, however, serologic titers should not be used to differentiate early from late latent syphilis.
- Long-term sex partners of patients who have latent syphilis should be evaluated clinically and serologically for syphilis and treated on the basis of the evaluation findings.
- Sexual partners of infected patients should be considered at risk and provided treatment if they have had sexual contact with the patient within:
- 3 months plus the duration of symptoms for patients diagnosed with primary syphilis,
- 6 months plus duration of symptoms for those with secondary syphilis, and
- 1 year for patients with early latent syphilis.