Syphilis management for tertiary stage: Difference between revisions
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===Other Management Considerations=== | ===Other Management Considerations=== | ||
Patients who have [[Syphilis history and symptoms#Tertiary syphilis|symptomatic late syphilis]] should be given a [[Syphilis laboratory findings#CSF analysis|CSF examination]] before therapy is initiated. Patients with cardiovascular syphilis may be treated with the same regimen as neurosyphilis but there is limited data available to support this. | Patients who have [[Syphilis history and symptoms#Tertiary syphilis|symptomatic late syphilis]] should be given a [[Syphilis laboratory findings#CSF analysis|CSF examination]] before therapy is initiated. Patients with cardiovascular syphilis may be treated with the same regimen as neurosyphilis but there is limited data available to support this.<ref name="pmid17469346">{{cite journal| author=Carrada-Bravo T| title=[Cardiovascular syphilis: diagnosis, treatment]. | journal=Arch Cardiol Mex | year= 2006 | volume= 76 Suppl 4 | issue= | pages= S189-96 | pmid=17469346 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17469346 }} </ref> | ||
===Special Considerations=== | ===Special Considerations=== |
Revision as of 16:58, 27 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Tertiary syphilis refers to gumma and cardiovascular syphilis but not to all neurosyphilis. Patients who are not allergic to penicillin and have no evidence of neurosyphilis should be treated with the following regimen.
Management for Tertiary Stage Syphilis
CDC Recommendations: Pharmacotherapy
“ |
Recommended Regimen1. Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1-week intervals. |
” |
Other Management Considerations
Patients who have symptomatic late syphilis should be given a CSF examination before therapy is initiated. Patients with cardiovascular syphilis may be treated with the same regimen as neurosyphilis but there is limited data available to support this.[3]
Special Considerations
Penicillin Allergy: Alternative Regimen
Patients allergic to penicillin should be treated in consultation with an infectious disease specialist.
Pregnancy
Pregnant patients who are allergic to penicillin should be desensitized and treated with penicillin.
Follow-Up
Limited information is available concerning clinical response and follow-up of patients who have tertiary syphilis.
References
- ↑ "Sexually Transmitted Diseases Treatment Guidelines, 2010". Retrieved 2012-12-19.
- ↑ http://www.cdc.gov/std/tg2015/syphilis.htm#Neurosyphilis Accessed on September27, 2016
- ↑ Carrada-Bravo T (2006). "[Cardiovascular syphilis: diagnosis, treatment]". Arch Cardiol Mex. 76 Suppl 4: S189–96. PMID 17469346.