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Author: Admin | 2025-04-28
Thus, if results of the first test are negative, the test should be repeated at 1- and 3-month intervals. False-positive results may occur with disorders such as systemic lupus erythematosus, malaria, and hepatitis.Specific treponemal tests include FTA-ABS, T palladium particle agglutination, and microagglutination assay for antibodies to T palladium. These confirmatory tests usually become positive with 3 to 6 weeks and remain so for many years, despite effective treatment.TREATMENTParenteral penicillin G is the drug of choice to resolve the lesions and prevent sexual transmission and late sequelae. The recommended treatment for adults is a single dose of benzathine penicillin G, 2.4 million units IM.Patient who are allergic to penicillin may be given a 14-day course of oral doxycycline, 100 mg bid, or oral tetracycline, 500 mg qid.Ceftriaxone, 1 g IV or IM per day for 8 to 10 days, is effective for early syphilis.A single 2-g dose of azithromycin has been effective in primary syphilis. However, evidence of widespread resistance to azithromycin in T palladium has recently been reported in San Francisco.Table - Differential diagnosis of common genital ulcersSyphilis Uncomplicated granuloma inguinale StaphylococciSexually transmittedInfection with herpes simplex virus type 2 or type 1 Chancroid Complicated granuloma inguinale Nonsexually transmittedBehçet syndrome Squamous cell carcinoma TraumaticReferences:FOR MORE INFORMATION:Brown DL, Frank JE. Diagnosis and management of syphilis. Am Fam Physician. 2003;68:283-290.Centers for Disease Control and Prevention. Sexually transmitted diseases. Treatment guidelines 2002. MMWR. 2002;51(RR-6):1-78.Hook EL 3rd, Martin DH, Stephens J, et al. A randomized, comparative pilot study of azithromycin versus benzathine penicillin G for treatment of early syphilis. Sex Transm Dis. 2002;29:486-490.Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev. 1995;8:1-21.Mitchell SJ, Engleman J, Kent CK, et al. Azithromycin-resistant syphilis infection: San Francisco, California, 2000-2004. Clin Infect Dis. 2006;42:337-345.Thompson S, Larsen S, Moreland A. Syphilis.
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