tx of prim,sec,ter sypihils? - stefan78

[ArchivalUser]

diagnosis
of neurosyphilis usually depends on various combinations
of reactive serologic test results, CSF cell count or protein, or
a reactive VDRL-CSF with or without clinical manifestations.
The CSF leukocyte count usually is elevated (>5 white blood
cell count [WBC]/mm3) in patients with neurosyphilis; this
count also is a sensitive measure of the effectiveness of therapy.
The VDRL-CSF is the standard serologic test for CSF, and
when reactive in the absence of substantial contamination of
CSF with blood, it is considered diagnostic of neurosyphilis.
However, the VDRL-CSF might be nonreactive even when
neurosyphilis is present. Some specialists recommend performing
an FTA-ABS test on CSF. The CSF FTA-ABS is less specific
(i.e., yields more false-positive results) for neurosyphilis
than the VDRL-CSF, but the test is highly sensitive. Therefore,
some specialists believe that a negative CSF FTA-ABS
test excludes neurosyphilis.

[ArchivalUser]

Parenteral penicillin G is the only therapy with documented
efficacy for syphilis during pregnancy. Pregnant women with
syphilis in any stage who report penicillin allergy should be
desensitized and treated with penicillin. Skin testing for penicillin
allergy might be useful in pregnant women; such testing
also is useful in other patients

[ArchivalUser]

Management of Sex Partners
Sexual transmission of T. pallidum occurs only when mucocutaneous
syphilitic lesions are present; such manifestations
are uncommon after the first year of infection. However, 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 >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., >1:32) can be assumed to have
early syphilis. However, serologic titers should not be used
to differentiate early from late latent syphilis for the purpose
of determining treatment (see Latent Syphilis,
Treatment).
¢ 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.
For identification of at-risk sexual partners, the periods before
treatment are 1) 3 months plus duration of symptoms
for primary syphilis, 2) 6 months plus duration of symptoms
for secondary syphilis, and 3) 1 year for early latent syphilis

[ArchivalUser]

hi showman...what's ur ref?

[ArchivalUser]

cmdt

[ArchivalUser]

cdc guidelines