Syphilis

Question 1

Treatment of primary, secondary or latent syphilis < 1 yr:

Answer 1

Benzathine PCN G 2.4million units IM once

Question 2

Treatment of latent syphilis > 1 yr (or unknown duration ) and tertiary

Answer 2

Benzathine PCN G 2.4million units IM weekly x 3 weeks

Question 3

Treatment of Neurosyphilis

Answer 3

Aqueous crystalline PCN G 18-24 million units/day x 10-14 days

Question 4

Jarisch-Herxheimer reaction

Answer 4

Patients need to be counseled that this is not a PCN allergy

Common to have this reaction of fever & flu-like symptoms 14 hours after initiating therapy