By vgreene, 16 November, 2015 Consider seropositive pregnant women infected unless an adequate tx hx documented clearly in medical record and sequential serologic Ab titers declined appropriately for syphilis stage8
By vgreene, 16 November, 2015 Presumptive dx1 requires 2 tests 2 nontreponemal VDRL or RPR 3 treponemal FTA ABS TP PA various EIAs others 4
By vgreene, 16 November, 2015 Treponemal tests may remain positive for life6 and should not be used to monitor tx response
By vgreene, 16 November, 2015 VDRL/RPR used to follow tx response; ≥4-fold change5 considered significant
By vgreene, 16 November, 2015 If initial CSF pleocytosis repeat CSF exam q6mo until cell count normal if CSF cell count not darr after 6mo or if cell count protein not normal after 2y consider re tx
By vgreene, 16 November, 2015 After completion of neurosyphilis tx, consider benzathine penicillin G 2.4 MU IV qwk x3 after to provide total duration of tx comparable to latent syphilis tx
By vgreene, 16 November, 2015 Tx neurosyphilis ocular syphilis1 w IV aqueous crystalline penicillin G 18 24 MU day divided 3 4 MU IV q4h or via continuous infusion x10 14 days2