SYPHILIS
Essentials of Diagnosis
•
Chancre is the initial evidence.
•
Chancre is single in the form of erosion of an
ulcer, painless and not tender.
•
Base is indurated, floor is clean with serous discharge.
•
Usually found over genitals, lips, tongue and fingers.
•
Chancre heals with atrophic scar even without
any treatment.
•
Regional lymph nodes are bilaterally enlarged, discrete,
rubbery in consistency and not tender.
•
Headache, fever, malaise and arthralgia which is
worst at night.
Management
•
Early syphilis
o
Benzathine penicillin 2.4 mega units.
Or
o
Procaine
penicillin G in oil, 4.8 mega units at one time and 1.2 mega units for 2
injections three days apart.
Or
o
Procaine penicillin G 6 lacs units daily for 8
days. Late syphilis
o
Benzathine penicillin 6-9 mega units in divided
doses.
o
If patient is allergic to Penicillin.
Erythromycin 500 mg qid for 3 to 4 weeks.
o
Tetracycline is another alternative 30 to 40 gm
over 10 to 15 days.
