Abstract
Perceptions in Reproductive Medicine Challenges in the Management of Syphilis Sankaranantham M* Community Care Centre, India *Corresponding author:Sankaranantham M, HIV and Sexual Medicine, Medical Officer in Community Care Centre, Tirunelveli, Tamil Nadu, India Submission: July 13, 2018;Published: August 17, 2018 DOI: 10.31031/PRM.2018.02.000543 ISSN: 2640-9666Volume2 Issue4
Highlights
Even after 70 years of antibiotic therapy and with advanced diagnostic procedures the management and follow up of syphilis poses an immense problem
In one of my studies [4], out of 180 cases of syphilitic serology positive individuals during the period of January 2010 to December 2017, 16 were found to be biological false positive. 164 (91.1%) were found to have real syphilis as per Trponemal tests. 4 were were having Diabetes Mallitus. 10 patients were in early syphilis (Two were having Primary syphilis, seven were with secondary manifestations and one was in early latent stage) and another 5 were having late manifestations ( Three were having Coronary ostial stenosis diagnosed by angiogram, one case of aneurysm of aorta, one case of optic syphilis) and 149 were in late latent stage of syphilis without any manifestations
Among the 106 who were followed up, 22 had attained either a considerable fall in titer or a reversal to nonreactive status for Syphilis whereas another 84 (79.2%) are still on my follow up for one year and in some cases up to 5 years with persistent serology either in same titer or a raise in titer
Summary
Even after 70 years of antibiotic therapy and with advanced diagnostic procedures the management and follow up of syphilis poses an immense problem. The response to treatment and sero-reversion in cases of early syphilis is prompt, when compared to late or late latent syphilis. Among these 84 patients, 17 were further treated either with Injection Procaine Penicillin daily for 21 days or with InjBenzy Penicillin G 20 lakhs units IV twice daily or with Doxycyclins 100mg twice daily for 30 days in case of late syphilis and in one case with Injection Ceftrixone 1 gram daily IM for 3 weeks without any benefit. In the presence of HIV infection, syphilis poses a lot of problems in the diagnosis, management and for the follow up.
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