Penicillin treatment of cardiovascular syphilis.

Abstract

Evaluation of Treatment Among the still unsolved problems in the evaluation of penicillin therapy are: (1) uncertain criteria of diagnosis, clinical and post-mortem, of uncomplicated syphilitic aortitis; (2) influence of race and sex; (3) prophylactic effect; (4) amount of treatment adequate in early syphilis to prevent the development of cardiovascular complications. Furthermore, insufficient time has elapsed to determine the efficiency of penicillin in the management of cardiovascular syphilis. Evaluation of the effect of penicillin therapy on prognosis is also difficult because we do not know whether or not cardiovascular syphilis is changing with the passage of time, so that we are now seeing a different type of this phase of syphilis. The simultaneous occurrence in patients of cardiovascular and other forms of late syphilis, such as neurosyphilis, may alter the picture of therapeutic efficacy, besides increasing the potential reactivity of the patient to a particular treatment system or drug. Other variable factors involved are: the presence of diabetes mellitus; hypertension; degree of arteriosclerosis; renal function.