IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 3549 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
   A 30-year-old ba...

 Article Access Statistics
    Viewed2634    
    Printed32    
    Emailed0    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 


 
HOW I MANAGE?
Year : 2000  |  Volume : 66  |  Issue : 2  |  Page : 87

How I manage



Correspondence Address:
K Pavithran


Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 20877035

Rights and PermissionsRights and Permissions



How to cite this article:
Pavithran K. How I manage. Indian J Dermatol Venereol Leprol 2000;66:87

How to cite this URL:
Pavithran K. How I manage. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2019 Sep 21];66:87. Available from: http://www.ijdvl.com/text.asp?2000/66/2/87/4877



  A 30-year-old bachelor's blood VDRL was reported as reactive 1:8 on two occasions. Twelve years back he had sexual intercourse with a commercial sex worker. He doesn't remember having any genital sore in the past. How will you manage this patient. Top


The patient has a low VDRL titre on testing the blood. First of all a specific test such as TPHA test should be done to confirm that bood VDRL positivity is truely syphilitic origin. In case no genital or skin lesions are associated and if there are no clinical evidences of cardiovascular or neurosyphilis, the possibility of 'latent syphilis' is to be considered. Before labelling as 'latent syphilitic, a CSF study including cell count and CSF VDRL to exclude neurosyphilis, and screening of aorta to exclude aneurism should be performed.

'Latent syphilis' of less than 2 years dura­tion of infection should be treated as for early syphilis ie. inj. benzathine penicillin 2.4 mega units deep IM as single dose. If patient is allergic to penicillin he can be given oral doxycycline 100mg bid X 15 days.

If patient denies consent for lumbar puncture and CSF study or if latent syphilis is of more than 2 years duration or if patient has syphilis of unknown duration (SUD), or if patient has associated HIV infection he should be given treatment as for neurosyphilis which consists inj.benzyl penicillin 2-4 million units, every 4 hours, intravenously for 10-14 days followed by inj benzathine penicillin 2.4 mega units deep IM.

If the patient is allergic to penicillin, treat­ment consists oral doxycyclin,100 mg bid for 30 days.

After treatment a rapid fall in VDRL titre may occur if latent syphilis is early. In case of late latent syphilis the titre may not fall at all. Further treatment is not indicated in such cases unless there is a persistent 4-fold rise in VDRL titre (eg 1:8 becomes 1:32) on follow up.






 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow