Syphilis

Primary, secondary, or latent syphihs of less dian 1 year s duration 

Benzathine penicilhn G 2.4 milhon units IM in a single dose 

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In the late fifteenth century AD mercury was successfully used as a treatment for syphilis. In the late sixteenth century the development of the Patio process for the recovery of silver by amalgamation (see Silverand silveralloys) greatiy increased the consumption of mercury. Usage of mercury increased in 1643 when Torricelli invented the barometer, and again in 1720 when Fahrenheit invented the mercury thermometer. Other scientific and medical appHcations foUowed. Industrial usage after 1900, particularly in electrical appHcations, expanded rapidly, offsetting the sharp decline in its use in amalgamation. 

In certain diseases, such as osteomalacia, syphilis, and osteomyeHtis, bones break spontaneously and without a trauma. The severity of the fracture usually depends on the force that caused the fracture. If a bone s breaking point was exceeded only slightly, then the bone may crack rather than break all the way through. If the force is extreme, such as in an automobile collision or a gunshot, the bone may shatter. An open or compound fracture is particularly serious because infection is possible in both the wound and the bone. A serious bone infection can result in amputation. 

Bismuth compounds were once employed for the treatment of amoebic dysentery, certain skin diseases, and several spirochetal diseases besides syphilis, but these substances are now seldom considered the dmgs of choice. Various insoluble preparations of bismuth, especially the subcarbonate, subnitrate, subgaHate, subcitrate, and subsahcylate, are stiU employed for the treatment of ulcers and other gastrointestinal disorders, even though use for these purposes is often supported largely by tradition. With a few possible exceptions, it is now difficult to justify the presence of bismuth compounds in a modem therapeutic armamentarium. A review of the biological activity of organobismuth compounds has been pubHshed (179). 

Paracelsus, a Swiss physician of the sixteenth century, stated that everything is toxic, it is just the dose that matters. This statement still holds true 500 years after Paracelsus developed it to defend the use of toxic compounds such as lead and mercury in the treatment of serious diseases such as syphilis. Chemical compounds cause their toxic effects by inducing changes in cell physiology and biochemistry, and an understanding of cellular biology is a prerequisite if one wishes to understand the nature of toxic reactions. 

Venerie, /. venereal disease, specif, syphilis, venerisch, a. syphilitic. 

The natural and semi ynthetic penicillins are used in tire treatment of bacterial infections due to susceptible microorganisms. Fbnicillins may be used to treat infections such as urinary tract infections, septicemia, meningitis, intra-abdominal infection, gonorrhea, syphilis, pneumonia, and other respiratory infections. Examples of infectious microorganisms (bacteria) that may respond to penicillin therapy include gonococci, staphylococci,... 

The well-known adverse reaction formerly often observed after intramuscular injection of clemizol penicilUn in the treatment of syphilis with anaphylaxis-like symptoms plus CNS involvement in the absence of immimological sensitization to penicillin was called the Hoigne syndrome or embolic-toxic reaction, and might be explained by intravasal appUcation of LA with subsequent toxic effects [8]. 

Treponema pallidum is the causal organism of syphilis. Treponema pertenue causes the tropical disease called yaws. 

Propagated outbreaks of infection relate to the direct transmission of an infective agent from a diseased individual to a healthy, susceptible one. Mechanisms of such transmission were described in Chapter 4 and include inhalation of infective aerosols (measles, mumps, diphtheria), direct physical contact (syphilis, herpes virus) and, where sanitation standards are poor, through the introduction of infected faecal material into drinking water (cholera, typhoid). The ease oftransmission, and hence the rate of onset of an epidemic (Fig. 16.3) relates not only to the susceptibility status, and general state of health of the individuals but also to the virulence properties of the organism, the route oftransmission, the duration of the infective period associated with the disease. 

However, the pregnancies of 67 percent of all mothers were complicated by a variety of medical problems including anemia, hepatitis B, syphilis, and psychiatric emergencies. At the time of delivery, 57 percent of mothers of full-term infants and 80 percent of mothers of preterm infants were noted to have had one or more medical problems during the pregnancy. Seventy-five percent of... 

Jarisch-Herxheimer reaction following treatment of syphilis, brucellosis, schistosomiasis, or trypanosomiasis... 

Venereal Disease Research Laboratory slide test (VDRL) for syphilis... 

Syphilis. Early disease may be characterized by a single genital lesion. Diagnosed by positive serologic testing [e.g., VDRL or rapid plasma reagin (RPR) test]. 

Cleocin/Garamycin) Syphilis dosed based on pharmacokinetics x 14 days ... 

Treat syphilis during lactation with benzathine penicillin G or any of the CDC-recommended alternatives for penicillin-allergic patients (Table 44-5). All choices are deemed compatible with breast-feeding by the AAP.14... 

Penicillin desensitization is the most common drug desensitization protocol and is required for penicillin-allergic patients when penicillin is clearly the best treatment option, e.g., when syphilis is present in pregnancy. Protocols have been adapted to most antibiotics. Tables 51-5 and 51-6 describe procedures for oral and intravenous penicillin desensitization.25... 

Note CF may produce false-positive reactions in those exposed to leishmaniasis, syphilis, and malaria. PCR may be more definitive for diagnosis.)... 

Parenteral penicillin is the drug of choice for all stages of syphilis. 

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