syphilis ,what to know?

syphilis, what to know?

Recommended approach to the treatment of syphilis. (IM = intramuscular; HIV = human immunodeficiency virus; CSF = cerebrospinal fluid; IV = intravenous)

*--Alternative treatments for nonpregnant penicillin-allergic patients: doxycycline (Vibramycin), 100 mg taken orally twice daily for 2 weeks, or tetracycline, 500 mg taken orally four times daily for 2 weeks; limited data support efficacy for ceftriaxone (Rocephin), 1 g once daily IM or IV for 8 to 10 days, or azithromycin (Zithromax), 2 g orally (single dose).

†--Alternative treatments for nonpregnant penicillin-allergic patients: doxycycline, 100 mg taken orally twice daily for 4 weeks, or tetracycline, 500 mg taken orally four times daily for 4 weeks.

Selected Differential Diagnosis of Genital Lesions

DISORDER OR DISEASE	CHARACTERISTICS OF GENITAL LESION	ETIOLOGY
Primary syphilis: chancre	Solitary, painless ulcer with indurated border	Treponema pallidum
Secondary syphilis: condyloma latum	Slightly raised or flat, round or oval papules covered by gray exudate	T. pallidum
Genital herpes	Cluster of shallow, small, painful ulcers on a red base	Herpes simplex virus
Chancroid	Painful ulcer with sharp, undermined borders	Haemophilus ducreyi
Venereal warts	Soft, usually painless skin-colored or red papules	Human papillomavirus
Lymphogranuloma venereum: primary stage	Painless papule, shallow erosion, or ulcer; may be multiple or single	Chlamydia trachomatis