Queries and Minor Notes: Effectiveness of Prolonged Antisyphilitic Treatment
May 1948
in “
Journal of the American Medical Association
”
TLDR The reply suggests checking for false positive or asymptomatic syphilis and using penicillin for treatment if necessary.
A physician from Iowa questioned the effectiveness of prolonged antisyphilitic treatment for a 42-year-old man with positive syphilis tests but no venereal disease history, after 20 months of treatment with oxophensarsine hydrochloride and bismuth subsalycilate. The reply highlighted the need for initial and monthly titered serologic tests to assess the patient's status accurately. It was proposed that the patient might have a false positive or asymptomatic central nervous system syphilis, which should be checked with a lumbar puncture. If central nervous system involvement was confirmed, hospitalization and treatment with crystalline penicillin G were recommended. If the lumbar puncture and cardiovascular examination were normal, the patient might have late latent syphilis, and further treatment could be unnecessary. The response also indicated a preference for penicillin over heavy metal therapy, though the latter could be used as an adjunct.
