Soarawee Weerasopone, Urologist
Samitivej Sriracha hospital, Thailand
We Wellness clinic, Chonburi Thailand
Royal Phnom Penh hospital, Cambodia
In Cambodia, there’s a plenty of syphilis-positive patients which come to see me at my Urology office. Some are naïve cases whereas some are treatment-fail cases from other local clinics. This topic we will show you on how generally we’re dealing with this infection and how to correct the proper treatment on it, more than that we will show you on how to successfully confirm the treatment.
From latest 2015 USA Center of Disease Control (CDC) on Syphilis treatment, they have been recommended as follow.
- Treatment regimens
- Benzathine Penicillin G intramuscular injection as FIRST line regimen.
- Oral Doxycycline or Tetracycline as ALTERNATIVE regimens.
- Patient educated
- Avoid all sexual contacting (including oral sex) until after completion of treatment and the resolutions of all symptoms.
- The magic number is 7 days after completion of the treatment course which is all lesions were healed.
- Avoid contacting with ongoing sexual partners unless we make sure that those partners have been seeking the medical evaluation and confirmed that they are being free infected from Syphilis.
- Patients shall do the observation on the Syphilis-specific reaction from that treatment called “Jarisch-Herxheimer Reaction”. The reaction usually occurs within 24 hours after the initial treatment. The symptoms included generalized rash, fever, malaise, myalgia, nausea, vomiting and headache. This reaction happens from the endotoxin which released from dead Syphilis. Don’t be worried, all symptoms will resolve within 24 hours safely.
- Other Sexually transmitted diseases such as HIV, Gonorrhea and Chlamydia must put on suspicious and will highly recommend doing the tests.
- Follow up plan
- VDRL blood test is the tool we’re using to observe a successful treatment in Syphilis.
- 4-fold decline in VDRL test consider as successful treatment.
- Mostly the VDRL will turn negative 6 – 12 months after successful Syphilis treatment.
Any questions, you can discuss with your trusted Urologist or just text me! See you in next topic.
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