Perform CSF exam in all pts w 3 syphilis

By rray, 21 June, 2024
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<sup>1</sup> Some providers treat pts who have cardiac syphilis w/ a neurosyphilis regimen.<br><br>
<sup>2</sup> Limited data available on clinical response and f/u of 3° syphilis.
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<sup>3</sup> Based on limited data. Cross-sensitivity between ceftriaxone and penicillin can occur, but risk for penicillin cross-reactivity between 3rd-gen cephs is negligible. If safety concern, perform skin test and desensitize in consultation w/ specialist.
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<sup>4</sup> Jarisch-Herxheimer: Acute febrile rxn (HA, myalgia, fever, other sx) can occur w/in first 24h after the initiation of syphilis tx; most frequent among pts w/ early syphilis. Antipyretics can be used to manage sx, but not proven to prevent the rxn.
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Perform CSF exam in all pts w/ 3° syphilis