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Is Benzathine Penicillin Injection The Treatment Of Choice For Syphilis?
Question: Thanks doctor for your reply, another questions :
o with VDRL 1/16, must I still take another antibiotics or penicilin injection?
o currently, my left eyes can't see clearly and the doctor said that my retina has swollen and this caused by stress. Is this also caused by sipilis?
o i am afraid that I also can suffer by HIV, what is the syndroms of this HIV?
Thanks
o with VDRL 1/16, must I still take another antibiotics or penicilin injection?
o currently, my left eyes can't see clearly and the doctor said that my retina has swollen and this caused by stress. Is this also caused by sipilis?
o i am afraid that I also can suffer by HIV, what is the syndroms of this HIV?
Thanks
Brief Answer:
Your VDRL titres are falling as expected
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern. I have also reviewed the recent discussion which you had with our other doctor, though you have note mentioned what form of treatment which was given to you for syphilis.
Injection benzathine penicillin G 2.4 MU, 1/2 inn each buttock is the treatment of choice for syphilis. Alternative treatments include doxycycline, ceftriaxone etc
After adequate treatment fo syphilis, VDRL titres usually fall 4-fold within 3 months e.g an initial VDRL titre of 1:32 would reduce down to 1:8 when it is measured again at 3 months. Your VDRL titres have fallen 2-fold within 1 month of treatment i.e came down to 1:16 from initial titres of 1:32, suggests that the titres are falling as expected and would continue to fall further.
TPHA on the other hand stays positive for a long time and even for a lifetime and titres of TPHA are not useful for monitoring treatment of syphilis.
Hiv may initially present with symptoms like fever, rash, thrush, lympadenopathy etc and later when immunodeficiency sets in, as frequent infections bacterial and fungal infections, weight loss, diarrhea, reactivation of pulomonary tuberculosis, reactivation of herpes e.g Zoster etc etc. These presentations depend on the stage of HIV infection and requires an index of suspicion based on sexual history. Hiv infection may be completely asymptomatic at an early stage and detected only when imunodeficiency (AIDS) sets in.
I would like to know why do you think that you could also suffer from HIV? Are you sexual active? If yes, do you have a single or multiple sexual partners?? Is there a recent history of a risky sexual contact(s)?? Was it protected or unprotected?
Regards
Your VDRL titres are falling as expected
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern. I have also reviewed the recent discussion which you had with our other doctor, though you have note mentioned what form of treatment which was given to you for syphilis.
Injection benzathine penicillin G 2.4 MU, 1/2 inn each buttock is the treatment of choice for syphilis. Alternative treatments include doxycycline, ceftriaxone etc
After adequate treatment fo syphilis, VDRL titres usually fall 4-fold within 3 months e.g an initial VDRL titre of 1:32 would reduce down to 1:8 when it is measured again at 3 months. Your VDRL titres have fallen 2-fold within 1 month of treatment i.e came down to 1:16 from initial titres of 1:32, suggests that the titres are falling as expected and would continue to fall further.
TPHA on the other hand stays positive for a long time and even for a lifetime and titres of TPHA are not useful for monitoring treatment of syphilis.
Hiv may initially present with symptoms like fever, rash, thrush, lympadenopathy etc and later when immunodeficiency sets in, as frequent infections bacterial and fungal infections, weight loss, diarrhea, reactivation of pulomonary tuberculosis, reactivation of herpes e.g Zoster etc etc. These presentations depend on the stage of HIV infection and requires an index of suspicion based on sexual history. Hiv infection may be completely asymptomatic at an early stage and detected only when imunodeficiency (AIDS) sets in.
I would like to know why do you think that you could also suffer from HIV? Are you sexual active? If yes, do you have a single or multiple sexual partners?? Is there a recent history of a risky sexual contact(s)?? Was it protected or unprotected?
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thx doctor. Yes before . I was a sexual active with multiple partners and unprotected. I don't know about their background.
For the sympthoms above. I think I have severals last time but is that sympthoms are also same for the syphilis ?
Last time, my weight are losing 5 kg but now my weight are getting back.
I'm really afraid for this.
Doctor how about with my eyes as I mention before?
Another thing, is this discussion are threated confindential? Will not uploaded to your web?
Thx
For the sympthoms above. I think I have severals last time but is that sympthoms are also same for the syphilis ?
Last time, my weight are losing 5 kg but now my weight are getting back.
I'm really afraid for this.
Doctor how about with my eyes as I mention before?
Another thing, is this discussion are threated confindential? Will not uploaded to your web?
Thx
Brief Answer:
I suggest you to take a test for Hiv
Detailed Answer:
Hi.
History of unprotected sexual contact with differenr partners is a risk factor for Hiv, therefore, suggest that you get tested for Hiv (a 4th generation Hiv test i.e P 24 antigen and anti-Hiv antibody test would be reliable if your last risky sexual contact was at least 4 weeks ago).
Presence or absence of symptoms is a not a reliable criteria for confirming or ruling out an infection because Hiv and syphilis can be completely asymptomatic Or present with non-specific symptoms initially.
Regarding eye I think you should better follow the advice of your eye specialist.
Yes, this discussion and your identity is confidential.
Regards
take care
I suggest you to take a test for Hiv
Detailed Answer:
Hi.
History of unprotected sexual contact with differenr partners is a risk factor for Hiv, therefore, suggest that you get tested for Hiv (a 4th generation Hiv test i.e P 24 antigen and anti-Hiv antibody test would be reliable if your last risky sexual contact was at least 4 weeks ago).
Presence or absence of symptoms is a not a reliable criteria for confirming or ruling out an infection because Hiv and syphilis can be completely asymptomatic Or present with non-specific symptoms initially.
Regarding eye I think you should better follow the advice of your eye specialist.
Yes, this discussion and your identity is confidential.
Regards
take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thx doctor for your advice but I think I haven't been ready for this test.
I heard that someone who got HIV and syphilis even he got injection or medicine for the syphilis then the vdrl test is also won't have a different from bef take the medicine, is this parameter can be used for determine thet someone is also have an HIV?
Thx
I heard that someone who got HIV and syphilis even he got injection or medicine for the syphilis then the vdrl test is also won't have a different from bef take the medicine, is this parameter can be used for determine thet someone is also have an HIV?
Thx
Brief Answer:
I suggest specific tests for Hiv.
Detailed Answer:
Hi.
HIV has to be either ruled out or confirmed only by specific tests. Most of the times there is no direct co-relation between HIV infection and VDRL titres even though in cases of Hiv and syphilis co-infection, vdrl titres may not fall as expected or stay elevated even after adequate treatment for syphilis has been given.
Regards
I suggest specific tests for Hiv.
Detailed Answer:
Hi.
HIV has to be either ruled out or confirmed only by specific tests. Most of the times there is no direct co-relation between HIV infection and VDRL titres even though in cases of Hiv and syphilis co-infection, vdrl titres may not fall as expected or stay elevated even after adequate treatment for syphilis has been given.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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