(1) Treatment of choice. In its primary or secondary stages, syphilis can be
easily treated with one injection of penicillin. The injection is penicillin G benzathine
Bicillin in the dosage 2.4 million units intramuscularly. If the patient has had syphilis for
more than a year, it is probably late syphilis requiring penicillin G benzathine Bicillin in
the dosage of 2.4 million units intramuscularly once a week for three weeks.
(2) Alternative treatments. An alternative treatment is to use aqueous
procaine penicillin G (Wycillin) 600,000 units daily by intramuscular injection for 8 to 12
days. For patients allergic to penicillin, give tetracycline or erythromycin. Tetracycline
(Tetracyn)) should be given in the dosage of 500 mg by mouth four times a day for 15
days. Give erythromycin (Erythrocin)) in the dosage of 500 mg by mouth four times a
day for 15 days to 30 days.
h. Additional Considerations.
(1) Be sure the patient understands how important it is to follow the
treatment even after all his symptoms have disappeared.
Lesions of secondary syphilis must be kept clean and dry.
Treat symptoms of late syphilis.
(4) Suggest to patients that they have VDRL testing at intervals after
beginning therapy to detect a possible relapse. Testing should be once a month for the
first 3 months, then the patient should be tested at the 6th month, 12th month, and the
(5) Suggest strongly that patients with syphilis tell their sexual partners of
the infection so that these partners can also be tested and treated. (This may be
required by state law.)
Herpes simplex is a recurrent viral infection which is caused by Herpesvirus
hominis (HVH). There are two types of herpes simplex: Herpes Type I and Herpes
Type II. Herpes Type I is transmitted by oral and respiratory secretions and affects the
skin and mucous membranes. This type of herpes virus commonly causes cold sores
and fever blisters. Herpes Type II, the virus to be dealt with in this lesson, primarily
affects the genital area. This virus is transmitted by sexual contact. About 40 million
Americans have herpes type II (also known as genital herpes). It is estimated that
500,000 new cases of genital herpes occur each year. Herpes type II reached epidemic
When vesicles occur on the genitalia, the condition is known as herpes progenitalis.