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Syphilis Clinical Recommendations Primary Syphilis 1. Clinicians should routinely assess all patients with the following signs or symptoms of syphilis: genital, oral or rectal ulcers or chancres rash Alopecia 2. Sexually active patients with any risk factors for syphilis infection should be tested for syphilis. Individuals at risk for syphilis infection include those who: engage in unprotected sex have multiple or anonymous partners are infected with HIV Penile Chancre Syphilitic Mouth Ulcer 3. Patients diagnosed with syphilis (and their partners) should receive immediate treatment per the CDC treatment guidelines for syphilis. (See Reverse Side) http://www.cdc.gov/std/treatment/2010/genital-ulcers.htm STD Treatment Pocket Guide http://www.cdc.gov/std/treatment/2010/pdf/2011-Booklet-Whole-Press.pdf 4. All patients with suspected or confirmed syphilis should receive an HIV test if not already known to be HIV positive. Anorectal Syphilitic Chancre Labia Chancre Secondary Syphilis 5. Suspected cases syphilis should be reported within 24 hours of diagnosis to the local county health department. Information for Medical Providers http://www.wakegov.com/humanservices/publichealth/providers/Pages/defaul t.aspx 919-250-4462 Palmar Syphilis Rash Syphilis Rash on the Torso Syphilis Alopecia Source: NC DHHS Communicable Disease Branch, March 2015 Centers for Disease Control & Prevention Syphilis Treatment Guidelines Primary, Secondary, & Early Latent Syphilis - Benzathine Penicillin G 2.4mu IM x1 - Doxycycline 100mg BID x 14 days (PCN allergy) • Late Latent Syphilis - Benzathine Penicillin G 2.4 mu IM q weekly x 3 - Doxycycline 100 mg BID x 28 days (PCN allergy) • Tertiary Syphilis, Neurosyphilis & Congenital Syphilis Infectious Disease Consult Recommended! Wake County Communicable Disease 919-250-4462 CDC Fact Sheet http://www.cdc.gov/std/syphilis/stdfactsyphilis-detailed.htm Syphilis Case Management Wake County Human Services Disease Intervention Specialists 919-250-4422 North Carolina Communicable Disease Branch Disease Intervention Specialists 919-715-4283 Wake County Human Services Resources Health Education & Outreach Wake County HIV/STD Education 919-250-3883 [email protected] SYPHILIS “The Great Imitator” Community Counseling & Testing Non-Traditional Testing Site Infoline 919-250-3950 Non-Traditional Testing Site Locations http://www.wakegov.com/humanservices/publich ealth/information/hiv/Pages/default.aspx Clinical Testing and Treatment Wake County Public Health Center Clinic A 919-250-4410 First come, first served. Monday, Wednesday, Thursday and Friday: Sign-in: 8:30 a.m. and 12:30 p.m. Tuesday: Sign-in: 9:30 a.m. and 12:30 p.m. Wednesday Evening Clinic: Sign-in: 4:30 p.m. Syphilis Management Recommendations