1/3. Inadequate treatment of syphilis in pregnancy.pregnant women with untreated syphilis have high rates of adverse pregnancy outcome. Early syphilis in pregnancy, if not treated, results in 40% loss either by spontaneous abortions, stillbirth, or perinatal death. Another 40% of such pregnancies result in an infant born with congenital syphilis. Only 20% of such pregnancies result in a normal infant. Currently recommended treatment of early syphilis in pregnant women uses a dosage of 2.4 million U of benzathine penicillin G. Because of the potentially disastrous effect syphilis has on pregnancy outcome, the occurrence of any treatment failure must be considered seriously. In this brief report we present clinical summaries of four pregnant women treated for syphilis who represent probable treatment failures.- - - - - - - - - - ranking = 1keywords = treatment failure (Clic here for more details about this article) |
2/3. Syphilitic neuroretinitis.Four patients (three men, 32, 43, and 53 years old, and one 37-year-old woman) with syphilitic neuroretinitis had cerebrospinal fluid evidence of neurosyphilis. Therapy failed in one patient given penicillin g benzathine intramuscularly and it may have failed in a second patient. Another treatment failure occurred in a patient given tetracycline orally. Intramuscular penicillin g benzathine or intramuscular penicillin g procaine in doses of less than 2.4 million units/day does not produce spirocheticidal drug levels in the cerebrospinal fluid. All four patients improved after high-dose treatment with aqueous penicillin G.- - - - - - - - - - ranking = 0.5keywords = treatment failure (Clic here for more details about this article) |
3/3. Congenital syphilis after treatment of maternal syphilis with a penicillin regimen exceeding CDC guidelines.BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasional treatment failures and the importance of adequate follow-up of infants at risk for congenital syphilis.- - - - - - - - - - ranking = 0.5keywords = treatment failure (Clic here for more details about this article) |