Clinical management of Syphilis in Uganda
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Clinical Stages
Primary: 10-90 days, painless genital ulcer. Secondary: weeks-months, generalized rash, mucous patches, condyloma lata, lymphadenopathy. Early latent: <1 year. Late latent: >1 year, quiescent. Late (tertiary): skin/bone tumours, aortitis, neurosyphilis.
Investigations
Non-treponemal (VDRL/RPR) - screening. Treponemal (TPHA) - confirmation.
Treatment
Primary, secondary, and early latent syphilis
Benzathine penicillin 2.4 million IU IM stat (half in each buttock). OR Doxycycline 100 mg every 12 hours for 14 days.
Late latent or tertiary (without neurosyphilis)
Benzathine penicillin 2.4 million IU IM weekly for 3 weeks. OR Doxycycline 100 mg every 12 hours for 28 days.
Neurosyphilis
Benzylpenicillin 4 million IU IV every 4 hours OR Ceftriaxone 2 g IV/IM daily for 10-14 days. Followed by Benzathine penicillin 2.4 million IU IM weekly for 3 weeks.
Clinical Tools