Post-Treatment Concerns for Syphilis: When to Seek Medical Advice

Q: Post-Treatment Concerns for Syphilis: When to Seek Medical Advice

Hello： One injection of penicillin is the treatment method, followed by regular check-ups and long-term blood tests. <br>If the levels rise fourfold, further treatment is necessary. <br>Long-term monitoring is essential, and once stable, blood tests should be done once a year. <b

Post-treatment issues of syphilis?

Hello doctor, I discovered red spots on my hand on July 1st.
That same day, I took a rapid test and confirmed that I have syphilis.
I immediately went to the hospital for treatment, and the doctor said it is stage 2 syphilis, with a titer of 32.
He mentioned that one injection would be sufficient.
Is that true?
It has been two weeks, and the red spots on my hand have slowly started to disappear, but a few days ago, I impulsively picked at the peeling skin, and now the red spots have not only not disappeared but have also become a bit more pronounced and painful.
The area where I peeled the skin has not healed.
Should I see a doctor again?
Also, how long should I wait before engaging in intimate contact with others to avoid transmitting the infection to them (while using a condom)?

Ani, 20~29 year old female. Ask Date: 2019/07/14

Dr. Du Shixi reply Urology

Hello: One injection of penicillin is the treatment method, followed by regular check-ups and long-term blood tests.
If the levels rise fourfold, further treatment is necessary.
Long-term monitoring is essential, and once stable, blood tests should be done once a year.
Syphilis (a Class III notifiable infectious disease) has a dedicated page on the CDC website.
The main transmission routes for syphilis are unprotected sexual intercourse, blood transmission, and vertical transmission from mother to child.
Sexual contact is the primary mode of transmission, accounting for the vast majority of cases.
Therefore, practicing safe sex is crucial, as the early infectious period of syphilis is the most contagious.
As the disease progresses over time, the infectiousness decreases; generally, after 4 to 5 years post-infection, the risk of transmission through sexual contact is very low, but precautions should still be taken, and regular blood tests are recommended.
Of course, patients who have been confirmed cured of syphilis can engage in normal sexual activity.
However, we advocate for the use of condoms during sexual intercourse, as there is a certain rate of recurrence for syphilis.
Additionally, your sexual partners should also be tested, not just the patient.
Wishing you good health.
https://www.cdc.gov.tw/Disease/SubIndex/0m_BXsu8AnI7slMt75OUaQ

Reply Date: 2019/07/14

More Info

When it comes to post-treatment concerns for syphilis, it is essential to understand the nature of the disease, the treatment process, and the necessary follow-up care. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum, and it can present in several stages, with secondary syphilis characterized by skin rashes and lesions.
In your case, you mentioned that you were diagnosed with secondary syphilis on July 1st and received a single injection of benzathine penicillin, which is the standard treatment for this stage of the infection. The treatment is generally effective, and many patients see an improvement in their symptoms shortly after receiving the injection. However, it is crucial to monitor your condition post-treatment to ensure that the infection has been adequately addressed.

Regarding your concerns about the red spots on your hand, it is not uncommon for lesions to take some time to heal after treatment. The fact that you noticed improvement initially is a positive sign. However, the act of picking at the skin can lead to irritation, inflammation, or even secondary infections, which may explain why the area has become more painful and noticeable. It is advisable to avoid picking at any lesions, as this can exacerbate the problem and delay healing.

Given your symptoms, it would be prudent to seek medical advice. A healthcare provider can assess the affected area, determine if there is any secondary infection or other complications, and provide appropriate treatment if necessary. They can also offer guidance on wound care to promote healing and prevent further irritation.

As for your question about resuming intimate contact, the Centers for Disease Control and Prevention (CDC) recommends that individuals wait until they have completed treatment and have been confirmed as cured before engaging in sexual activity. For syphilis, this typically means waiting until you have received the appropriate treatment and have had follow-up testing to confirm that the infection has been cleared. In general, it is advisable to wait at least 7 days after treatment before having sexual contact, even with a condom, as condoms do not provide complete protection against syphilis due to the possibility of lesions outside the covered area.

In summary, it is essential to follow up with your healthcare provider regarding the healing of your skin lesions and to discuss when it is safe to resume intimate contact. They can provide personalized advice based on your specific situation and ensure that you are on the right track to recovery. Remember, open communication with your healthcare provider is key to managing your health effectively.

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